title: Fertility preservation consultation for women with cancer: are we helping patients make high-quality decisions?
abstract: To investigate the efficacy of the current fertility preservation consultation process in patients' decision-making and socio-demographic and cognitive factors that may affect patients' decision-making, a prospective pilot survey was conducted at university-based IVF centres and included women aged 18-43 years seen for fertility preservation between April 2009 and December 2010. Patients' views on consultation and decision-making about fertility preservation were measured. Among 52 women who completed the survey, more than half (52%) requested their consultation. All patients answered that consultation was a helpful resource of information, and 73% made their decision about treatment after consultation. Decisional conflict was lower in patients who felt strongly that they were given opportunities to ask questions during the consultation (P=0.001) and higher those who reported that cost was strongly influential in the treatment decision (P<0.001) and who did not receive treatment (P<0.001). Although consultation appeared to play a critical role in patients' decision-making about fertility preservation, the referral rate for consultation by oncologists is still poor. Decision-making appears to be significantly impaired in patients grappling with financial concerns and when the opportunity to ask questions is not felt to be sufficient.
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
authors.forename: Jayeon
authors.initials: J
authors.lastname: Kim
authors.forename: Allison M
authors.initials: AM
authors.lastname: Deal
authors.forename: Ursula
authors.initials: U
authors.lastname: Balthazar
authors.forename: Laxmi A
authors.initials: LA
authors.lastname: Kondapalli
authors.forename: Clarisa
authors.initials: C
authors.lastname: Gracia
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Mersereau
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000523:psychology / Q000628:therapy; D003657:Decision Making; D005260:Female; D059247:Fertility Preservation / Q000191:economics; D006801:Humans; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D017060:Patient Satisfaction; D011446:Prospective Studies; D012017:Referral and Consultation