Medical consultations about fertility preservation with haematological patients of childbearing age: A qualitative study.
OBJECTIVE
Oncological treatments can cause serious long-term consequences, including effects on patients' fertility. Communication about possible fertility impairment is essential for cancer patients who want to have children. When oncologists initiate this discussion in a timely manner, patients can be referred to fertility specialists and avail themselves of fertility preservation methods. The oncologist plays a key role in this context.


METHODS
30 cancer patients of childbearing age (21-43 years) took part in semi-structured interviews between March 2011 and April 2012 about fertility and their desire to have children. Interview transcripts were thematically analyzed.


RESULTS
Physician-patient consultations broached the issue as a central theme in almost all patients. A few consultations were patient initiated, and the majority took place before the beginning of treatment. Almost half of the patients were satisfied with their consultations and were referred to a fertility specialist. The ideal setting for these conversations is in the presence of the patient's partner, in a private space, before the beginning of treatment.


CONCLUSIONS
All patients should be informed about the possibility of their fertility being impaired due to treatments, even if they have not explicitly expressed wanting children. The oncologist is the first and most important contact for the patient and, hence, should bring up the issue of family planning and fertility. An interdisciplinary communication and collaboration between oncologists and fertility specialists can improve patient care.
University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany. Electronic address: Diana.Richter@medizin.uni-leipzig.de.
Diana
D
Richter
University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany.
Kristina
K
Geue
University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany.
Annekathrin
A
Sender
University Medical Center Leipzig, Clinic and Policlinic of Dermatology, Venereology and Allergology, Philipp-Rosenthal-Straße 23, 04103 Leipzig, Germany.
Uwe
U
Paasch
University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany; Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
Elmar
E
Brähler
University of Applied Sciences Zittau/Görlitz, Faculty of Managerial and Cultural Studies, Chair of Health Sciences, Furtstraße 3, House G IV, 02826 Görlitz, Germany.
Yve
Y
Stöbel-Richter
University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany.
Jochen
J
Ernst
D000328:Adult; D000367:Age Factors; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D007938:Leukemia / Q000150:complications* / Q000523:psychology* / Q000628:therapy; D008223:Lymphoma / Q000150:complications* / Q000523:psychology* / Q000628:therapy; D008297:Male; D020380:Needs Assessment; D017060:Patient Satisfaction; D036301:Qualitative Research; D012017:Referral and Consultation; D055815:Young Adult
Childbearing age; Desire to have a child; Fertility preservation; Oncology; Physician–patient-communication; Qualitative research