1
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Alon I, Bussod I, Golan OC, Ravitsky V. Mapping ethical, legal, and social implications (ELSI) of fertility preservation. J Assist Reprod Genet 2024:10.1007/s10815-024-03210-w. [PMID: 39141169 DOI: 10.1007/s10815-024-03210-w] [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: 05/23/2024] [Accepted: 07/17/2024] [Indexed: 08/15/2024] Open
Abstract
RESEARCH QUESTION The study examines the ethical, legal, and social implications of fertility preservation, highlighting its importance across oncofertility, elective egg freezing, and posthumous assisted reproduction, as well as its impact on transgender individuals undergoing gender-affirming surgeries. DESIGN A comprehensive analysis of 600 articles, focusing on a diverse range of disciplines, including bioethics, psychology, and sociology, to explore public and healthcare professionals' knowledge, patient experiences, and regulatory constraints. RESULTS The body of literature is growing, indicating increasing recognition of FP's significance. Key themes included the centrality of counseling and informed decision-making, especially in oncofertility and EEF, and ethical debates surrounding informed consent and the autonomy of involved individuals. The analysis underscored a western-centric bias in current research, emphasizing the need for more inclusive and culturally sensitive studies. CONCLUSIONS The study calls for a nuanced understanding of FP, advocating for policies that consider ethical, cultural, and social dimensions. It suggests the necessity for interdisciplinary research to address identified gaps, particularly in understanding non-Western perspectives and ensuring equitable access to FP services globally. Moreover, the review emphasizes the importance of integrating patient-centric approaches and ethical frameworks to guide FP practices and policies, ensuring they respect diverse values and meet individuals' needs.
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Affiliation(s)
- Ido Alon
- Department of Development Economics, Autonomous University of Madrid, Madrid, Spain.
- University of Montreal, Montreal, Canada.
| | | | - Orit Cherny Golan
- University of Montreal, Montreal, Canada
- Yezreel Valley College, Yezreel Valley, Israel
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2
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Pawłowski P, Ziętara KJ, Michalczyk J, Fryze M, Buchacz A, Zaucha-Prażmo A, Zawitkowska J, Torres A, Samardakiewicz M. Fertility Preservation in Children and Adolescents during Oncological Treatment-A Review of Healthcare System Factors and Attitudes of Patients and Their Caregivers. Cancers (Basel) 2023; 15:4393. [PMID: 37686669 PMCID: PMC10487203 DOI: 10.3390/cancers15174393] [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: 07/07/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
Oncofertility is any therapeutic intervention to safeguard the fertility of cancer patients. Anti-cancer therapies (chemotherapy, radiation therapy, etc.) entail the risk of reproductive disorders through cytotoxic effects on gamete-building cells, especially those not yet fully developed. This literature review analyzes the available data on securing fertility in pediatric and adolescent populations to identify the methods used and describe aspects related to financing, ethics, and the perspective of patients and their parents. Topics related to oncofertility in this age group are relatively niche, with few peer-reviewed articles available and published studies mostly on adults. Compared to pubertal individuals, a limited number of fertility preservation methods are used for prepubertal patients. Funding for the procedures described varies from country to country, but only a few governments choose to reimburse them. Oncofertility of pediatric and adolescent patients raises many controversies related to the decision, parents' beliefs, having a partner, ethics, as well as the knowledge and experience of healthcare professionals. As the fertility of young cancer patients is at risk, healthcare professionals should make every effort to provide them with an opportunity to fulfill their future reproductive plans and to have a family and offspring. Systemic solutions should form the basis for the development of oncofertility in pediatric and adolescent populations.
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Affiliation(s)
- Piotr Pawłowski
- Student Scientific Association at the Department of Psychology, Faculty of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (P.P.); (J.M.)
| | - Karolina Joanna Ziętara
- Student Scientific Association at the Department of Psychology, Faculty of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (P.P.); (J.M.)
| | - Justyna Michalczyk
- Student Scientific Association at the Department of Psychology, Faculty of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (P.P.); (J.M.)
| | - Magdalena Fryze
- Department of Psychology, Psychosocial Aspects of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (M.F.); (M.S.)
| | - Anna Buchacz
- Youth Cancer Europe, 400372 Cluj-Napoca, Romania;
| | - Agnieszka Zaucha-Prażmo
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, 20-093 Lublin, Poland; (A.Z.-P.); (J.Z.)
| | - Joanna Zawitkowska
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, 20-093 Lublin, Poland; (A.Z.-P.); (J.Z.)
| | - Anna Torres
- Department of Pediatric and Adolescent Gynecology, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Marzena Samardakiewicz
- Department of Psychology, Psychosocial Aspects of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (M.F.); (M.S.)
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3
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Guzik P, McKinney JA, Ulack C, Suarez J, Davis V, Teisberg E, Wallace S, Eckhardt SG, Capasso A. Outcomes That Matter Most to Young Adults Diagnosed with Cancer: A Qualitative Study. J Adolesc Young Adult Oncol 2020; 10:534-539. [DOI: 10.1089/jayao.2020.0150] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Paul Guzik
- Department of Internal Medicine, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
| | - Jennifer A. McKinney
- Livestrong Cancer Institutes, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
- Department of Oncology, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
| | - Christopher Ulack
- Value Institute for Health & Care, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
| | - Joel Suarez
- Value Institute for Health & Care, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
| | - Victoria Davis
- Value Institute for Health & Care, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
| | - Elizabeth Teisberg
- Value Institute for Health & Care, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
- Department of Medical Education, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
| | - Scott Wallace
- Value Institute for Health & Care, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
- Department of Medical Education, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
| | - S. Gail Eckhardt
- Livestrong Cancer Institutes, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
- Department of Oncology, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
| | - Anna Capasso
- Department of Internal Medicine, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
- Livestrong Cancer Institutes, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
- Department of Oncology, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
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4
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Gonçalves V, Ferreira PL, Quinn GP. Integration of partners of young women with cancer in oncofertility evidence-based informational resources. Cancer Med 2020; 9:7375-7380. [PMID: 32864852 PMCID: PMC7571813 DOI: 10.1002/cam4.3377] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/07/2020] [Accepted: 07/25/2020] [Indexed: 12/22/2022] Open
Abstract
Oncofertility has evolved over the years, with a prodigious amount of research documenting the importance of fertility for young patients with cancer, and the potential impact that fertility impairments due to cancer treatments has on their Quality of Life (QoL). Multiple professional bodies and scientific societies have included fertility as an integral part of clinical management. Clinical guidelines advocate that health professionals have the duty to discuss the risk of infertility and fertility preservation options as early as possible and refer to fertility specialists when appropriate. Collectively, fertility decisions are regarded as difficult for both patients and providers. Since providing fertility‐related information is vital for better decision making, researchers and policy makers have concentrated their efforts in developing educational tools to aid decisions and guidelines to optimize the delivery of this information, focusing mainly on patients‐providers and largely neglecting the role and influence that partners play in this process. Here, we reflect on the importance of partners in fertility decisions, with a focus on the provision of fertility‐related information that is also geared towards partner. We highlight the need to involve partners in fertility discussions, and that their needs should be taken into account in both clinical guidelines and in the development of educational tools, for an optimal decision‐making process.
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Affiliation(s)
- Vânia Gonçalves
- Centre for Health Studies and Research of the University of Coimbra (CEISUC), Faculty of Economics, University of Coimbra, Coimbra, Portugal
| | - Pedro L Ferreira
- Centre for Health Studies and Research of the University of Coimbra (CEISUC), Faculty of Economics, University of Coimbra, Coimbra, Portugal
| | - Gwendolyn P Quinn
- Departments of Obstetrics and Gynecology and Population Health, Grossman School of Medicine, New York University, New York, NY, USA
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5
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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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6
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Speller B, Sissons A, Daly C, Facey M, Kennedy E, Metcalfe K, Baxter NN. An evaluation of oncofertility decision support resources among breast cancer patients and health care providers. BMC Health Serv Res 2019; 19:101. [PMID: 30728004 PMCID: PMC6366104 DOI: 10.1186/s12913-019-3901-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 01/14/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer patients of reproductive age are at risk of infertility as a result of their treatment. Oncofertility decision support resources can assist patients with fertility decision-making before treatment yet available oncofertility resources contain varying levels of detail and different fertility options. The key information/sections needed in oncofertility resources remain unclear. To explore the information needs for oncofertility decision-making before cancer treatment, we aimed to evaluate existing oncofertility decision support resources with breast cancer patients and providers. METHODS We conducted 30 to 90-min interviews that included a survey questionnaire and open-ended questions with patients and providers between March and June 2016. Interviews were transcribed verbatim. Analysis involved descriptive statistics for survey responses and thematic analysis of qualitative data. RESULTS A total of 16 participants completed interviews. Key information perceived by most participants as necessary for fertility decision-making included tailored post-treatment pregnancy rates, cost ranges and financial assistance for the fertility options based on patients' situation. However, patient and provider participants expressed differing opinions on the inclusion of all before and after treatment fertility options and the amount of fertility information required at diagnosis. CONCLUSION The evaluation identified fertility information needs among patients in addition to providers' views on patient needs. While existing oncofertility resources contain information perceived as necessary for decision-making there is an opportunity to use these findings to create or enhance resources to better meet the needs of patients. Additionally, patients and providers differing views on information needs highlight the opportunity for provider training to ensure better communication using resources in clinic to understand specific patient needs.
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Affiliation(s)
- Brittany Speller
- Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Amanda Sissons
- Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Corinne Daly
- Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Marcia Facey
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Erin Kennedy
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of Surgery, Mount Sinai Health System, Toronto, Canada
| | - Kelly Metcalfe
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.,Women's College Research Institute, Women's College Hospital, Toronto, Canada
| | - Nancy N Baxter
- Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada. .,Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
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7
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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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8
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Ussher JM, Parton C, Perz J. Need for information, honesty and respect: patient perspectives on health care professionals communication about cancer and fertility. Reprod Health 2018; 15:2. [PMID: 29304873 PMCID: PMC5756327 DOI: 10.1186/s12978-017-0441-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 12/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Individuals affected by cancer report a need for information about fertility from health care professionals (HCPs), in order to inform decision making and alleviate anxiety. However, there is evidence that many health professionals do not engage in such discussions. METHOD A mixed method design was used to examine the construction and subjective experience of communication with health professionals about fertility in the context of cancer, from the perspective of patients. A survey was completed by 693 women and 185 men, across a range of cancer tumour types and age groups, and in-depth one-to-one interviews conducted with a purposively selected subsample of survey respondents, 61 women and 17 men. The chi square test for independence was used to test for group differences between women and men on closed survey items. Thematic analysis was used to examine the open ended survey responses and interviews. RESULTS Significantly more women (57%, n = 373) than men (46%, n = 80) (X2(2517) = 6.54, p = .011) reported that they had discussed fertility with a HCP since diagnosis of cancer. Satisfaction with the discussion was reported by 65% (n = 242) of women and 69% (n = 54) (ns) of men. This discussion was reported to have been initiated by the patient or their partner in 44% (n = 165) of women and 47% (n = 37) (ns) of men. In the interviews and open ended surveys three themes were identified: Feeling heard and informed about fertility after cancer: Positive experiences of HCP communication; "I was never given full disclosure": HCP silence or reticence about discussing fertility after cancer, including the sub-theme "Their primary concern is getting me cancer free": Constructions of absence of fertility communication by HCPs; and Confusion and lack of compassion: Unsatisfactory information provision about fertility and cancer. CONCLUSION Discussion with a HCP about fertility concerns, and satisfaction with the discussion, was associated with reports of lower patient distress, greater knowledge and understanding of the consequences of cancer on fertility, involvement in the decision making process about fertility preservation, and satisfaction with health care.
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Affiliation(s)
- Jane M. Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751 Australia
| | - Chloe Parton
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751 Australia
| | - Janette Perz
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751 Australia
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9
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Fathi R, Rezazadeh Valojerdi M, Ebrahimi B, Eivazkhani F, Akbarpour M, Tahaei LS, Abtahi NS. Fertility Preservation in Cancer Patients: In Vivo and In Vitro Options. CELL JOURNAL 2017; 19:173-183. [PMID: 28670510 PMCID: PMC5412777 DOI: 10.22074/cellj.2016.4880] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 07/25/2016] [Indexed: 12/29/2022]
Abstract
Oocyte, embryo and ovarian tissue cryopreservation are being increasingly proposed for fertility preservation among cancer patients undergoing therapy to enable them to have babies after the cancer is cured. Embryo cryopreservation is not appropriate for single girls without any sperm partner and also because oocyte retrieval is an extended procedure, it is impossible in cases requiring immediate cancer cure. Thus ovarian tissue cryopreservation has been suggested for fertility preservation especial in cancer patients. The main goal of ovarian cryopreservation is re-implanting the tissue into the body to restore fertility and the hormonal cycle. Different cryopreservation protocols have been examined and established for vitrification of biological samples. We have used Cryopin to plunge ovarian tissue into the liquid nitrogen and promising results have been observed. Ovarian tissue re-implantation after cancer cure has one problem- the possibility of recurrence of malignancy in the reimplanted tissue is high. Xenografting-implantation of the preserved tissue in another species- also has its drawbacks such as molecular signaling from the recipient. In vitro follicle culturing is a safer method to obtain mature oocytes for fertilization and the various studies that have been carried out in this area are reviewed in this paper.
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Affiliation(s)
- Rouhollah Fathi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mojtaba Rezazadeh Valojerdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Anatomy, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Bita Ebrahimi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Farideh Eivazkhani
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mahzad Akbarpour
- Department of Pediatrics, Pritzker School of Medicine, University of Chicago, Chicago, USA
| | - Leila Sadat Tahaei
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Naeimeh Sadat Abtahi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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10
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Vindrola-Padros C, Dyer KE, Cyrus J, Lubker IM. Healthcare professionals' views on discussing fertility preservation with young cancer patients: a mixed method systematic review of the literature. Psychooncology 2017; 26:4-14. [PMID: 26890220 PMCID: PMC5025377 DOI: 10.1002/pon.4092] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 11/16/2015] [Accepted: 01/18/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE In spite of efforts to guarantee patients are adequately informed about their risk of fertility loss and offered treatment for fertility preservation (FP), previous studies have reported that this topic is not routinely discussed with patients, especially with younger patient populations. A mixed method systematic review was undertaken to explore the factors shaping the discussion of FP with children (0-15 years) and adolescents/young adults (16-24 years) with cancer. METHODS Six databases were searched independently using a combination of keywords and controlled vocabulary/subject headings relating to cancer and fertility. Inclusion criteria consisted of: (a) being published in a peer-reviewed journal, (b) a focus on healthcare professionals' (HCPs') beliefs, attitudes, or practices regarding fertility issues in cancer patients, (c) primary data collection from HCPs, and (d) a focus on HCPs who provide services to young patients. Of the 6276 articles identified in the search, 16 articles presenting the results of 14 studies were included in the final review. RESULTS Common themes reported across studies indicate that five main factors influence HCPs' discussion of FP with young cancer patients: (a) HCPs' knowledge, (b) HCPs' sense of comfort, (c) patient factors (i.e., sexual maturity, prognosis, partnership status, and whether or not they initiate the conversation), (d) parent factors (i.e., HCPs' perception of the extent of their involvement), and (e) availability of educational materials. CONCLUSIONS Future work should ensure that HCPs possess knowledge of cancer-related FP and that they receive adequate training on how to consent and discuss information with young patients and their parents.
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Affiliation(s)
| | - Karen E. Dyer
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, United States of America
| | - John Cyrus
- Tompkins-McCaw Library, Virginia Commonwealth University Libraries, Richmond, VA, United States of America
| | - Irene Machowa Lubker
- Tompkins-McCaw Library, Virginia Commonwealth University Libraries, Richmond, VA, United States of America
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11
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Gonçalves V, Quinn GP. Review of fertility preservation issues for young women with breast cancer. HUM FERTIL 2016; 19:152-65. [DOI: 10.1080/14647273.2016.1193228] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Vânia Gonçalves
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Gwendolyn P. Quinn
- Department of Health Outcomes & Behavior, H. Lee Moffitt Cancer and Research Institute, Morsani College of Medicine, The University of South Florida, Tampa, FL, USA
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12
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Mahajan N, Patil M, Kaur S, Kaur S, Naidu P. The role of Indian gynecologists in oncofertility care and counselling. J Hum Reprod Sci 2016; 9:179-186. [PMID: 27803586 PMCID: PMC5070400 DOI: 10.4103/0974-1208.192061] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Oncofertility is gaining importance because of increasing cancer incidence, high survivorship, the need to provide a good quality of life to survivors and the desire of patients to preserve their fertility. Disseminating information about the effect of cancer and cancer treatment on fertility and the availability and effectiveness of fertility preservation techniques is critical. Gynaecologists in India act as family physicians and are in a unique position to guide cancer patients on issues of fertility and fertility preservation. Their contribution in oncofertility is vital to improve the quality of life of many young survivors. This paper presents the result of a survey done with Indian gynaecologists. The aim of this survey was to ascertain awareness and knowledge of reproductive damage by cancer therapy, knowledge of fertility preservation techniques and an understanding of the barriers to fertility preservation. This information would assist in planning programs to improve oncofertility care and counselling.
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Affiliation(s)
- Nalini Mahajan
- Director, Mother and Child Hospital, Delhi, India; Ex-Clinical Director, Nova IVI Fertility, Delhi, India
| | - Madhuri Patil
- Director, Dr. Patil's IVF and Endoscopy Centre, Bangalore, India
| | | | - Simrandeep Kaur
- Associate Consultant, Mother and Child Hospital, Delhi, India
| | - Padmaja Naidu
- Associate Consultant, Nova IVI Fertility, Delhi, India
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13
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Ussher JM, Cummings J, Dryden A, Perz J. Talking about fertility in the context of cancer: health care professional perspectives. Eur J Cancer Care (Engl) 2015; 25:99-111. [PMID: 26361092 DOI: 10.1111/ecc.12379] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2015] [Indexed: 11/28/2022]
Abstract
Health care professionals (HCPs) play a key role in providing information and counselling about the implications of cancer for fertility, however, many patients do not receive such information. The aim of this study was to examine the perspectives and practices of Australian HCPs in relation to discussing fertility with cancer patients. A mixed-methods design, comprising of an online survey of 263 HCPs [41.4% nurses; 25.5% doctors; 31% allied health care professionals (AHP)] and qualitative interviews with 49 HCPs, was utilised. HCPs reported that fertility is an important concern for patients and their partners; however, only 50% of doctors and nurses, and 24% of AHPs reported that they always addressed this issue. The primary barriers to discussing fertility were poor patient prognosis; patient gender or age; time constraints; and absence of appropriate resources and materials. Only a minority of HCPs (29%) had undergone training in discussing fertility with cancer patients. The majority wanted further training or education: including nurses (81.8%), AHPs (80.6%) and doctors (55.4%). HCPs agreed that a number of resources would assist them to raise fertility with their patients, including a list of appropriate referral sources, fact sheets, information booklets, a fertility consultation checklist and on-line resources.
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Affiliation(s)
- J M Ussher
- Centre for Health Research, Western Sydney University, Sydney, NSW, Australia
| | - J Cummings
- Centre for Health Research, Western Sydney University, Sydney, NSW, Australia
| | - A Dryden
- Centre for Health Research, Western Sydney University, Sydney, NSW, Australia
| | - J Perz
- Centre for Health Research, Western Sydney University, Sydney, NSW, Australia
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14
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Woodruff TK. Oncofertility: a grand collaboration between reproductive medicine and oncology. Reproduction 2015; 150:S1-10. [PMID: 26130814 PMCID: PMC4710491 DOI: 10.1530/rep-15-0163] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 06/29/2015] [Indexed: 01/01/2023]
Abstract
In 2007, I was asked by the University of Calgary to participate in a symposium called 'Pushing the Boundaries--Advances that Will Change the World in 20 Years'. My topic was oncofertility, a word I had just coined to describe the intersection of two disciplines--oncology and fertility--and I was thrilled to share my passion for this new field and help young women with cancer protect their future reproductive health. Fertility preservation in the cancer setting lacked a concerted effort to bridge the disciplines in an organized manner. In early 2015, I was delighted to deliver a presentation for the Society for Reproduction and Fertility titled 'Sex in Three Cities', where I gave an update on the oncofertility movement, a remarkable cross-disciplinary, global collaboration created to address the fertility preservation needs of young cancer patients. During my tour of the UK, I was impressed by the interest among the society and its members to engage colleagues outside the discipline as well as the public in a dialogue about cutting-edge reproductive science. In this invited review, I will describe the work of the Oncofertility Consortium to provide fertility preservation options in the cancer setting and accelerate the acceptance of this critical topic on a global scale. I hope that one day this word and field it created will change the world for women who had been left out of the equation for far too long.
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Affiliation(s)
- Teresa K Woodruff
- The Thomas J Watkins Professor of Obstetrics and GynecologyDepartment of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 303 E Superior Street, Lurie 10-250, Chicago, Illinois 60611, USA
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Gonçalves V, Tarrier N, Quinn G. Thinking about white bears: fertility issues in young breast cancer survivors. PATIENT EDUCATION AND COUNSELING 2015; 98:125-126. [PMID: 25200632 DOI: 10.1016/j.pec.2014.08.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 07/27/2014] [Accepted: 08/18/2014] [Indexed: 06/03/2023]
Affiliation(s)
- Vânia Gonçalves
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
| | - Nicholas Tarrier
- Department of Psychology, King's College London, Institute of Psychiatry, London, UK
| | - Gwendolyn Quinn
- H. Lee Moffitt Cancer and Research Institute, Department of Health Outcomes & Behavior, Tampa, USA
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Gonçalves V, Sehovic I, Quinn G. Childbearing attitudes and decisions of young breast cancer survivors: a systematic review. Hum Reprod Update 2013; 20:279-92. [PMID: 24077938 PMCID: PMC3922144 DOI: 10.1093/humupd/dmt039] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Young breast cancer survivors often need to deal with adverse effects of treatments on fertility and complex reproductive decisions. In this systematic review, we highlight what is known about childbearing and parenthood attitudes and decisions of young breast cancer survivors from their own perspective. METHODS We conducted manual and electronic searches on Pubmed, PsychInf and CINAHL databases for articles, published in English between 1 January 1990 and 31 October 2012, that assessed childbearing, pregnancy and parenthood attitudes/decisions of female breast cancer survivors (premenopausal and/or <50 years old). Eligible articles were classified into quantitative studies, qualitative studies and mixed methods studies. Data from each study were individually extracted by all the authors, and standardized tables were created and discussed to ensure congruence of the information extracted. RESULTS Of the 493 publications identified in PubMed (results are presented for PubMed searches as the other databases did not yield any new relevant papers), 8 met the inclusion criteria, in addition to 2 publications retrieved manually. A total of 10 studies provided information on pregnancy and parenthood attitudes and decisions, in addition to risks and benefits of childbearing after breast cancer. Survivors had mixed attitudes towards the issue. Fear associated with future pregnancy was reported, namely the risk of cancer recurrence. However, for many survivors, pregnancy and parenthood can represent normalcy, happiness and life fulfilment. CONCLUSIONS Childbearing after breast cancer is an important issue for survivors. Future larger and prospective studies should be implemented to increase certainty of conclusions of current research. Clinicians may benefit from a deeper understanding of the importance of pregnancy and parenthood to survivors in order to provide the needed educational and psychosocial support services, overcome misinformation and better assist women with their fertility-related decisions.
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Affiliation(s)
- Vânia Gonçalves
- Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802 Coimbra, Portugal
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Oktay K. Fertility preservation: we are in this for a long haul. Am J Obstet Gynecol 2013; 209:77-9. [PMID: 23746594 DOI: 10.1016/j.ajog.2013.05.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 03/19/2013] [Accepted: 05/20/2013] [Indexed: 01/06/2023]
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