Study Objective
Survival into adulthood is now a reality for many adolescents facing cancer. FP (Fertility Preservation) is a rapidly advancing field, but oncology providers and health systems struggle to incorporate the newest FP technologies into the clinical care of adolescents. Our objective was to systematically review and synthesize the available data regarding the perspectives, experiences, and preferences of adolescents, parents, and oncology providers about FP to inform clinical implementation of FP technologies.
Design
Five electronic databases (PubMed, Embase, Web of Knowledge, CINAHL, PsychInfo) were systematically searched for studies published between January 1999 and May 2014. Adolescents were defined as 12-18y at diagnosis or designated as pubertal/post pubertal and <18yrs. Studies were assessed for methodological quality, data were extracted using a standardized form, and results were synthesized using guidelines for a narrative syntheses of both quantitative and qualitative data.
Results
In total, 1237 records were identified, with 22 articles, 17 unique studies meeting the inclusion criteria. The following topics were consistently observed across studies and populations: 1. “Fertility in Trust”, 2. Decision Making Challenges, 3. Provider Knowledge and Practices, and 4. Discrepancies between Desired and Actual Experiences.
Conclusions
Despite the challenges associated with a new cancer diagnosis, adolescents and parents value the opportunity to discuss fertility concerns and preservation options. Providers play an important role in addressing these topics for families and efforts should be made to incorporate FP discussions into routine cancer care for all adolescents, with attention paid to the unique needs of adolescents and their parents.