title: A national study of the provision of oncofertility services to female patients in Canada.
abstract: OBJECTIVE
  This study aimed to gain a better understanding of the fertility preservation services provided by Canadian fertility clinics to women with cancer.
  
  
  METHODS
  We invited a total of 76 fertility clinics across Canada to complete a mailed questionnaire related to the availability, accessibility, affordability, and utilization of fertility preservation services for oncology patients.
  
  
  RESULTS
  The total response rate was 59.2%: 72.4% for IVF clinics and 51.1% for fertility centres without on-site IVF. Not all the responding IVF centres accepted oncology referrals for women. Six clinics without on-site IVF accepted cancer patients for consultation. The medical consultation fees are covered by public health insurance in all provinces. The majority of respondents expedited the referrals to schedule an initial medical appointment within three days. Despite that, the referral volume reported by respondents was markedly low for all except two facilities. With over 4000 young women of reproductive age given a diagnosis of cancer each year in Canada, the findings suggest that cancer patients are severely under-served by fertility clinics.
  
  
  CONCLUSIONS
  There is a need to develop a stronger partnership between the fields of oncology and reproductive medicine to further improve access of patients with cancer to fertility preservation services. Development of evidence-based practice guidelines covering medical, clinical, psychosocial, ethical, and legal aspects geared to the Canadian health care system would help to avoid ambiguity relating to the roles and responsibilities in the provision of fertility preservation services. Such processes would ensure optimization of services so that all young cancer patients would receive the best care in protecting their fertility.
authors.affiliation: Centre for Fertility and Reproductive Health, Mount Sinai Hospital, Toronto ON; Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto ON.
authors.forename: Samantha
authors.initials: S
authors.lastname: Yee
authors.affiliation: McGill University Reproductive Centre, Royal Victoria Hospital, Montreal QC; Department of Obstetrics and Gynecology, McGill University, Montreal QC.
authors.forename: William
authors.initials: W
authors.lastname: Buckett
authors.affiliation: PROPEL Centre for Population Health Impact, Waterloo ON.
authors.forename: Sharon
authors.initials: S
authors.lastname: Campbell
authors.affiliation: CancerCare Manitoba, Winnipeg MB; Pediatric Hematology and Oncology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg MB.
authors.forename: Rochelle
authors.initials: R
authors.lastname: Yanofsky
authors.affiliation: Departments of Pediatrics, Pathology and Medicine, McMaster University, Hamilton ON.
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Barr
mesh_terms: D002170:Canada; D003365:Costs and Cost Analysis; D005260:Female; D059247:Fertility Preservation / Q000191:economics / Q000706:statistics & numerical data*; D005307:Fertilization in Vitro; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D011795:Surveys and Questionnaires; D035862:Vulnerable Populations / Q000706:statistics & numerical data