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Young cancer patients 'unaware of fertility options'

10 August 2015

Adolescents or young adults with cancer may not be aware of available options to preserve their fertility, according to a study published in the journal Cancer.

Dr Margarett Shnorhavorian, of Seattle Children's Hospital, Washington, and colleagues, analysed questionnaires from 459 young patients diagnosed with cancer in 2007-2008.

More than 70 percent of these patients reported that their doctors had explained that there was a risk of infertility following cancer treatment. However, less than a third of men and less than ten percent of women said they had made arrangements for fertility preservation.

Men were also twice as likely as women to have discussed fertility preservation options, such as freezing sperm or eggs, with their doctor.

Looking for factors that might affect which patients received fertility advice, the researchers found that patients without health insurance were less likely to discuss fertility options with their doctor, as were patients who already had children.

Similarly, these were also the main factors that predicted whether men were less likely to make arrangements for fertility preservation. There were not enough women who made fertility preservation arrangements in the study to carry out similar analyses.

When asked why they decided not to pursue fertility preservation avenues, patients frequently cited lack of awareness, financial reasons, or not wanting to delay treatment.

Dr Shnorhavorian commented that the findings show a need for 'partnerships between cancer healthcare providers and fertility experts to develop strategies that increase awareness of fertility preservation options and decrease delays in cancer therapy as fertility preservation for adolescent and young adult cancer patients improves.'

Since 2006, the American Society of Clinical Oncology has recommended that oncologists discuss fertility options with all reproductive-age patients.

Speaking to Reuters, Dr Kutluk Oktay who was a senior author on those guidelines, said that it was up to physicians to initiate such conversations, and not leave it up to patients to raise the issue.

Patients 'are under so much psychological and financial pressure that they naturally try to avoid opening up a new front,' Oktay said.

'It's not surprising, but it is disappointing, that many patients who could benefit from fertility preservation aren't hearing the message,' Dr Jani Jensen, co-director of the IVF programme at the Mayo Clinic in Rochester, Minnesota, told Reuters.

'Fertility and childbearing become hugely important for many patients during survivorship,' she added.

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