A nationwide survey of oncologists regarding treatment-related infertility and fertility preservation in female cancer patients

Abstract

Objective: To survey oncologists regarding their knowledge and practice patterns concerning fertility preservation for female cancer patients.

Design: An online survey was sent to oncologists at cancer centers ranked by U.S. News & World Report.

Setting: Oncologists who treat women of reproductive age at academic medical centers.

Patient(s): None.

Intervention(s): None.

Main outcome measure(s): Counseling and referral practices of oncologists regarding fertility risks among young women with cancer.

Results: Most (95%) of the 249 responding oncologists routinely discuss a treatment's impact on fertility; 1,701 surveys were sent. Although 82% have referred patients to reproductive endocrinologists, more than half rarely refer. When planning treatment, 30% rarely consider a woman's desire for fertility. Gynecologic oncologists were more likely to routinely consider fertility compared with other oncologists (93% vs. 60%). Gynecologic oncologists also were more likely to provide a less effective regimen to better preserve fertility (61% vs. 37%). Most oncologists (86%) would be willing to sacrifice less than a 5% reduction in disease-free survival if a regimen offered better fertility outcomes; 36% felt patients would be willing to sacrifice >5%.

Conclusion(s): Although most oncologists at academic medical centers discuss the risk of infertility with female patients, referrals to reproductive endocrinologists are rare. Gynecologic oncologists may be more likely than others to consider modifying treatment to preserve fertility. According to oncologists, patients may be willing to sacrifice more in survival than they would.