ORLANDO, FL—A comprehensive program to provide fertility preservation awareness, education, and meaningful treatment options for patients with cancer is addressing the nationally identified lack of discussion about the infertility risks of chemotherapy, a study reported at the ONS 40th Annual Congress.
Despite the American Society of Clinical Oncology 2006 Quality Oncology Practice Initiative (QOPI) guidelines recommendation that infertility risks should be discussed prior to chemotherapy with patients of reproductive age, national adherence remains low, at 6%, noted Maria Grabowski, RN, MSN, OCN®, UT Southwestern, Dallas, Texas.
“At our institution, a survey of patient records found that less than 5% included a documented discussion of infertility risks,” she reported. In an era when cancer survivorship is a reality, “many patients do not receive timely information about fertility preservation, leading to disillusionment and mistrust. This is now recognized as an important quality metric.”
The fertility program being implemented addresses meaningful treatment options—from early intervention pretreatment through survivorship—throughout the reproductive life span, with nursing services ensuring awareness, informed consent, and patient self-advocacy.
Fertility preservation options for women include embryo banking, oocyte banking, ovarian tissue banking, hormone suppression, and pelvic shielding/ovarian transposition. The main option for men is sperm banking.
The program is designed to reach all adult oncology patients as well as providers at the time of the initial patient encounter. It features a streamlined electronic medical record (EMR) tool that populates for all patients with cancer who are of child-bearing age.
Through the EMR, an immediate referral option is offered to the campus reproductive endocrinology clinic, “which has committed to seeing patients and initiating care within 48 hours,” Grabowski noted. Patient education is available regarding fertility preservation options, with reduced pricing for patients.
“As cited in 2006 QOPI guidelines, early referrals are essential,” she added. “The focus has been on program development, implementation, and tracking of performance metrics. Our program increases provider ease and mandates compliance to address fertility preservation using streamlined systems.”Use of the EMR also supports simple quantitative analysis for future nursing research, such as studies identifying barriers to compliance.”
The program’s overall goal is “to assist provider’s efforts toward supporting their patients achieving maximum fertility where choice is available. Provider education is critical for visibility and successful implementation. A comprehensive approach to fertility preservation supports our patients’ hopes, dreams, and trust in us.”