Trends of socioeconomic disparities in referral patterns for fertility preservation consultation

Goodman, Linnea R.; Balthazar, Ursula; Kim, Ja‐Yeon; Mersereau, Jennifer E.

doi:10.1093/humrep/des133

Cited by 107 publications

(108 citation statements)

References 21 publications

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“…15 In our study, the average age of patients accepting referral to a reproductive specialist was 32 and of those who declined the referral was 35, suggesting more interest in younger patients; however, this difference was not statistically significant (P = .37), perhaps due to our small sample size. In the same study of newly diagnosed women with cancer, a significantly higher percentage of Caucasian women received FP counseling as compared with AfricanAmerican, Hispanic, and Asian women (26.3%, 17.6%, 0%, and 13.3%, respectively).…”

contrasting

confidence: 59%

“…15 In our study, both men and women without prior children were more likely to accept referral to the reproductive specialist (P = .048). However, having prior children did not exclude interest in FP as 8 patients with prior children proceeded with the referral to a reproductive specialist.…”

mentioning

confidence: 57%

“…In the same study of newly diagnosed women with cancer, a significantly higher percentage of Caucasian women received FP counseling as compared with AfricanAmerican, Hispanic, and Asian women (26.3%, 17.6%, 0%, and 13.3%, respectively). 15 In the general population, there is a disproportionately low representation of AfricanAmerican women undergoing assisted reproductive technology. 16 The patients in our study were predominantly Caucasian (79%) and there was no statistically significant difference in acceptance of reproductive specialist by race (P = .75), but the population of non-Caucasian patients was quite small.…”

mentioning

confidence: 99%

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Fertility preservation in primary brain tumor patients

Stone

Kelvin

DeAngelis³

2016

Neuro-Oncology Practice

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Background Fertility preservation (FP) is an infrequently addressed issue for young adults with primary brain tumors. Given the improved prognosis and enhanced technology in reproductive medicine, more primary brain tumor patients see procreation as feasible, making the discussion of FP increasingly important. The goals of this study were to describe patients who received FP counseling by a fertility nurse specialist (FNS) and determine which sociodemographic and disease-related factors predict acceptance of referral to a reproductive specialist. Methods Institutional review board-approved retrospective review of primary brain tumor patients, ages 18 to 45, who were referred for FP counseling with a FNS from 2009 to 2013. Results Seventy patients were referred for FP counseling: 38 men, 32 women, with a median age of 32 years and median KPS of 90. Eighty-nine percent had gliomas; 58% grade III, 17% grade IV. Sixty-seven percent were referred for counseling at initial diagnosis. Of those referred, 73% accepted referral to a sperm bank (87% of men) or reproductive endocrinologist (56% of women). Patients were more likely to accept referral if they had no prior children (P = .048). There was no statistically significant difference in referral acceptance by age, race/ethnicity, marital status, religion, or tumor grade. After treatment, 3 men conceived naturally, 2 men conceived using banked sperm, and 2 women conceived naturally. Conclusions Despite the historically poor prognosis of patients with primary brain tumors, there is significant interest in FP among these patients, particularly if they have no prior children. Clinicians should develop strategies to incorporate FP counseling into practice.

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confidence: 59%

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confidence: 57%

mentioning

confidence: 99%

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Fertility preservation in primary brain tumor patients

Stone

Kelvin

DeAngelis³

2016

Neuro-Oncology Practice

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“…6,23,[31][32][33][34] Utilization rates of fertility preservation services for women cancer patients in the United States are low, ranging from 4% to 20%. 35,36 There is an overwhelming level of frustration among female survivors with the lack of fertility information received. In a study by Gorman et al, participants discussed scenarios in which healthcare providers offered little to no information about fertility issues, or that sufficient information was provided but the women felt they were unable to take advantage of the fertility preservation options presented.…”

Section: Practice Guidance For Fertility Preservationmentioning

confidence: 99%

A Review of the Oncology Patient's Challenges for Utilizing Fertility Preservation Services

Flink

Sheeder

Kondapalli

2017

Journal of Adolescent and Young Adult Oncology

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Purpose: The American Society of Clinical Oncology issued practice guidelines in 2006 to provide critical information about fertility impact to adolescents and young adults (AYA) at the time of cancer diagnosis. Survivors continue to express concerns about their long-term reproductive health after cancer therapy even as treatment options for fertility preservation evolve. An underutilization of fertility preservation methods by cancer patients continues to persist. A review of the literature cites barriers and challenges that limit fertility information and preservation options for AYA cancer patients. Methods: A review of medical literature was conducted to examine current practice for patients receiving fertility information and the barriers to patients receiving fertility preservation services. Results: A total of 69 publications were included in this review. The review summarizes (1) patient experiences with receiving fertility information and (2) patient desires, barriers, and challenges to utilizing fertility preservation services. Conclusions: Despite advances in fertility preservation, there are challenges for patients to utilizing fertility preservation services. Barriers include the following: urgency to initiate treatment, inadequate information, clinic time constraints, and perceptions around patients' gender, age, cost, parity, race, relationship, and sociodemographic status influence whether patients receive fertility preservation consultation. Patients report a lack of adequate information to make informed fertility decisions.

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“…15 In a 2012 survey of medical oncologists, while 95% reported routinely discussing fertility risk, a striking 61% rarely or never referred patients for FP, and 30% rarely considered a woman's desire for future fertility when considering potential treatment regimens.…”

Section: Barriers To Implementation Of National Fp Guidelinesmentioning

confidence: 99%

Innovative fertility preservation strategies and programs for young adults with cancer

Johnson¹

2016

COAYA

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Preservation of fertility is a key issue for young adults newly diagnosed with cancer. Up to 90% of cancer patients under the age of 45 are at risk for fertility impairment following cancer therapy. Cancer patients who are not offered fertility preservation (FP) and those who become infertile following therapy may experience long-term psychosocial distress. This review summarizes the numerous effective strategies for preserving fertility, including sperm banking, electroejaculation, and testicular sperm extraction in males and cryopreservation of embryos or oocytes in females. This paper also highlights novel methods currently in development, such as gonadal tissue cryopreservation and in vitro maturation of gametes. In women, anti-Mullerian hormone is emerging as an accurate marker of ovarian reserve, and the use of gonadotropin releasing hormone analogs to protect fertility is increasingly well validated. Although national guidelines mandate FP counseling and referral prior to the start of cancer therapy for patients with reproductive potential, only a minority of young cancer patients in the USA currently take steps to preserve fertility prior to the start of therapy. Some cancer centers across the USA are developing institutional strategies to support FP, resulting in increased utilization of fertility services by newly diagnosed cancer patients.

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Trends of socioeconomic disparities in referral patterns for fertility preservation consultation

Abstract: Overall referral rates for FPC are low, and there appear to be significant discrepancies in referral based on ethnicity, age, parity and cancer type. This highlights a need for further provider education and awareness across all oncologic disciplines.

Cited by 107 publications

References 21 publications

Fertility preservation in primary brain tumor patients

Fertility preservation in primary brain tumor patients

A Review of the Oncology Patient's Challenges for Utilizing Fertility Preservation Services

Innovative fertility preservation strategies and programs for young adults with cancer

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