Discussion of fertility preservation with newly diagnosed patients: oncologists’ views

Quinn, Gwendolyn P.; Vadaparampil, Susan T.; Gwede, Clement K.; Miree, Cheryl A.; King, Lindsey; Clayton, Heather B.; Wilson, Crystal; Münster, Pamela N.

doi:10.1007/s11764-007-0019-9

Cited by 226 publications

(241 citation statements)

References 21 publications

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“…The success rates of these options range from 5 to 25% . Despite an increasing number of studies and guidelines demonstrating the need for discussion of FP issues with cancer patients, information provision about treatment-induced infertility and FP techniques and referral for FP are still not sufficient and often provided too late (Dunn & Steginga, 2000;Jenninga, Hilders, Louwe, & Peters, 2008;Nakayama et al, 2009;Quinn et al, 2007;Rosen, Rodriguez-Wallberg, & Rosenzweig, 2009;Thewes et al, 2005;Tschudin & Bitzer, 2009). …”

Section: Introductionmentioning

confidence: 99%

Feasibility and effects of a decision aid about fertility preservation

et al. 2016

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This paper reports on the feasibility and preliminary effects of a decision aid (DA) about female fertility preservation (FP). We conducted a pilot multicentre randomized controlled trial of women with breast cancer aged 18-40 who were randomized to brochures or the DA. Over 18 months, 62 women were eligible, of which 42 were invited by their healthcare provider (74%) to participate in the study. A total of 36 women signed up for participation and 26 (72%) were randomized to brochures (n ¼ 13) or the DA (n ¼ 13). In both groups, many women (87%) read the brochures and eight women used all available brochures. In the intervention group, 7/13 women logged in to the DA. Women who received brochures had slightly less decisional conflict, whereas knowledge improved in both groups. Our results indicate that both brochures about FP and a detailed DA have beneficial effects with regard to knowledge, but the DA seemed to introduce slightly more decisional conflict (DC) than the brochures. Although we encountered challenges with recruitment, our design and measurements seem feasible and the effects of the information materials seem promising, hence justifying conducting a larger study. ARTICLE HISTORY

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Section: Introductionmentioning

confidence: 99%

Feasibility and effects of a decision aid about fertility preservation

et al. 2016

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“…Unfortunately, these issues are still not routinely addressed by most physicians. 5,9 It is known that the rate of treatment-induced infertilityincreaseswithmoreaggressivechemotherapy. [10][11][12][13][14] However, there still are many open questions about the probability of amenorrhea, reduced ovarian reserve, and infertility after distinct chemotherapies and the impact of age at treatment onset, as well as about the chance of recovery and the risk of suffering from symptoms of hypogonadism.…”

Section: Introductionmentioning

confidence: 99%

Gonadal Function and Fertility in Survivors After Hodgkin Lymphoma Treatment Within the German Hodgkin Study Group HD13 to HD15 Trials

Behringer¹,

Mueller²,

Goergen³

et al. 2013

JCO

214

159

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A B S T R A C T PurposeTo optimize fertility advice in patients with Hodgkin lymphoma (HL) before therapy and during survivorship, information on the impact of chemotherapy is needed. Therefore, we analyzed gonadal functions in survivors of HL. Patients and MethodsWomen younger than age 40 and men younger than 50 years at diagnosis in ongoing remission at least 1 year after therapy within the German Hodgkin Study Group HD13 to HD15 trials for earlyand advanced-stage HL were included. Hormone parameters, menstrual cycle, symptoms of hypogonadism, and offspring were evaluated. ResultsA total of 1,323 (55%) of 2,412 contacted female and male survivors were evaluable for the current analysis (mean follow-up, 46 and 48 months, respectively). Follicle-stimulating hormone, anti-Mü llerian hormone, and inhibin B levels correlated significantly with therapy intensity (P Ͻ .001). Low birth rates were observed in survivors after advanced-stage treatment within the observation time (women, 6.5%; men, 3.3%). Regular menstrual cycle was reported by more than 90% of female survivors of early-stage HL (recovery time mostly Յ 12 months). After six to eight cycles of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone, menstrual activity was strongly related to age (Ͻ v Ն 30 years: 82% v 45%, respectively; P Ͻ .001; prolonged recovery time). Thirty-four percent of women age Ն 30 years suffered severe menopausal symptoms (three-to four-fold more frequently than expected). In contrast, male survivors had mean levels of testosterone within the normal range and reported no increased symptoms of hypogonadism. ConclusionThe present analysis in a large group of survivors of HL provides well-grounded information on gonadal toxicity of currently used treatment regimens and allows risk-adapted fertility preservation and comprehensive support during therapy and follow-up.

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“…Many barriers have been identified, including a lack of knowledge about fertility preservation options 44 and available local resources 45,46 , and the perception that assisted reproductive technologies are cost-prohibitive and of limited efficacy 47,48 . The constraints of time and concern about cancer treatment delay are also cited, but early involvement of the fertility specialist is critical for the provision of timely fertility preservation services 49,50 .…”

Section: Guidelines Early Access To Care and Barriers To Referralmentioning

confidence: 99%