Cancer Survivors' Use of Fertility Preservation

Bann, Carla; Treiman, Katherine; Squiers, Linda; Tzeng, Janice; Nutt, Stephanie; Arvey, Sarah R.; McGoldrick, Devon; Rechis, Ruth

doi:10.1089/jwh.2014.5160

Cited by 35 publications

(36 citation statements)

References 14 publications

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“…Fertility preservation and treatment are costly medical procedures (30, 31). Our results suggest that women who have no insurance or are publicly insured are less likely to receive fertility counseling.…”

Section: Discussionmentioning

confidence: 99%

Which female cancer patients fail to receive fertility counseling before treatment in the state of Georgia?

Chin

Howards

Kramer

et al. 2016

Fertility and Sterility

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Objective To assess which characteristics are associated with failure to receive fertility counseling among a cohort of young women diagnosed with cancer. Design A population-based cohort study. Setting Not applicable. Patients A total of 1,282 cancer survivors, of whom 1,116 met the inclusion criteria for the analysis. Interventions None. Main Outcome Measure(s) The main outcome in this study was whether or not women reported receiving any information on how cancer treatment might affect their ability to become pregnant at the time of their cancer diagnosis. Results Forty percent of cancer survivors reported that they did not receive fertility counseling at the time of cancer diagnosis. Women were more likely to fail to receive counseling if they had a high school education or less (OR=1.90, 95% CI: 0.97, 3.70) or if they had a prior birth (OR=1.92, 95% CI: 1.31, 2.81). Cancer related variables that were associated with a lack of counseling included not receiving chemotherapy as part of treatment (OR=4.39, 95% CI: 2.96, 6.51) and diagnosis with certain cancer types. Conclusions Counseling about the risk of infertility and available fertility preservation options is important to cancer patients. Additionally, counseling can make women aware other adverse reproductive outcomes such as early menopause and its associated symptoms. Less educated women and parous women are at particular risk of not getting fertility-related information. Programs that focus on training not just the oncologist, but also other healthcare providers involved with cancer care, to provide fertility counseling may help expand access.

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Section: Discussionmentioning

confidence: 99%

Which female cancer patients fail to receive fertility counseling before treatment in the state of Georgia?

Chin

Howards

Kramer

et al. 2016

Fertility and Sterility

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“…The best time to address concerns for future infertility is prior to oncologic treatment; however, in many cases, this is not fulfilled or patients who did receive counseling did not have adequate time or resources to complete preservation options before treatment onset [74,75].…”

Section: Fertility/pregnancy Concernsmentioning

confidence: 99%

Gynecologic Issues in the Pediatric and Adolescent Patient with Cancer

Trotman

Hoefgen

2016

Curr Treat Options Peds

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“…In female cancer survivors of reproductive age, pretreatment counseling regarding the potential fertility‐related complications of cancer treatment and options for fertility preservation has been associated with a higher quality of life . However, many young women diagnosed with breast cancer report that they were not informed about infertility risks before initiating cancer treatment . Since 2006, national guidelines from the American Society of Clinical Oncology (ASCO), the National Comprehensive Cancer Network, and the American Society for Reproductive Medicine have recommended fertility counseling for reproductive‐age patients with a cancer diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“…Fertility counseling is more often received by women who are younger, have lower parity, a higher educational level, higher income, non‐Hispanic white ethnicity, and insurance coverage . Among women who do receive counseling, lower use of fertility preservation has been associated with concerns about cost, treatment delay, and/or an adverse impact on their cancer treatment . In prior studies of reproductive‐age women diagnosed with cancer who wanted to retain their fertility, approximately 40% to 50% of women did not use fertility preservation …”

Section: Introductionmentioning

confidence: 99%

Fertility‐related experiences after breast cancer diagnosis in the Sister and Two Sister Studies

Bressler

Mersereau

Anderson

et al. 2019

Cancer

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Background Commonly used chemotherapies can be toxic to the ovaries. To the authors’ knowledge, the majority of studies evaluating receipt of fertility counseling for women in their reproductive years have been performed in specific settings, thereby limiting generalizability. Methods A nationwide sample of US women diagnosed with breast cancer before age 45 years completed a survey assessing the prevalence of fertility counseling. Age‐adjusted log‐binomial regression was used to estimate prevalence ratios (PRs) and 95% CIs for fertility counseling. Results Among 432 survivors diagnosed between 2004 and 2011, 288 (67%) had not discussed the effects of treatment on fertility with a health care provider before or during treatment. Fertility discussion was associated with younger age (PR, 3.49 [95% CI, 2.66‐4.58] for aged <35 years vs ≥40 years) and lower parity (PR, 1.81 [95% CI, 1.29‐2.53] for parity 1 vs 2). Approximately 20% of respondents reported that they were interested in future fertility (87 of 432 respondents) at the time of their diagnosis, but not all of these individuals (66 of 87 respondents) received counseling regarding the impact of treatment on their fertility, and few (8 of 87 respondents) used fertility preservation strategies. Among 68 women with a fertility interest who provided reasons for not taking steps to preserve fertility, reasons cited included concern for an adverse impact on cancer treatment (56%), lack of knowledge (26%), decision to not have a child (24%), and cost (18%). Conclusions Across multiple treatment settings, the majority of women of reproductive age who are diagnosed with breast cancer did not discuss fertility with a health care provider or use fertility preservation strategies. Discussing the potential impact of cancer treatment on future fertility is an important aspect of patient education.

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Cancer Survivors' Use of Fertility Preservation

Abstract: The study points to other areas for research in women's health, including the development of educational interventions with patients and providers to reduce gender disparities in FP and ensure timely patient-provider discussions related to fertility issues.

Cited by 35 publications

References 14 publications

Which female cancer patients fail to receive fertility counseling before treatment in the state of Georgia?

Which female cancer patients fail to receive fertility counseling before treatment in the state of Georgia?

Gynecologic Issues in the Pediatric and Adolescent Patient with Cancer

Fertility‐related experiences after breast cancer diagnosis in the Sister and Two Sister Studies

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