A remote pilot program was recently shown to enable access to fertility preservation services to women with cancer who were of reproductive age, according to the results of a study published in the Journal of Cancer Education.
The 1-year pilot program, which was based in Ontario, Canada, involved the use of telemedicine to communicate between a regional cancer center and a fertility clinic at a tertiary care center located approximately 1400 kilometers (approximately 870 miles) away. Patients and physicians were surveyed regarding their experiences with the program.
An oncology nurse navigator (ONN) role was developed at the regional center. The ONN identified and communicated with women treated for cancer who were of reproductive age and who may benefit from fertility preservation services, in addition to providing care coordination throughout the oncofertility process.
As part of fertility preservation care, the ONN coordinated a telemedicine-based consultation with a fertility specialist, and services were provided by a local gynecologist skilled in fertility care. Oocyte retrieval involved a trip to the main fertility clinic.
The study included 22 patients, mean age, 33.5 years. One patient died before completing the study. A total of 5 patients expressed a wish to have any/additional children in the future, and 2 were undecided. Fertility preservation consultations were given to 4 patients, and 2 patients completed oocyte or embryo cryopreservation at the main fertility clinic. Three of 4 women who participated in consultations/treatment indicated long-distance travel would not have been a deterrent.
Following the pilot program, responses were evaluated from 11 physicians, all of whom reported supporting the continuation of the program. For enabling access to fertility preservation services, 8 of 9 physicians reported that the ONN was useful, and 4 of 6 reported that telemedicine consultations were helpful.
The study investigators concluded that having an ONN working at a regional care center, in conjunction with telemedicine services and an appropriately trained local gynecologist, was useful for providing fertility preservation services remotely with limited requirements for travel.
Zwingerman R, Melenchuk K, McMahon E, et al. Expanding urgent oncofertility services for reproductive age women remote from a tertiary level fertility centre by use of telemedicine and an on-site nurse navigator. J Cancer Educ. 2020;35(3):515-521.