Fertility Preservation in Reproductive-Age Women Facing Gonadotoxic Treatments

Roberts, James W.; Ronn, Ruth; Tallon, Niamh; Holzer, Hananel

doi:10.3747/co.22.2334

Cited by 26 publications

(23 citation statements)

References 165 publications

(159 reference statements)

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“…As more young women with cancer survive, issues such as fertility preservation increase in importance. This is evident from the number of publications and guidelines that have been recently published (2)(3)(4)(5)(6). Despite these recommendations, the provision of fertility preservation remains low (7,8).…”

Section: Introductionmentioning

confidence: 95%

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Fertility preservation in post-pubescent female cancer patients: A practical guideline for clinicians

et al. 2017

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Abstract. Increasing accessibility of fertility preservation (FP) options has permitted women to retain fertility following anticancer therapies. Several published guidelines have made recommendations for FP however their implementation into practice is currently unknown. In this review, we aim to provide oncology clinicians practical information about FP options for post-pubescent female cancer patients and recommendations for care delivery in order to answer preliminary questions and help triage whether FP referral is appropriate. Herein, we present a resource for oncology providers to guide them with FP discussions. Key points that are discussed in this critical review include: i) All cancer patients beginning a new plan of care should be informed of potential fertility risk. ii) If a woman requests further information on FP interventions, referral to a FP clinic should be made. iii) Given the evolving technologies in this area, patients should be informed of those which are proven and unproven, with oocyte and embryo preservation recognized as standard practice. iv) Random start (independent of menstrual cycle day) techniques are available to minimize oncologic treatment delays. v) Specific protocols for ovarian stimulation may be center-specific. vi) There is unlikely an increased cancer recurrence risk as a result of stimulation protocols in women with hormone-sensitive cancers. vii) Lastly, given the absence of consensus in the literature, routine use of GnRH analogs is not recommended for all cancer patients, however may be considered in select cases, such as high-risk women in whom definitive FP is not possible or feasible.

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Section: Introductionmentioning

confidence: 95%

“…Many of these treatments can lead to detrimental impact on a woman's fertility, such as alkylating agents and radiation therapy (1,2). As more young women with cancer survive, issues such as fertility preservation increase in importance.…”

Section: Introductionmentioning

confidence: 99%

Fertility preservation in post-pubescent female cancer patients: A practical guideline for clinicians

et al. 2017

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“…Despite clinical practice guidelines recommending that fp options be discussed with all cancer patients 8,9 , many health care providers (hcps) fail to initiate those discussions with adolescents [10][11][12][13][14][15][16] . As a result, adolescents are less likely to have access to fp services and supports.…”

Section: What Is the Current Gap In Practice Related To Fertility Prementioning

confidence: 99%

Listening through Narratives: Using a Narrative Approach When Discussing Fertility Preservation Options with Young Cancer Patients

Roher

Gibson

et al. 2017

Current Oncology

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Despite clinical practice guideline recommendations mandating that fertility preservation be discussed with young cancer patients, many providers fail to initiate such discussions with adolescents. Researchers and clinicians often focus on system-level changes to improve access to fertility preservation for adolescents and young adults in Canada. However, little of the available information considers the way in which health care providers approach those discussions.Research has shown that, even when fertility preservation options are broached with adolescents, survivors often report dissatisfaction with those conversations, thus raising additional concerns about their content and quality. Here, we consider how a narrative approach-and the Frank narrative typology in particular-could improve the quality of such conversations by helping providers to more accurately and thoughtfully respond to the needs of adolescent patients when discussing the possibility of fertility preservation. Based on findings from a qualitative research project, we provide concrete suggestions for how to more sensitively approach fertility preservation conversations with male adolescent cancer patients and survivors.

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“…This finding is likely because provision of fertility information and increased knowledge lowers psychological distress and therefore clinicians with greater fertility expertise during a fertility consultation may be better equipped to respond to reproductive concerns. Moreover, guidelines recommend that increased collaboration between oncology and fertility experts, or a multidisciplinary approach, will increase the opportunity for timely and complete fertility counseling to occur …”

Section: Fertility Counselingmentioning

confidence: 99%

“…Within current guidelines, fertility counseling often refers to the consultation where threatened fertility is initially discussed, by a medical practitioner 42 or reproductive specialist, 41,[43][44][45][46] or simply reports on counseling as the provision of information without reference to counselor expertise. 32,33,39,40,[47][48][49] Fertility counseling, as a fertility information consultation, sits in line with the internationally recommended best-practice approach; for timely discussion and provision of information by a medical team.…”

Section: Recommendation (Including Non-cancer): None Statedmentioning

confidence: 99%

The psychological importance of fertility preservation counseling and support for cancer patients

Logan

Anazodo

2019

Acta Obstet Gynecol Scand

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Infertility associated with cancer can have significant psychological impacts for cancer patients and survivors, necessitating appropriate fertility‐related psychological support. This literature review details the psychological impact of infertility in cancer patients and survivors, and discusses fertility counseling as described in current international guidelines; as either the provision of fertility information or psychosocial support. Fertility counseling has a role in assisting with fertility treatment decision‐making, but also in supporting patients with the emotional distress associated with potential infertility at the time of cancer diagnosis, and infertility in survivorship. The necessity of psychological support for fertility patients is outlined, alongside recommendations for adolescent and young adult patients, and family members of cancer patients involved in fertility and oncological care. Moving forward, clear guidelines for fertility counseling of cancer patients in the context of fertility preservation may be beneficial, in removing ambiguity as to whom conducts counseling, what counseling involves, and what level of psychosocial support may be most effective in supporting cancer patients longitudinally.

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Fertility Preservation in Reproductive-Age Women Facing Gonadotoxic Treatments

Abstract: Background Advancements in the treatments for cancer and autoimmune and other hematologic conditions

Cited by 26 publications

References 165 publications

Fertility preservation in post-pubescent female cancer patients: A practical guideline for clinicians

Fertility preservation in post-pubescent female cancer patients: A practical guideline for clinicians

Listening through Narratives: Using a Narrative Approach When Discussing Fertility Preservation Options with Young Cancer Patients

The psychological importance of fertility preservation counseling and support for cancer patients

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