Fertility-Related Information Urgently Needed for Female Patients with Cancer
(ChemotherapyAdvisor) – Marked differences exist between young adult males and females with cancer with respect to receiving fertility-related information and use of fertility preservation, results of a study conducted in Sweden reported in the Journal of Clinical Oncology online May 14.
“Being able to have children is an important part of cancer survivorship, and several options are available to preserve patients' future fertility,” the investigators noted. “Our findings indicate deficiencies regarding fertility-related information provided to patients with cancer of reproductive age, particularly female patients.”
They investigated perception of fertility-related information and use of fertility preservation among male and female cancer survivors diagnosed from 2003 to 2007 identified in population-based registers in Sweden. Survivors were 18 to 45 years of age at diagnosis and had lymphoma, acute leukemia, testicular cancer, ovarian cancer, or female breast cancer treated with chemotherapy. “Of 810 eligible participants, 484 survivors (60% response rate) completed a postal questionnaire,” they wrote.
Responses revealed that 80% of the male participants reported receiving information about treatment impact on fertility and 68% on fertility preservation; 54% had banked frozen sperm. However, among women, 48% reported receiving information about treatment impact on fertility and 14% about fertility preservation. “Only seven women (2%) underwent fertility preservation,” the investigators reported.
Predictors for receiving information about treatment impact on fertility were a pretreatment desire to have children (OR, 3.5), male sex (OR, 3.2), and being ≤35 years of age at diagnosis (OR, 2.0). Predictors for receiving information about fertility preservation included male sex (OR, 14.4), age ≤35 at diagnosis (OR, 5.1), and having no children at diagnosis (OR, 2.5).
“Fertility-related information presented to young adult patients with cancer must be improved to increase their opportunities to make informed decisions regarding their treatment and their future reproductive ability,” they concluded. “In view of the complexity of fertility preservation for female patients, oncologists and hematologists should set aside extra time for discussing fertility issues with premenopausal women. In addition, close collaboration between cancer clinics and reproductive centers may be advantageous to safeguard reproductive health among patients with cancer."
They also found that “only a few of the cancer survivors had received written information, which can be an important tool in doctor-patient communication and a valuable supplement to verbal information, especially because fertility-related information for women can be complicated.”Abstract