Do doctors discuss fertility issues before they treat young patients with cancer?
BACKGROUND
Many children treated for cancer are at risk of infertility, but for girls and prepubertal boys, all fertility preservation techniques remain experimental. We have assessed UK practice relating to information provision about the effects of cancer treatment on fertility and options for fertility preservation.


METHODS
Paediatric oncologists prospectively completed a data form for each new patient registered over a 12 month period.


RESULTS
Data were available on 1030 patients (68% of total registered). The effect of cancer treatment on fertility was discussed with 63% of patients. Of these, 61% were judged to be at high or medium risk of fertility problems. Discussions took place more commonly with boys than girls; the commonest reason for discussion not occurring was young age. The majority (83%) of post-pubertal boys assessed as high/medium risk of infertility were referred for semen cryopreservation. This rate fell to 39% of those in early puberty. Only 1% (n=4) of girls were referred to an assisted conception unit.


CONCLUSIONS
These data indicate a high awareness of the potential adverse effects of therapy on fertility among UK paediatric oncologists. High referral rates for older boys indicate that current guidelines are followed, but there is a need for fertility preservation techniques for girls and younger boys.
Anderson
Richard A
RA
Division of Developmental and Reproductive Science, University of Edinburgh, Edinburgh, UK.
Weddell
Annette
A
Spoudeas
Helen A
HA
Douglas
Carolyn
C
Shalet
Stephen M
SM
Levitt
Gill
G
Wallace
W Hamish B
WH
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D024221:Antineoplastic Protocols; D002648:Child; D002675:Child, Preschool; D030881:Disclosure; D005260:Female; D005298:Fertility; D006066:Gonads / Q000187:drug effects / Q000528:radiation effects; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007246:Infertility / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D009926:Organ Preservation; D010817:Physician-Patient Relations; D011446:Prospective Studies; D011878:Radiotherapy / Q000009:adverse effects; D012662:Semen Preservation; D012737:Sex Factors; D006113:United Kingdom
D000970:Antineoplastic Agents