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Klijn NF, ter Kuile MM, Lashley EELO. Patient-Reported Outcomes (PROs) and Patient Experiences in Fertility Preservation: A Systematic Review of the Literature on Adolescents and Young Adults (AYAs) with Cancer. Cancers (Basel) 2023; 15:5828. [PMID: 38136372 PMCID: PMC10741741 DOI: 10.3390/cancers15245828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
With better survival rates for patients diagnosed with cancer, more attention has been focused on future risks, like fertility decline due to gonadotoxic treatment. In this regard, the emphasis during counselling regarding possible preservation options is often on the treatment itself, meaning that the medical and emotional needs of patients regarding counselling, treatment, and future fertility are often overlooked. This review focuses on patient-reported outcomes (PROs) and patient experiences regarding fertility preservation (FP)-among adolescents and young adults (AYAs) with cancer. A systematic review of the literature, with a systematic search of online databases, was performed, resulting in 61 selected articles. A quality assessment was performed by a mixed methods appraisal tool (MMAT). Based on this search, three important topics emerged: initiating discussion about the risk of fertility decline, acknowledging the importance of future fertility, and recognizing the need for more verbal and written patient-specific information. In addition, patients value follow-up care and the opportunity to rediscuss FP and their concerns about future fertility and use of stored material. A clear FP healthcare pathway can prevent delays in receiving a referral to a fertility specialist to discuss FP options and initiating FP treatment. This patient-centered approach will optimize FP experiences and help to establish a process to achieve long-term follow up after FP treatment.
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Affiliation(s)
- Nicole F. Klijn
- Department of Gynecology and Obstetrics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
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Qin N, Wan Z, Kang Y, Luo Y, Duan Y, Xie J, Cheng AS. Effectiveness and feasibility of online fertility preservation decision aids for young female patients with cancer: a systematic review protocol. BMJ Open 2023; 13:e070294. [PMID: 36940948 PMCID: PMC10030757 DOI: 10.1136/bmjopen-2022-070294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Abstract
INTRODUCTION Cancer diagnosis and treatment can impair fertility, and younger female patients with cancer have a particularly strong need for fertility preservation. Fertility preservation decision aids are thought to help patients make proactive and informed treatment decisions. This systematic review aims to assess the effectiveness and feasibility of online fertility preservation decision aids for young female patients with cancer. METHODS AND ANALYSIS PubMed, Web of Science Core Collection, Embase, The Cochrane Central Register of Controlled Trials, PsycINFO and CHINAL, along with three grey literature sources (Google Scholar, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform), will be searched from each database's establishment to 30 November 2022. Two trained reviewers will independently screen the articles, and the data extraction and methodological quality of eligible randomised controlled trials and quasiexperimental studies will be assessed. A meta-analysis will be performed using Review Manager V.5.4 (Cochrane Collaboration) software, and heterogeneity will be assessed using I² statistics. If a meta-analysis is not possible, a narrative synthesis will be done. ETHICS AND DISSEMINATION Since this systematic review is based on published data, no ethical approval is required. The study's findings will be disseminated through peer-reviewed publications and conference presentations. PROSPERO REGISTRATION NUMBER CRD42022363287.
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Affiliation(s)
- Ning Qin
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Ziyu Wan
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Yue Kang
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Yating Luo
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Yinglong Duan
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jianfei Xie
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Andy Sk Cheng
- Department of Rehabilitation Sciences, the Hong Kong Polytechnic University, Hong Kong, China
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Wang M, Zhu L, Xiong H, Wang J, Li Z, Yang L, Jin L, Xi Q. Lack of Knowledge, the main Stumbling Block of Fertility Preservation Promotion in China. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:739-747. [PMID: 32920747 DOI: 10.1007/s13187-020-01875-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/09/2020] [Indexed: 06/11/2023]
Abstract
The aim of this study is to evaluate fertility preservation (FP) popularization in China among female cancer patients in terms of awareness of fertility, knowledge about FP, and attitudes toward FP. A questionnaire-based survey was conducted among female cancer patients in Tongji Hospital in China from March 2019 to July 2019. The 29 fertility-related issues, which were presented in either five-point Likert scales or "yes or no", in this questionnaire consisted of demographic characteristic and disease-related situation, awareness of fertility, knowledge about FP, and attitudes toward FP. Participants were required to finish the questionnaire, and data were gathered and analyzed by SPSS. Forty-five valid questionnaires without missing data remained in the final analysis. The survey discovered that a regional imbalanced limitation in knowledge of infertility risk and FP in young cancer patients acted as a major obstacle in FP promotion nationwide and FP decision-making in patients. Compared with rural patients, patients from urban areas were more eager to give birth and more likely to have a better understanding of FP with a more positive attitude. Moreover, most of the participants (62.2%) had a low level of understanding of FP, although they remained positive toward it. "Cancer treatment as the priority", "Cancer relapse caused by FP", and "Health of the next generation" were the top three factors affecting decisions on FP. The findings revealed a general FP actuality in China and specifically offered some intervention targets in the near future to improve FP service and networks, benefiting more female patients of childbearing age who are at risk of infertility.
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Affiliation(s)
- Meng Wang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lixia Zhu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hua Xiong
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiaming Wang
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, China
| | - Zhou Li
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liu Yang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Qingsong Xi
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Omani-Samani R, Vesali S, Navid B, Mohajeri M, Rafsanjani KA, Aghamaleki SZN, Mohammadi M. Adult cancer patients and parents of younger cancer patients have little information about fertility preservation: a survey of knowledge and attitude. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2021. [DOI: 10.1186/s43043-021-00072-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Impaired fertility is one of the side effects of effective cancer therapy. Saving the potential or storing the material to enable people to have biological children after cancer treatment can be of high importance to many cancer survivors. Therefore, we designed a study to determine knowledge and attitudes to fertility preservation (FP) in adult cancer patients and the parents of patients with cancer. Participants who completed this survey were a convenience sample of 384 parents of cancer patients < 18 years and cancer patients ≥ 18 years from two large referral hospitals. A 25-item self-administered questionnaire measured knowledge and attitudes to FP. Responses were yes/no, or on a 4-point Likert scale (greatly, usually, rarely, never) scored from 1 for never to 4 for greatly.
Results
Most parents and most cancer patients were unaware of the FP methods of embryo cryopreservation (96.3% and 88.4%, respectively) and sperm cryopreservation (97.5% and 89.0%, respectively). Attitudes among cancer patients and parents to use of FP options, based on a 4-point Likert scale, were determined by financial cost, lack of access and information on FP options.
Conclusion
Of concern in this sample of Iranian adult cancer patients and their parents is that knowledge of the fertility risk associated with cancer therapy and knowledge of FP treatment options was generally poor, particularly among the parents. To enable cancer patients or their parents to make the best decisions about using FP services, oncologists and fertility specialists should discuss FP options during their consultation.
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Ehrbar V, Germeyer A, Nawroth F, Dangel A, Findeklee S, Urech C, Rochlitz C, Stiller R, Tschudin S. Long-term effectiveness of an online decision aid for female cancer patients regarding fertility preservation: Knowledge, attitude, and decisional regret. Acta Obstet Gynecol Scand 2021; 100:1132-1139. [PMID: 33538329 DOI: 10.1111/aogs.14108] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 01/14/2021] [Accepted: 01/30/2021] [Indexed: 01/23/2023]
Abstract
INTRODUCTION The decision, whether to undergo fertility preservation or not is highly demanding for cancer patients. Decision aids may act as an additional source of support. So far, only a limited number of decision aids regarding fertility preservation for female cancer patients exist and have been evaluated systematically. This paper presents the results of secondary analyses of the first randomized controlled trial evaluating an online decision aid for female cancer patients affected by different types of cancer. It focuses on fertility-related knowledge, attitude toward fertility preservation, and long-term effectiveness regarding decisional regret. MATERIAL AND METHODS Young female cancer patients between 18 and 40 years of age were recruited after fertility counseling with a reproductive specialist. They were assigned to either the control group (counseling only) or the intervention group (counseling followed by the additional use of the decision aid). Both groups had to complete a questionnaire after counseling as well as 1 and 12 months later, covering topics such as fertility-related knowledge, attitude towards fertility preservation, decisional conflict and regret. Recruitment was ongoing during 18 months in eight fertility centers located in Switzerland and Germany. RESULTS Mean age of participating women was 29.31 years (SD 4.57). Of the entire sample (n = 51) 53% were affected with breast cancer, 27.4% with lymphoma, and 19.6% with various other types of cancer. Knowledge regarding the most common fertility preservation methods was high and comparable in both groups. Positive attitude significantly exceeded negative attitude among all participants (p = 0.001). Although the altogether low scores for decisional regret were on a higher level in the control group (T2: mean = 19.00, SD = 13.24; T3: mean = 22.0, SD = 20.67) than in the intervention group (T2: mean = 14.12, SD = 11.07; T3: mean = 12.94, SD = 13.24), there were no statistically significant differences between and within both groups. There was a positive association between decisional conflict and decisional regret at T3 (p = 0.001, r = 0.510). CONCLUSIONS This decision aid was suitable as an additional source of knowledge and may positively impact decisional regret in the long term. Results suggest that the provision of an online decision aid as a complement to fertility counseling may facilitate decision-making.
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Affiliation(s)
- Verena Ehrbar
- Department of Gynecology and Obstetrics, University Hospital Basel, Basel, Switzerland
| | - Ariane Germeyer
- Department of Gynecological Endocrinology and Fertility Disorders, University Hospital Heidelberg, Heidelberg, Germany
| | - Frank Nawroth
- Center for Infertility, Prenatal Medicine, Endocrinology and Osteology, amedes experts, Hamburg, Germany
| | - Astrid Dangel
- Center for Infertility, Prenatal Medicine, Endocrinology and Osteology, amedes experts, Hamburg, Germany
| | - Sebastian Findeklee
- Department of Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, Homburg, Germany
| | - Corinne Urech
- Department of Gynecology and Obstetrics, University Hospital Basel, Basel, Switzerland
| | - Christoph Rochlitz
- Department of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - Ruth Stiller
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - Sibil Tschudin
- Department of Gynecology and Obstetrics, University Hospital Basel, Basel, Switzerland
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Knowledge and awareness about fertility preservation among female patients with cancer : a cross-sectional study. Obstet Gynecol Sci 2020; 63:480-489. [PMID: 32689774 PMCID: PMC7393751 DOI: 10.5468/ogs.20003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 05/05/2020] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE The incidence of women in the reproductive age group diagnosed with cancer has recently increased. However, very few patients opt for or are offered fertility preservation (FP) strategies because of a significant lack in awareness. The present study was conducted to evaluate the knowledge of the effect of cancer treatment on fertility and available options for FP. METHODS This was a cross-sectional study conducted at a tertiary care center from March 2019 through August 2019. One hundred female patients with gynecological or nongynecological cancer and 18-40 years of age were interviewed. The participants were categorized on the basis of the modified Kuppuswamy socioeconomic status (SES) scale and the responses of the patients in the different categories were compared. RESULTS More than half the patients (63%) were in the 20-35-year age group. Most of the patients (71%) were married, and of them, 28 (39.4%) desired to have children. Only 32% of the patients were aware of the detrimental effect of cancer and its treatment on future fertility, and of them, only 28% could specify the gonadotoxic effect of chemotherapy. Knowledge was significantly higher in the upper and middle SES levels than it was in the lower SES level (P<0.001). More than half of the patients (68%) were not aware of the existing FP options, whereas one-third of the patients (32%) were given information about FP by their physicians. CONCLUSION The overall awareness of the gonadotoxic effect of cancer therapy and available FP options in the present study was poor. Awareness of FP among both patients and clinicians needs to be increased.
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Randomized controlled trial on the effect of an online decision aid for young female cancer patients regarding fertility preservation. Hum Reprod 2019; 34:1726-1734. [DOI: 10.1093/humrep/dez136] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 06/17/2019] [Indexed: 11/15/2022] Open
Abstract
Abstract
Study question
Does the use of an online decision aid (DA) about fertility preservation (FP), in addition to standard counselling by a specialist in reproductive medicine, reduce decisional conflict compared to standard counselling alone?
Summary answer
Female cancer patients who could make use of the online DA had a significantly lower short-term decisional conflict score.
What is known already
Nowadays, female cancer patients have several options for preserving fertility, but having to decide whether to opt for FP within a short time frame after cancer diagnosis and before the start of treatment is challenging. According to previous studies focussing mainly on breast cancer patients, decisional conflict among these women is high, and they have expressed the need for additional support.
Study design, size, duration
The study was a randomized controlled trial including female cancer patients who were referred by their treating oncologist to a specialist in reproductive medicine for fertility counselling. Participants were randomly assigned to the control group (counselling only) or to the intervention group (counselling and additional use of the online DA immediately after counselling). Recruitment was ongoing from July 2016 to December 2017 at eight fertility centres in Switzerland and Germany.
Participants/materials, setting, methods
The online DA was developed by an interdisciplinary team of specialists in reproductive medicine, gynaecologists, oncologists and psychologists. Of 79 recruited participants, 59 completed the first assessment and could therefore be enrolled in the study. They were asked to complete an online questionnaire at three time points: at T1, after counselling (control group, n = 27) or after counselling and the additional use of the DA (intervention group, n = 24); at T2, 1 month later (N = 41: control group, n = 23; intervention group, n = 18); and at T3, 12 months later (N = 37: control group, n = 20; intervention group, n = 17). The survey comprised questions about fertility-related knowledge, attitude towards FP, willingness to undergo FP and socio-demographic data, as well as the decisional conflict and decisional regret scales.
Main results and the role of chance
All participants showed low decisional conflict scores. Women who used the online DA in addition to counselling (intervention group) showed a significantly lower total score on the Decisional Conflict Scale (DCS) compared to the control group at T1 (P = 0.008; M = 12.15, SD = 4.38; 95% CI, 3.35–20.95) and at T2 (P = 0.043; M = 9.35, SD = 4.48; 95% CI, 0.31–18.38). At T3, the mean total score of the DCS was still lower in the intervention group compared to the control group; however, this group difference was no longer significant (P = 0.199, M = 6.86, SD = 5.24; 95% CI, −3.78 to 17.51). The majority of participants had already made a decision regarding FP (yes or no) at T1 (72.5%): 91.7% in the intervention group compared to 55.6% in the control group (P = 0.014). Those who had decided already at T1 showed significantly lower decisional conflict (P = 0.007; M = 13.69, SD = 4.89; 95% CI, 3.86–23.52). The average number of DA sessions per user was 2.23, and 80.8% of the participants completed the DA’s value clarification exercises. Participants in the intervention group were satisfied with the DA and would recommend it to other patients.
Limitations, reasons for caution
The recruitment of participants was challenging because of the emotionally difficult situation patients were in. This led to the limited sample size for final analysis. Education levels were high in two-thirds of the participants. It is difficult to say whether the DA would be equally effective in women with a lower educational background.
Wider implications of the findings
There is evidence that the DA served as a helpful complement to the decision-making process for young female cancer patients qualifying for FP. This is, to our knowledge, the first randomized controlled trial evaluating a DA targeted at patients with several cancer types and in a language other than English (i.e. German). This study contributes to extending the range of the still limited number of DAs in the context of FP.
Study funding/competing interest(s)
The study was supported by a research grant of the Swiss Cancer Research. The authors declare that no competing interests exist.
Trial registration number
Clinicaltrials.gov, trial no. NCT02404883.
Trial registration date
19 March 2015
Date of first patient’s enrolment
4 July 2016
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Gonçalves V, Travado L, Ferreira PL, Quinn G. Protocol for the development and acceptability of a fertility-related decision aid for young women with breast cancer in Portugal. BMJ Open 2019; 9:e030690. [PMID: 31345986 PMCID: PMC6661612 DOI: 10.1136/bmjopen-2019-030690] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/17/2019] [Accepted: 06/25/2019] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Young patients with breast cancer may face impaired fertility due to cancer treatments, which often leads to complex fertility decisions. To aid fertility decision-making, it is crucial that women have access to high-quality information; however, their fertility information needs are often unmet. Decision aids (DAs) are educational materials to assist with decision-making, by addressing individual values and preferences. In oncofertility, DAs may constitute a valuable resource to help patients obtain information and make better informed decisions. This paper reports on the protocol of the development and transcreation of a fertility-related DA booklet to support young Portuguese patients with breast cancer, originally developed and validated for an Australian audience. METHODS AND ANALYSIS Recent literature on clinical guidelines will be reviewed. A summary of these guidelines will be created and will inform the first round of DAs revisions. A forward translation process will translate the DA from Australian English to Portuguese. A multidisciplinary Portuguese experts panel will revise and give feedback on the scientific and cultural aspects of the DA content for Portuguese audience. Next, a backward translation process will assess content equivalence between the original and the final adapted version. Finally, Learner Verification (LV) will be used in a qualitative study of young patients with breast cancer and their partners. Two focus groups with 6-10 participants each will be conducted with: (1) recently diagnosed young patients with breast cancer; (2) breast cancer survivors and (3) their partners. Results from the DA acceptability assessment will inform its final version. Data will be analysed using content analysis and constant comparison method to identify key themes/textual units related to LV. ETHICS AND DISSEMINATION Ethical approval was granted by the Portuguese Institute of Oncology Porto. Results will be disseminated through peer-reviewed journals and presented at scientific meetings for academic and health professionals audiences.
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Affiliation(s)
- Vânia Gonçalves
- Centre for Health Studies and Research of the University of Coimbra (CEISUC), Coimbra, Portugal
| | - Luzia Travado
- Psycho-oncology, Neuropsychiatry Unit, Champalimaud Foundation, Lisbon, Portugal
| | - Pedro Lopes Ferreira
- Centre for Health Studies and Research of the University of Coimbra (CEISUC), Faculty of Economics, University of Coimbra, Coimbra, Portugal
| | - Gwendolyn Quinn
- Population Health, NYU Langone Health, New York City, New York, USA
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Ehrbar V, Urech C, Tschudin S. Fertility decision-making in cancer patients – current status and future directions. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/23809000.2018.1503539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Verena Ehrbar
- Department of Gynecology and Obstetrics, University Hospital Basel, Basel, Switzerland
| | - Corinne Urech
- Department of Gynecology and Obstetrics, University Hospital Basel, Basel, Switzerland
| | - Sibil Tschudin
- Department of Gynecology and Obstetrics, University Hospital Basel, Basel, Switzerland
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Müller M, Urech C, Boivin J, Ehrbar V, Moffat R, Daellenbach RZ, Rochlitz C, Tschudin S. Addressing decisional conflict about fertility preservation: helping young female cancer survivors' family planning decisions. BMJ SEXUAL & REPRODUCTIVE HEALTH 2018; 44:175-180. [PMID: 29150522 DOI: 10.1136/bmjsrh-2017-101820] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 10/26/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Health professionals are challenged by a growing number of young long-term cancer survivors with their specific needs with regard to family planning. This study aimed at assessing decisional conflict (DC) in young female cancer patients regarding fertility preservation, identifying demographic, fertility and fertility preservation related factors, which may affect DC, and assessing the helpfulness of various decision-supports. METHODS A retrospective, cross-sectional, web-based survey via an online questionnaire available in three languages with specific items concerning cancer, fertility, fertility preservation and the validated Decisional Conflict Scale targeted at current or former female cancer patients aged 18-45 years, with cancer types or treatment potentially affecting reproductive function. RESULTS The 155 participating women showed considerable DC, especially with regard to missing information and support. DC was significantly lower in patients when the risk of infertility was discussed with a health professional, when they had undergone any procedure to preserve fertility, and when they had a university education. A longer time interval since cancer diagnosis was associated with higher DC. The most helpful decision-support tools were specialised websites and leaflets. CONCLUSIONS Young female cancer patients' DC with regard to fertility preservation is very high. Information and support seem to be deficient. More information through standardised information tools might be an effective strategy to lower their DC at the time when treatment decisions need to be taken, and to improve their reproductive health after they have overcome cancer in the future.
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Affiliation(s)
- Madleina Müller
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Corinne Urech
- Department of Gynecology and Obstetrics, University Hospital Basel, Basel, Switzerland
| | - Jacky Boivin
- School of Psychology, Cardiff University, Cardiff, UK
| | - Verena Ehrbar
- Department of Gynecology and Obstetrics, University Hospital Basel, Basel, Switzerland
| | - Rebecca Moffat
- Department of Gynecology and Obstetrics, University Hospital Basel, Basel, Switzerland
| | | | - Christoph Rochlitz
- Department of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - Sibil Tschudin
- Department of Gynecology and Obstetrics, University Hospital Basel, Basel, Switzerland
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Pacey AA. Focus on fertility preservation. HUM FERTIL 2018; 21:1-2. [PMID: 29490556 DOI: 10.1080/14647273.2018.1443380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Allan A Pacey
- a Academic Unit of Reproductive and Developmental Medicine, Department of Oncology and Metabolism , School of Medicine and Biomedical Sciences, University of Sheffield , Sheffield , UK
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