On-Site Fertility Preservation Services for Adolescents and Young Adults in a Comprehensive Cancer Center

Abstract

Purpose: Adolescents and young adults (AYAs) receiving cancer treatments that may impair fertility should receive counseling about risk of infertility and options for fertility preservation (FP) before treatment and/or during survivorship. Our objective was to define the AYA patient population referred to an on-site fertility consultation service within a comprehensive cancer center and determine factors associated with patients proceeding with FP treatment.

Methods: We conducted a retrospective chart review of AYA women who completed a consultation at the MD Anderson Fertility Preservation and Family Building Service during the first year of service. Records of 154 referred AYA patients were reviewed for age, ethnicity, cancer type gravidity and parity, survivorship status, and decision to pursue FP treatment.

Results: Patients (mean age 29.7) were Caucasian (55%), Hispanic (23%), and African American (10%). The majority of women (67%) were seen for FP before cancer treatment and the remaining sought options for family building while in survivorship. The most common cancer types were hematologic (29%), breast (25%), and gynecologic (23%).

Conclusions: Patients referred to an on-site fertility consultation service were medically and ethnically diverse. Interest in fertility counseling and treatment was apparent in both survivorship pre- and postcancer treatment. Although the referral group was ethnically diverse, Caucasian women were most likely to pursue FP treatment compared to women of other ethnicities.

Keywords: comprehensive cancer center; fertility preservation; survivorship.

FIG. 1.

The mean ages of AYA patients within the three subgroups of most commonly represented oncologic diagnoses (hematologic n = 44, gynecologic n = 36, and breast n = 38) were determined, with mean ages of 26.8, 30.6, and 34.1 years, respectively (*p < 0.005, **p < 0.0005). AYA, adolescent and young adult.