title: Factors associated with frequency of discussion of or referral for counselling about fertility issues in female cancer patients.
abstract: Current practices in counselling of female cancer patients with respect to fertility issues need considerable improvement, particularly given the general underuse of fertility preservation options and the negative impact that infertility can have on quality of life. We investigated the relationship between physicians' and physician-related factors and the frequency of physicians discussing fertility issues and referring to a reproductive specialist. We invited 1,832 physicians in the Netherlands who had treated at least five reproductive-age female cancer patients within the past year to complete a questionnaire. Of the 748 respondents, 406 met our inclusion criteria, and 280 participated. Analysis revealed that 79% of the participants usually or always discuss fertility issues. Specialty, confidence in knowledge regarding fertility issues and a lack of reproductive specialists in their region contributed independently to the variance in the frequency of discussing fertility issues. Moreover, 54% either regularly or always refer. Specialty and frequency of discussion contributed independently to the variance in referral. In conclusion, although high, frequency of discussion of fertility issues is not optimal, and referral seems limited. Patients would benefit from more knowledge among physicians regarding fertility issues and referral options, both in terms of informed choice, and more importantly, quality of life.
authors: Department of Gynaecology, Leiden University Medical Centre, Leiden, The Netherlands.
authors: L A
authors: LA
authors: Louwé
authors: Department of Medical Decision Making/Quality of Care, Leiden University Medical Centre, Leiden, The Netherlands.
authors: A M
authors: AM
authors: Stiggelbout
authors: Department of Paediatric Oncology/Haematology, VU University Medical Centre, Amsterdam, The Netherlands.
authors: A
authors: A
authors: Overbeek
authors: Department of Gynaecology, Reinier de Graaf Hospital, Delft, The Netherlands.
authors: C G J M
authors: CGJM
authors: Hilders
authors: Department of Paediatric Oncology/Haematology, VU University Medical Centre, Amsterdam, The Netherlands.
authors: M H
authors: MH
authors: van den Berg
authors: Department of Paediatric Oncology/Haematology, VU University Medical Centre, Amsterdam, The Netherlands.
authors: E
authors: E
authors: Wendel
authors: Department of Paediatric Oncology/Haematology, VU University Medical Centre, Amsterdam, The Netherlands.
authors: E
authors: E
authors: van Dulmen-den Broeder
authors: Department of Gynaecology, Leiden University Medical Centre, Leiden, The Netherlands.
authors: M M
authors: MM
authors: Ter Kuile
mesh_terms: D000328:Adult; D003376:Counseling / Q000706:statistics & numerical data*; D005260:Female; D059247:Fertility Preservation; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007246:Infertility / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D009426:Netherlands; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011788:Quality of Life; D012017:Referral and Consultation / Q000706:statistics & numerical data*
keywords: adults; chemotherapy; communication; fertility preservation; physicians