Whereas sperm banking was viewed as a routine part of oncology care for men, few women were afforded the opportunity to discuss their fertility options at cancer diagnosis, according to the findings of a small study.
After receiving a diagnosis of cancer, 16 men and 18 women aged 17 to 49 years were interviewed soon after their first consultation with a cancer-focused health professional. Topics discussed included the patient’s perceptions and understanding of the diagnosis; prognosis and future reproductive choices; perceived quality and source of information received, communication, and support; and the roles of partners, family members, friends, and health care professionals.
In addition, 15 health care professionals were asked for their opinions on the information given to younger people with cancer, their knowledge and views of the treatments available with respect to fertility preservation, and their perceptions of patients’ priorities.
Almost all of the patients had been given written information on cancer treatment, a small section of which was devoted to fertility preservation. Men and women were given different information reflecting the varying fertility preservation options available, the perceived success rates, and the subsequent delay in accessing cancer treatment. (Survival was always viewed as paramount, with future fertility a secondary concern.)
After analyzing the interview transcripts, Valerie L. Peddie, a fertility nurse specialist/research midwife at the University of Aberdeen [United Kingdom] School of Medicine and Dentistry, and coinvestigators found the primary barriers to pursuing fertility preservation to be the way in which information was provided and the “urgent need for treatment” conveyed by staff. As the researchers explained in BJOG: An International Journal of Obstetrics and Gynecology, sperm banking was viewed as “part and parcel” of oncology care, and the majority of men quickly stored sperm as “insurance” against future infertility. Few women, however, were provided with an opportunity to discuss their options, reflecting clinicians’ reservations about the experimental nature of egg and ovarian tissue cryopreservation and the need for partner involvement in embryo storage.
Peddie’s team concluded that significant gaps exist in the fertility information provided to young women diagnosed with cancer, suggesting the need for an early appointment with a fertility expert for these patients.