Clinician provision of oncofertility support in cancer patients of a reproductive age: A systematic review

Abstract

Objective: The emerging discipline of oncofertility advocates for the timely provision of fertility information and referral for fertility preservation to all cancer patients of reproductive age (<45 years). A systematic review was undertaken on the clinician provision of oncofertility support to determine whether cancer patients are having their support needs adequately met by staff.

Methods: An initial search conducted in May 2016 identified 351 potentially relevant studies. The papers were divided into 2 categories: Papers on the clinician provision of oncofertility support were reviewed for this study, and papers on patient oncofertility support needs were reviewed for a separate systematic review.

Results: A total of 23 studies were included within the final review of this manuscript. Although many clinicians are broadly informed about the risk to their patients' fertility brought about by cancer treatment, there are many factors which hinder the appropriate discussion, referral, or service utilisation needed to provide adequate oncofertility support to patients of reproductive age.

Conclusions: Oncofertility support is often not delivered to the standard of current guidelines, with many clinicians not providing the recommended care to all eligible patients, and as such many patients may lack the oncofertility support that they require. The implementation of a clear procedural process would assist clinicians in the provision of oncofertility support for cancer patients of reproductive age.

Keywords: cancer; fertility; fertility preservation; health service practices; oncofertility; oncology; support.