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Review suggests oncofertility support lacking

Many cancer patients of reproductive age are not getting fertility information and fertility preservation referrals, according to the findings of a systematic review recently published in Psycho-Oncology.

Cancer and cancer treatment, either temporarily or permanently, impacts the fertility potential of 50% to 75% of cancer survivors, according to researchers.

“Current treatment guidelines advocate for all cancer patients of reproductive age to be informed of the impact of cancer treatment on their fertility in a timely manner, alongside the referral to fertility specialist services to reduce significant later life impacts and meet the support needs of cancer patients and survivors,” Shanna Logan, PhD, DClin Psych, child psychologist at the School of Women and Children’s Health, University of New South Wales in Australia, and colleagues wrote. “Despite best practice recommendations, there are a number of barriers in providing oncofertility (fertility and oncological care) services and most centers do not have clear models of care ensuring that all patients have access.”

Researchers also wrote that patients with cancer should have the chance to experience fertility preservation and that there is growing agreement that fertility should be discussed with all patients with cancer at the time of their diagnosis.

Researchers analyzed 23 studies for their systematic review. All types of clinicians were covered by the review, which contained studies from seven different countries. Patients in the analyzed studies were aged 14 to 45 years.

Logan and colleagues found that although many clinicians are considerably aware of the risks to their patients’ fertility brought about by cancer treatment, there were many factors that hampered the patient receiving the correct service utilization, referral or conversation needed to provide sufficient oncofertility support. Some of these factors were:

•Patient’s age, resistance, embarrassment, and/or poor prognosis;

•Clinician’s lack of resources, assuredness, and/or understanding which forbid such discussions; and

•Clinic’s time limits, no such services available onsite, high staff turnover, and/or challenges in finding an applicable specialist or facilities.

“The vast majority of studies reported within the results are reflective of Western medical practices, and encompassed by the leading recommended guidelines within the United States, Europe or Australia,” Logan and colleagues wrote. “The implementation of a clear procedural process would assist clinicians in the provision of oncofertility support for cancer patients of reproductive age.” – by Janel Miller

Disclosure: Healio Family Medicine was unable to determine researchers’ relevant disclosures prior to publication.