SEOM Clinical Guideline of fertility preservation and reproduction in cancer patients (2016)

Abstract

Chemotherapy and radiotherapy often result in reduced fertility in cancer patients. With increasing survival rates, fertility is an important quality-of-life concern for many young cancer patients. Around 70–75% of young cancer survivors are interested in parenthood but the numbers of patients who access fertility preservation techniques prior to treatment are significantly lower. Moreover, despite existing guidelines, healthcare professionals do not address fertility preservation issues adequately. There is a critical need for improvements in clinical care to ensure patients are well informed about infertility risks and fertility preservation options and to support them in their reproductive decision-making prior to cancer treatment.

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

“…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).…”

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

“…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.…”

“…37,40,44,51 However, fertility counseling by way of medical information provision is a different concept to fertility counseling, being the therapeutic exploration of reproductive concerns and fertility treatment needs by a clinician with mental health training. 52 Counseling by mental health clinician 5,29,31,35,37,53 or the importance of psychological support 33,34,38,41,46,54 was only noted within one-third of the guidelines or recommendation documents. Some purely note the detrimental psychological effects of infertility or psychological impact when counseling is inadequate, without providing further recommendations for how psychological counseling should then be implemented.…”

Capsule Commentary on Streed et al., Assessment of Internal Medicine Resident Preparedness to Care for Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning Patients

“…LGBT competency training intervention in modifying knowledge regarding the unique healthcare needs of LGBT populations among a national sample of medical residents. 1 The web-based cultural competency focused on four areas of LGBT health: (1) sexual orientation and gender identityrelated terminology; (2) health disparities and preventive care issues; (3) unique considerations regarding mental health and substance abuse; and (4) sexually transmitted illnesses. Regardless of year of residency, knowledge increased significantly following the training.…”