Apr 01, 2019
Many young adult female cancer survivors want children in the future, but, for a variety of reasons, are unable to undergo fertility preservation before treatment. For those who maintain ovarian function after treatment but are at risk for premature ovarian failure, fertility preservation after treatment may be an option. However, patients cannot avail themselves of this technology if they are not informed of their risks and options.
I led a team at Memorial Sloan Kettering to survey young adult female cancer survivors from across the US about a variety of reproductive issues, including informational needs, reproductive concerns, and decisional conflict. Of the 346 patients who completed the survey, 179 wanted children (or were unsure) in the future, had not been told they were infertile, and had not previously undergone fertility preservation with egg or embryo freezing or ovarian transposition. Among this subgroup, the majority of respondents believed they did not have enough information about their risk of infertility (58%), risk of early menopause (60%), options to assess their fertility (62%), and options to preserve their fertility (51%). These unmet needs for information were all related to greater decisional conflict when prompted to consider the option of pursuing fertility preservation in the future (p’s<.01).
I, and my co-authors, believe that the findings from this study highlight the need to better address fertility issues in post-treatment survivorship care.
We recommend more comprehensive counseling for young adult female cancer survivors about fertility risks and fertility preservation options to ensure they do not miss their narrowed window of reproductive opportunity.
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