Reply: Comment on ‘Fertility preservation in cancer survivors: a national survey of oncologists’ current knowledge, practice and attitudes’ – Oncologists must not allow personal attitudes to influence discussions on fertility preservation for cancer survivors

Little information about fertility preservation is provided for cancer patients: A survey of oncologists’ knowledge, attitude and current practice

“…Findings of the current survey suggest that most oncologists discussed FP with their patients and considered it a priority. Extensive knowledge of fertility is not essential in order to discuss cancer treatment-related infertility with patients, but it is important that oncologists know where to refer the patients (Adams et al, 2013). ASCO guidelines highlighted that healthcare providers, including medical oncologists, radiation oncologists, gynaecologic oncologists, urologists, haematologists, paediatric oncologists and surgeons, should address the possibility of infertility with patients treated during their reproductive years or with parents or guardians of children and be prepared to discuss FP options and/or to refer all potential patients to appropriate reproductive specialists.…”

“…However, perceived barriers are identified for initiating a discussion about FP. The chief barriers to discussion of FP with cancer patients are risk of treatment delay, disease prognosis and the risk of hormonal stimulation on sensitive malignancies (Adams et al, 2013;Louwe et al, 2013;Quinn, Vadaparampil, Bell-Ellison, Gwede, & Albrecht, 2008). Patient characteristics (e.g., HIV status, homosexuality, gender, aggressiveness of cancer, low likelihood of survival, marital status and number of children) may impact the discussion (Clayton et al, 2008;Rabah et al, 2010;Schover, Brey, Lichtin, Lipshultz, & Jeha, 2002).…”

“…To measure self-perception of knowledge and attitudes and practice of oncologists regarding FP in cancer patients, a 23-item self-administered questionnaire was developed on the basis of previous research from the United States (US; Forman et al, 2010;Quinn, Vadaparampil, King, et al, 2009) and United Kingdom (UK; Adams, Hill, & Watson, 2013). A qualitative study of expert opinion regarding FP was undertaken via eight in-depth interviews with experts in gynaecology (two persons), oncology (four persons) and embryology (two persons).…”

“…Again, no statistically significant differences were observed between male and female oncologists (p = 0.832). views of FP and cancer indicated that the only FP method that the majority of oncologists felt knowledgeable or very knowledgeable about was sperm cryopreservation and the methods most knew least about were testicular cryopreservation and ovarian cryopreservation (Adams et al, 2013). On the contrary, a nationwide survey conducted among US oncologists revealed that more than 90% of oncologists stated that they were "very knowledgeable"…”

Evidence to Incorporate Inclusive Reproductive Health Measures in Guidelines for Childhood and Adolescent Cancer Survivors

“…23% of oncologists usually never discuss any fertility preservation guidelines with their patients 26 . In a survey of oncologists from the United Kingdom, only 38% admitted to giving written information on fertility preservation to their patients and 66% consulted a fertility specialist 27; 28 . Furthermore, only one third of women with hematological cancer pursue fertility preservation and half of those patients have already been exposed to chemotherapy 29 .…”