Attitudes, Beliefs, and Trends Regarding Adolescent Oncofertility Discussions: A Systematic Literature Review

Abstract

Purpose: Due to improved survival rates of adolescent cancers, increasing attention is paid to addressing patients' future quality of life after treatment. A salient quality of life issue for adolescent survivors is reproductive capacity. Discussing oncofertility, that is, cancer treatment's possible effects on fertility and fertility preservation (FP) options, is a means to address this concern by informing patients and parents regarding options available to them to prevent future struggles with infertility. This systematic literature review aggregates and summarizes the attitudes, beliefs, and patterns of behavior of all stakeholders (i.e., patients, parents, and healthcare providers) in oncofertility discussions when the patient is an adolescent (12-17 years old).

Methods: English, French, and German literature was systematically identified according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, via four databases, using several combinations of search terms. Book chapters, dissertations, and peer-reviewed qualitative and quantitative studies are included in this review.

Results: Adolescents and parents have similar informational and counseling needs. Both seek to be fully informed about cancer treatment's effects on fertility and FP options. Adolescents have varying experiences of oncofertility discussions and decision making due to sex and/or age differences. Parents and healthcare professionals alike sometimes underestimate the importance of fertility for adolescent cancer patients. Healthcare professionals hold various beliefs and practices with respect to adolescent oncofertility discussions. Many are cognizant of the various barriers that impede successful discussion and strive to overcome them.

Conclusion: In order to overcome discussion barriers and meet adolescent patients and their parents' informational needs, it is essential to create and implement practice guidelines, as well as properly educate and train healthcare professionals about oncofertility issues.

Keywords: decision making; discussion; fertility preservation; oncofertility.