title: Early referral makes the decision-making about fertility preservation easier: a pilot survey study of young female cancer survivors.
abstract: OBJECTIVE
  The purpose of the study was to investigate the association between patients' decision-making about fertility preservation (FP) and time between cancer diagnosis and FP consultation in young female cancer survivors.
  
  
  METHODS
  This is a pilot survey study of women aged 18-43 years seen for FP consultation between April 2009 and December 2010.
  
  
  RESULTS
  Among 52 women who completed the survey, 15 (29 %) had their FP consultation more than 2 weeks after their cancer diagnosis (late referral group) and 37 (71 %) were within 2 weeks of their cancer diagnosis (early referral group). In univariate analysis, the only difference between the late referral and early referral groups was a higher decisional conflict scale (DCS) in late referral group (p = 0.04). In multivariable analysis, late referral group was more likely to have high DCS (>35) compared to early referral group (odds ratio 4.8, 95 % confidence interval 1.5, 21.6) after adjusting for age, center, and type of cancer.
  
  
  CONCLUSIONS
  Early referral to a fertility specialist can help patients make better decision about FP. This is the first study to suggest that early referral is important in patients' decision-making process about FP treatment. Our finding supports the benefit of early referral in patients who are interested in FP which is consistent with prior studies about FP referral patterns.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of North Carolina at Chapel Hill, 4001 Old Clinic Building, CB 7570, Chapel Hill, NC, 27599-7570, USA.
authors.forename: Jayeon
authors.initials: J
authors.lastname: Kim
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Mersereau
mesh_terms: D000293:Adolescent; D000328:Adult; D003657:Decision Making; D005260:Female; D005298:Fertility / Q000502:physiology*; D059247:Fertility Preservation; D006801:Humans; D009369:Neoplasms / Q000175:diagnosis / Q000628:therapy; D016017:Odds Ratio; D010865:Pilot Projects; D012017:Referral and Consultation; D017741:Survivors; D013995:Time