title: Do Patient Characteristics Decide if Young Adult Cancer Patients Undergo Fertility Preservation?
abstract: OBJECTIVE
  The Fertility Attitudes and Cancer Treatment Study (FACTS) is a two-phase research initiative aimed to understand factors involved with decision making for future fertility. The FACTS will improve services and utilization of fertility preservation (FP) before cancer treatment. Phase-I examined patient characteristics as associated with FP decision.
  
  
  METHODS
  A retrospective cohort study of 108 reproductive-aged (18-45 years) males and females who received a fertility consultation before cancer treatment from January 1, 2012 to April 30, 2014 was conducted. Chi-square, student's t-test, and logistic regression were conducted to examine associations with FP decision.
  
  
  RESULTS
  The utilization rate of FP following fertility consultation was 49%. Gender was the most significant factor contributing to FP decision; 74% of those who choose FP were male (odds ratio = 12.5; 95% confidence interval 5.1-31.4). Those who opted for FP were more likely to be Caucasian (p = 0.042), have a solid tumor (p = 0.03), and have a shorter time from diagnosis to fertility consultation (29.5 vs. 58.8 days; p = 0.017). Age, relationship, tumor location, treatment plan, and parity were not significant predictors of FP.
  
  
  CONCLUSIONS
  Current perceptions about patient demographics do not predict FP utilization by young adult cancer patients. Providing patients an informed fertility consultation has demonstrated an increase in FP utilization to nearly one-half of patients. Despite gender being a significant factor in choosing FP, the study did not provide reasons as to why. The phase-II study will explore patients' reasons for FP decision in a qualitative design to understand these differences.
authors.affiliation: 1 Department of Obstetrics and Gynecology, University of Colorado School of Medicine , Aurora, Colorado.
authors.forename: Dina M
authors.initials: DM
authors.lastname: Flink
authors.affiliation: 2 Division of Family Planning, Department of Obstetrics and Gynecology, University of Colorado School of Medicine , Aurora, Colorado.
authors.forename: Jeanelle
authors.initials: J
authors.lastname: Sheeder
authors.affiliation: 3 Colorado Center for Reproductive Medicine , Lone Tree, Colorado.
authors.forename: Laxmi A
authors.initials: LA
authors.lastname: Kondapalli
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002755:Choice Behavior; D015331:Cohort Studies; D003657:Decision Making; D005260:Female; D059247:Fertility Preservation / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D016017:Odds Ratio; D010298:Parity; D011878:Radiotherapy / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012737:Sex Factors; D033581:Stem Cell Transplantation / Q000706:statistics & numerical data; D013514:Surgical Procedures, Operative; D013997:Time Factors; D044465:White People; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: fertility decision-making; fertility preservation; fertility preservation barriers; fertility preservation utilization; oncofertility