Quality of integrated female oncofertility care is suboptimal: A patient‐reported measurement

Abstract

Background Clinical practice guidelines recommend to inform female cancer patients about their infertility risks due to cancer treatment. Unfortunately, it seems that guideline adherence is suboptimal. In order to improve quality of integrated female oncofertility care, a systematic assessment of current practice is necessary. Methods A multicenter cross‐sectional survey study in which a set of systematically developed quality indicators was processed, was conducted among female cancer patients (diagnosed in 2016/2017). These indicators represented all domains in oncofertility care; risk communication, referral, counseling, and decision‐making. Indicator scores were calculated, and determinants were assessed by multilevel multivariate analyses. Results One hundred twenty‐one out of 344 female cancer patients participated. Eight out of 11 indicators scored below 90% adherence. Of all patients, 72.7% was informed about their infertility, 51.2% was offered a referral, with 18.8% all aspects were discussed in counseling, and 35.5% received written and/or digital information. Patient's age, strength of wish to conceive, time before cancer treatment, and type of healthcare provider significantly influenced the scores of three indicators. Conclusions Current quality of female oncofertility care is far from optimal. Therefore, improvement is needed. To achieve this, improvement strategies that are tailored to the identified determinants and to guideline‐specific barriers should be developed.

Pre-treatment fertility preservation and post-treatment reproduction in long-term survivors of adolescent and young adult (AYA) cancer

“…Accordingly, very few women completed cryopreservation, which tripled after 2013 due to the introduction of oocyte cryopreservation as a non-experimental option, and some even completed OTC at that time. Similar low cryopreservation rates of women treated in these times have been described previously [62,63], and fertility-related counseling in female cancer patients continues to be suboptimal [64]. Additional research in more recently treated AYA women is needed.…”

Patient-Reported Outcomes (PROs) and Patient Experiences in Fertility Preservation: A Systematic Review of the Literature on Adolescents and Young Adults (AYAs) with Cancer

“…In a few studies, patients indicated that initiating the discussion was influenced by interpretation of social status (i.e., married, single, existing children) and that unwarranted assumptions are made about fertility desires and plans [24,27,33]. Also, (higher) age is seen as a factor for not offering FP services [9,39,52,54]. Studies, however, show that assumptions based on socio-demographic factors are not reliable determinants about a patient's fertility desires and needs [24,32,64].…”