Oncofertility program implementation increases access to fertility preservation options and assisted reproductive procedures for breast cancer patients

Vu, Joceline V.; Llarena, Natalia C.; Estevez, Samantha L.; Moravek, Molly B.; Jeruss, Jacqueline S.

doi:10.1002/jso.24418

Cited by 45 publications

(52 citation statements)

References 36 publications

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“…One possible interpretation of the present result is that those physicians working at a cancer clinic that is geographically and organizationally close to a reproduction clinic are more likely to refer such discussions to fertility specialists, instead of having them directly with their patients. A multifaceted oncofertility program including both organizational and educational interventions has recently been shown to increase the frequency of documented fertility-related conversations between oncologists and patients, as well as referral rates to reproductive endocrinology and/or FP [24]. This strengthens the conclusion that, despite relatively high levels of perceived knowledge about treatment-related infertility risks among Swedish oncologists and hematologists, identifying and eliminating organizational barriers could be helpful in order to further improve fertility-related communication in cancer care.…”

Section: Discussionmentioning

confidence: 62%

Oncologists and hematologists’ perceptions of fertility-related communication – a nationwide survey

et al. 2017

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Background: Despite the negative impacts of several cancer treatments on fertility, many patients do not recall having fertility-related discussions with their physicians. This study was conducted to identify those factors related to physicians' discussing the treatment impacts on fertility with cancer patients of reproductive age. Material and methods: In this nationwide survey of cancer care physicians (n ¼ 329, response rate 55%), oncologists and hematologists (mainly) completed a questionnaire on practice behavior, barriers, attitudes and confidence in knowledge regarding treatment-related fertility risks. Logistic regression analyses were conducted to identify factors associated with not routinely discussing fertility issues with patients. Results: Most of the physicians agreed that they were responsible for discussing fertility issues with patients of reproductive age (91%), but approximately 30% did not do so regularly. Those factors decreasing the likelihood of discussion were: patient already had children (female/male OR 3.0/6.9), high workload (OR 3.3/4.8), seeing <5 female/male patients of reproductive age weekly (OR 3.2/3.4) and access to a reproduction clinic (OR 5.2/4.2). Conclusions: Most Swedish oncologists and hematologists regularly discuss impact of treatment on fertility with their patients. Those factors having a negative impact on fertility discussions may guide targeted organizational and educational efforts to further improve fertility-related communication in cancer care.

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Section: Discussionmentioning

confidence: 62%

Oncologists and hematologists’ perceptions of fertility-related communication – a nationwide survey

et al. 2017

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“…A recent review, identified eight established oncofertility models of care and their key components including clinician education about FP, collaboration with fertility specialists, established referral pathways, educational materials for patients, patient navigator and electronic notification. Promising results indicate that implementation of a multifaceted oncofertility program increased the frequency of documented fertility‐related discussions as well as referral rates to fertility specialists and the use of FP . The development and implementation of multifaceted oncofertility programs appears to be a promising way forward towards high‐quality FP care meeting patients' needs.…”

Section: Resultsmentioning

confidence: 99%

“…A recent review, 34 iden- to fertility specialists and the use of FP. 35 The development and implementation of multifaceted oncofertility programs appears to be a promising way forward towards high-quality FP care meeting patients' needs.…”

Section: Con Clus Ionmentioning

confidence: 99%

Oncologists' and pediatric oncologists' perspectives and challenges for fertility preservation

Lampic

Wettergren

2019

Acta Obstet Gynecol Scand

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International guidelines recommend that health‐care providers initiate discussions about the impact of treatment on fertility with cancer patients of reproductive age, or with parents/legal guardians of children, as early as possible in the treatment process. Still, both physicians and patients confirm that this is not always the case. This literature review summarizes findings regarding oncologists' and pediatric oncologists' perspectives and challenges of providing fertility preservation care, and points out directions for development. The results concerning the challenges facing clinicians are consistent and encompass both internal and external factors. The internal factors relate to clinicians' characteristics and values and include their knowledge of fertility preservation, clinical experience, perceptions of patients' plans for children, and how comfortable they are to discuss sensitive issues. The external factors relate to the availability of health‐care services and the organization of care, including the clinicians' working conditions. Several strategies to overcome identified challenges for clinicians to provide high‐quality fertility preservation care are proposed. These include educational interventions to increase clinicians' knowledge about treatment‐induced fertility impairment and available fertility preservation measures, as well as interventions aimed to increase clinicians' readiness and competence to communicate with patients and their parents. In addition, different types of educational resources for patients have been suggested to improve patient‐provider communication about fertility preservation, such as age‐appropriate brochures and decision aids. Organizational approaches suggested to address the identified external factors include development and implementation of policies and guidelines as well as closer collaboration between oncological and fertility clinics. Also, modifications of electronic medical record systems may support clinicians by prompting the documentation of discussions about potential treatment impact on future fertility and about available fertility preservation options. The development and implementation of multifaceted oncofertility programs appears to be a promising way forward towards high‐quality fertility preservation care meeting patients' needs.

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“…Communication about fertility preservation options and appropriate referral to a specialist are both critical to quality of life of young BC patients and may also impact disease outcomes 38 . Women who received a cancer diagnosis have indicated that the feeling of distress associated with the threat to fertility posed by cancer treatment was on par with the distress associated with BC diagnosis 39 .…”

Section: Fertilitymentioning

confidence: 99%

Psychological Impact of Alterations in Sexuality, Fertility, and Body Image in Young Breast Cancer Patients and Their Partners

Ávila

Platas

Martínez-Cannon

2017

RIC

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Young women with breast cancer have age-specific concerns regarding changes in sexuality, fertility, and body image. However, the psychological impact of BC and its treatments is not exclusive to young patients and it also affects their social context, especially their partners, as they experience higher illness intrusiveness than the partners of older women. In young BC patients, relationships, body image, and sexual problems are related to most quality of life domains. While BC treatment is being planned, all women should be informed about the possible side-effects of treatment on sexuality, fertility, and body image. Inclusion of partners into decision making should be pursued to restore, improve, and maintain effective communication and positive relationships in young couples facing BC. The aim of this review is to describe the psychological impact of alterations in sexuality, fertility, and body image in young BC patients and their partners, and to recommend strategies to address such issues in a timely manner.

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Oncofertility program implementation increases access to fertility preservation options and assisted reproductive procedures for breast cancer patients

Cited by 45 publications

References 36 publications

Oncologists and hematologists’ perceptions of fertility-related communication – a nationwide survey

Oncologists and hematologists’ perceptions of fertility-related communication – a nationwide survey

Oncologists' and pediatric oncologists' perspectives and challenges for fertility preservation

Psychological Impact of Alterations in Sexuality, Fertility, and Body Image in Young Breast Cancer Patients and Their Partners

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