title: Factors associated with the receipt of fertility preservation services along the decision-making pathway in young Canadian female cancer patients.
abstract: OBJECTIVE
  This study investigated the factors associated with the receipt of fertility preservation (FP) services along the decision-making pathway in young Canadian female cancer patients. The roles of the oncologists were examined.
  
  
  METHODS
  A total of 188 women who were diagnosed with cancer between the ages of 18-39 after the year 2000 and had finished active cancer treatment by the time of the survey (2012-2013) participated in the study. Logistic regression models and Pearson χ (2) tests were used for analyses.
  
  
  RESULTS
  The mean ages of participants at diagnosis and at survey time were 30.2 (SD = 3.7) and 33.9 (SD = 5.9). One quarter (n = 45, 23.9 %) did not recall having a fertility discussion with their oncologists. Of the three quarters who had a fertility discussion (n = 143, 76.1 %), discussions were equally initiated by oncologists (n = 71) and patients (n = 72). Of the 49 women (26 %) who consulted a fertility specialist, 17 (9 %) underwent a FP procedure. Fertility concern at diagnosis was the driving force of the receipt of FP services at all decision points. Our findings suggest that not only was the proactive approach of oncologists in initiating a fertility discussion important, the quality of the discussion was equally critical in the decision-making pathway.
  
  
  CONCLUSIONS
  Oncologists play a pivotal role in the provision of fertility services in that they are not only gate keepers, knowledge brokers, and referral initiators of FP consultation, but also they are catalysts in supporting cancer patients making important FP decision in conjunction with the consultation provided by a fertility specialist.
authors.affiliation: Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario, M5S 1V4, Canada. sy.yee@utoronto.ca.|CReATe Fertility Centre, 790 Bay Street, Suite 1002, Toronto, Ontario, M5G 1N8, Canada. sy.yee@utoronto.ca.
authors.forename: Samantha
authors.initials: S
authors.lastname: Yee
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada; D003657:Decision Making; D005260:Female; D005298:Fertility / Q000502:physiology*; D059247:Fertility Preservation / Q000379:methods*; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D011247:Pregnancy; D011795:Surveys and Questionnaires
keywords: Cryopreservation; Decision-making; Female cancer patients; Fertility preservation; Oncofertility; Oncologist-patient communication