Regret around fertility choices is decreased with pre-treatment counseling in gynecologic cancer patients

Chan, Jessica; Letourneau, Joseph M.; Salem, Wael; Cıl, Aylin Pelin; Chan, Si-Wa; Chen, Lee-may; Rosen, Mitchell P.

doi:10.1007/s11764-016-0563-2

Cited by 41 publications

(33 citation statements)

References 22 publications

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“…This association was not apparent in the current study sample. Similarly, the data from the current study support the lower end of the range of previous reports regarding how often reproductive‐age women diagnosed with cancer receive fertility counseling (34%‐81%) . The low prevalence of fertility counseling in the current study sample (33%) may reflect practice differences in our geographically diverse sample .…”

Section: Discussionsupporting

confidence: 84%

“…Similarly, the data from the current study support the lower end of the range of previous reports regarding how often reproductive-age women diagnosed with cancer receive fertility counseling (34%-81%). [17][18][19][20][21][22][23][24][25][26] The low prevalence of fertility counseling in the current study sample (33%) may reflect practice differences in our geographically diverse sample. 15 Uptake of in vitro fertilization services also may vary based on state-mandated insurance coverage.…”

Section: Discussionmentioning

confidence: 79%

“…Rates of receipt of fertility counseling have been reported to range from 34% to 81% across prior studies . 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 .…”

Section: Introductionmentioning

confidence: 99%

“…Rates of receipt of fertility counseling have been reported to range from 34% to 81% across prior studies. [17][18][19][20][21][22][23][24][25][26][27][28] Fertility counseling is more often received by women who are younger, 18 have lower parity, 17,18,22,29,30 a higher educational level, 17,18 higher income, 22,31 non-Hispanic white ethnicity, 21,32 and insurance coverage. 22 Among women who do receive counseling, lower use of fertility preservation has been associated with concerns about cost, 9,33…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…Fertility preservation counseling is not only beneficial in assisting with treatment decision‐making, via lower decisional conflict or regret, but has a significant impact on emotional health. A systematic review has indicated that lack of fertility preservation counseling is associated with poorer quality of life and mental health outcomes .…”

Section: Psychological Supportmentioning

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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Survival outcomes following pregnancy or assisted reproductive technologies after breast cancer: A population‐based study

Rauh-Hain

Zubizarreta

Nitecki

et al. 2022

Cancer

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BACKGROUND: This study sought to determine the impact of pregnancy or assisted reproductive technologies (ART) on breastcancer-specific survival among breast cancer survivors. METHODS: The authors performed a cohort study using a novel data linkage from the California Cancer Registry, the California birth cohort, and the Society for Assisted Reproductive Technology Clinic Outcome Reporting System data sets. They performed risk-set matching in women with stages I-III breast cancer diagnosed between 2000 and 2012. For each pregnant woman, comparable women who were not pregnant at that point but were otherwise similar based on observed characteristics were matched at the time of pregnancy. After matching, Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of pregnancy with breast-cancer-specific survival. We repeated these analyses for women who received ART. RESULTS: Among 30,021 women with breast cancer, 553 had a pregnancy and 189 attempted at least one cycle of ART. In Cox proportional hazards modeling, the pregnancy group had a higher 5-year disease-specific survival rate; 95.6% in the pregnancy group and 90.6% in the nonpregnant group (HR, 0.43; 95% CI, 0.24-0.77). In women with hormone receptorpositive cancer, we found similar results (HR, 0.43; 95% CI, 0.2-0.91). In the ART analysis, there was no difference in survival between groups; the 5-year disease-specific survival rate was 96.9% in the ART group and 94.1% in the non-ART group (HR, 0.44; 95% CI, 0.17-1.13). CONCLUSION: Pregnancy and ART are not associated with worse survival in women with breast cancer.

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Regret around fertility choices is decreased with pre-treatment counseling in gynecologic cancer patients

Cited by 41 publications

References 22 publications

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

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

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

Survival outcomes following pregnancy or assisted reproductive technologies after breast cancer: A population‐based study

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