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. 2013 Aug;48(8):1091-7.
doi: 10.1038/bmt.2013.13. Epub 2013 Feb 18.

Physician perceptions and practice patterns regarding fertility preservation in hematopoietic cell transplant recipients

A W Loren  1 , R Brazauskas, E J Chow, M Gilleece, J Halter, D A Jacobsohn, S Joshi, J Pidala, G P Quinn, Z Wang, J F Apperley, L J Burns, G A Hale, B M Hayes-Lattin, R Kamble, H Lazarus, P L McCarthy, V Reddy, A B Warwick, B J Bolwell, C Duncan, G Socie, M L Sorror, J R Wingard, N S Majhail
Affiliations

Physician perceptions and practice patterns regarding fertility preservation in hematopoietic cell transplant recipients

A W Loren et al. Bone Marrow Transplant. 2013 Aug.

Abstract

Physician practice variation may be a barrier to informing hematopoietic cell transplant (HCT) recipients about fertility preservation (FP) options. We surveyed HCT physicians in the United States to evaluate FP knowledge, practices, perceptions and barriers. Of the 1035 physicians invited, 185 completed a 29-item web-survey. Most respondents demonstrated knowledge of FP issues and discussed and felt comfortable discussing FP. However, only 55% referred patients to an infertility specialist. Most did not provide educational materials to patients and only 35% felt that available materials were relevant for HCT. Notable barriers to discussing FP included perception that patients were too ill to delay transplant (63%), patients were already infertile from prior therapy (92%) and time constraints (41%). Pediatric HCT physicians and physicians with access to an infertility specialist were more likely to discuss FP and to discuss FP even when prognosis was poor. On analyses that considered physician demographics, knowledge and perceptions as predictors of referral for FP, access to an infertility specialist and belief that patients were interested in FP were observed to be significant. We highlight variation in HCT physician perceptions and practices regarding FP. Physicians are generally interested in discussing fertility issues with their patients but lack educational materials.

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Conflict of interest statement

Financial Disclosures: None of the authors have any relevant financial conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Physician responses to survey on fertility preservation perceptions and practice behaviors showing: (a) knowledge about fertility among HCT recipients, (b) fertility preservation practice behaviors, (c) use of educational materials, (d) perceived barriers to discussing fertility preservation and (e) perceptions about fertility preservation
Figure 1
Figure 1
Physician responses to survey on fertility preservation perceptions and practice behaviors showing: (a) knowledge about fertility among HCT recipients, (b) fertility preservation practice behaviors, (c) use of educational materials, (d) perceived barriers to discussing fertility preservation and (e) perceptions about fertility preservation
Figure 1
Figure 1
Physician responses to survey on fertility preservation perceptions and practice behaviors showing: (a) knowledge about fertility among HCT recipients, (b) fertility preservation practice behaviors, (c) use of educational materials, (d) perceived barriers to discussing fertility preservation and (e) perceptions about fertility preservation
Figure 1
Figure 1
Physician responses to survey on fertility preservation perceptions and practice behaviors showing: (a) knowledge about fertility among HCT recipients, (b) fertility preservation practice behaviors, (c) use of educational materials, (d) perceived barriers to discussing fertility preservation and (e) perceptions about fertility preservation
Figure 1
Figure 1
Physician responses to survey on fertility preservation perceptions and practice behaviors showing: (a) knowledge about fertility among HCT recipients, (b) fertility preservation practice behaviors, (c) use of educational materials, (d) perceived barriers to discussing fertility preservation and (e) perceptions about fertility preservation
Figure 2
Figure 2
Reported fertility preservation practice behaviors for HCT recipients by physician practice type (adult HCT only vs. pediatric ± adult HCT) and access to an infertility specialist at the same institution or within their community
Figure 2
Figure 2
Reported fertility preservation practice behaviors for HCT recipients by physician practice type (adult HCT only vs. pediatric ± adult HCT) and access to an infertility specialist at the same institution or within their community
Figure 3
Figure 3
Perceived barriers to discussing fertility preservation with HCT recipients by physician practice type (adult HCT only vs. pediatric ± adult HCT) and access to an infertility specialist at the same institution or within their community
Figure 3
Figure 3
Perceived barriers to discussing fertility preservation with HCT recipients by physician practice type (adult HCT only vs. pediatric ± adult HCT) and access to an infertility specialist at the same institution or within their community
See this image and copyright information in PMC

References

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