A nationwide survey of oncologists regarding treatment-related infertility and fertility preservation in female cancer patients.
OBJECTIVE
To survey oncologists regarding their knowledge and practice patterns concerning fertility preservation for female cancer patients.


METHODS
An online survey was sent to oncologists at cancer centers ranked by U.S. News & World Report.


METHODS
Oncologists who treat women of reproductive age at academic medical centers.


METHODS
None.


METHODS
None.


METHODS
Counseling and referral practices of oncologists regarding fertility risks among young women with cancer.


RESULTS
Most (95%) of the 249 responding oncologists routinely discuss a treatment's impact on fertility; 1,701 surveys were sent. Although 82% have referred patients to reproductive endocrinologists, more than half rarely refer. When planning treatment, 30% rarely consider a woman's desire for fertility. Gynecologic oncologists were more likely to routinely consider fertility compared with other oncologists (93% vs. 60%). Gynecologic oncologists also were more likely to provide a less effective regimen to better preserve fertility (61% vs. 37%). Most oncologists (86%) would be willing to sacrifice less than a 5% reduction in disease-free survival if a regimen offered better fertility outcomes; 36% felt patients would be willing to sacrifice >5%.


CONCLUSIONS
Although most oncologists at academic medical centers discuss the risk of infertility with female patients, referrals to reproductive endocrinologists are rare. Gynecologic oncologists may be more likely than others to consider modifying treatment to preserve fertility. According to oncologists, patients may be willing to sacrifice more in survival than they would.
Forman
Eric J
EJ
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina 27713, USA. eric.forman@duke.edu
Anders
Carey K
CK
Behera
Millie A
MA
D000328:Adult; D000368:Aged; D003376:Counseling; D003625:Data Collection; D018572:Disease-Free Survival; D005260:Female; D005298:Fertility; D005833:Genital Neoplasms, Female / Q000628:therapy*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology*; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation; D012307:Risk Factors