Survey of Fertility Preservation Options Available to Patients With Cancer Around the Globe

Abstract

PurposeOncofertility focuses on providing fertility and endocrine-sparing options to patients who undergo life-preserving but gonadotoxic cancer treatment. The resources needed to meet patient demand often are fragmented along disciplinary lines. We quantify assets and gaps in oncofertility care on a global scale.MethodsSurvey-based questionnaires were provided to 191 members of the Oncofertility Consortium Global Partners Network, a National Institutes of Health–funded organization. Responses were analyzed to measure trends and regional subtleties about patient oncofertility experiences and to analyze barriers to care at sites that provide oncofertility services.ResultsSixty-three responses were received (response rate, 25%), and 40 were analyzed from oncofertility centers in 28 countries. Thirty of 40 survey results (75%) showed that formal referral processes and psychological care are provided to patients at the majority of sites. Fourteen of 23 respondents (61%) stated that some fertility preservation services are not offered because of cultural and legal barriers. The growth of oncofertility and its capacity to improve the lives of cancer survivors around the globe relies on concentrated efforts to increase awareness, promote collaboration, share best practices, and advocate for research funding.ConclusionThis survey reveals global and regional successes and challenges and provides insight into what is needed to advance the field and make the discussion of fertility preservation and endocrine health a standard component of the cancer treatment plan. As the field of oncofertility continues to develop around the globe, regular assessment of both international and regional barriers to quality care must continue to guide process improvements.

A prospective study of women and girls undergoing fertility preservation due to oncologic and non‐oncologic indications in Sweden–Trends in patients’ choices and benefit of the chosen methods after long‐term follow up

“…Moreover, women obtain more seldom information than men do . Barriers for information provision and access to FP have been acknowledged, in particular low confidence in knowledge from practicing oncologists, organization‐related barriers such as unclear referral paths or economic issues . In our program, we have made great efforts to develop a truly multidisciplinary network for FP aiming to educate young patients on their narrowed reproductive span, as a consequence of cancer treatments, genetic conditions or endocrine diseases.…”

Fertility preservation in oncology patients: A literature review examining current fertility preservation techniques and access to oncofertility services in Australia

“…An international study specifically analysed barriers to care for oncofertility patients specific to different countries. Australia reported the main barriers to care included lack of insurance, financial burden to patients, issues with referrals, inability to secure funding for research and a lack of donated tissue . These themes resonate throughout other Australian literature with the most commonly identified determinant for fertility preservation being a lack of clear referral pathways.…”

“…It is illegal to financially renumerate any third party parenting arrangement under Australian law . However, adoption, surrogacy and gamete donation are rarely discussed with paediatric and adolescent patients and are more commonly mentioned with adult oncofertility patients . Third party parenting options are not available in all fertility clinics.…”

“…Recent literature, including the National Service Delivery Framework for Adolescents and Young Adults with Cancer, has identified the barriers to accessing oncofertility care for AYAs within Australia …”

Oncofertility—An emerging discipline rather than a special consideration

“…At present, the economic impact of FP consultations and FP procedures is a significant barrier, with few countries having FP integrated into public or private health‐care provision . The cost of psychological distress due to infertility and FP treatment is also not known.…”