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. 2021 Jan-Mar;14(1):81-86.
doi: 10.4103/jhrs.jhrs_239_20. Epub 2021 Mar 30.

Current Awareness and Attitude toward Fertility Preservation in Indonesia: A Nationwide Survey Among Health-care Providers

Sarrah Ayuandari  1 , Nurida Khasanah  1 , Ismi W Riyanti  1 , Agung Dewanto  1 , Diannisa Ikarumi Enisar Sangun  1 , Budi Wiweko  2   3   4
Affiliations

Current Awareness and Attitude toward Fertility Preservation in Indonesia: A Nationwide Survey Among Health-care Providers

Sarrah Ayuandari et al. J Hum Reprod Sci. 2021 Jan-Mar.

Abstract

Context: Fertility preservation (FP) is necessary for cancer patients who develop infertility due to chemotherapy and radiotherapy. In Indonesia, many systematic steps and long-term continued actions must be taken to establish FP units since there has been an increasing incidence of cancer among people under 45 years old.

Aims: This study aimed at a comprehensive evaluation on the awareness and practices of health-care providers (HCPs) toward FP.

Settings and design: This was a descriptive cross-sectional study.

Subjects and methods: A validated nationwide online survey was completed by 160 HCPs as a representative sample from 11 provinces in 2017 that provide medical care to cancer patients at hospitals or clinics.

Statistical analysis used: Descriptive statistics, analysis of variance, logistic regression, and Pearson correlation tests were used for the statistical analysis.

Results: Respondents were specialists (59.4%) and other HCPs (40.6%). Around 60% of the HCPs who performed cancer therapies already discussed the fertility issues with their patients. Meanwhile, the HCPs (60.7%) also tended not to consult and refer their patients to fertility experts (P < 0.05). However, those who discussed the risk of infertility with patients tended to consult with and refer them to a fertility consultant for further FP procedure as the follow-up for their discussions (odds ratio = 8.98, confidence interval 95%, P < 0.05).

Conclusions: In Indonesia, FP awareness of the HCPs who performed cancer therapy was high. Nevertheless, attitudes to refer patients to fertility experts for possible FP management still need to be improved.

Keywords: Attitude; awareness; fertility preservation; health-care providers.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Fertility preservation techniques that are very familiar among respondents are oocyte cryopreservation 72.94%, followed by ovarian tissue cryopreservation 37.65%, embryo cryopreservation 23.35%, and sperm cryopreservation 16.47%. The four remaining methods were unfamiliar to the respondents
Figure 2
Figure 2
The majority (60.70%) of the respondent discuss fertility issue with their cancer patients, however only a few of them (39.30%) consult with and refer the patients to the fertility experts. Written information regarding gonadotoxicity of the chemotherapeutic agents was rarely (32.10%) given to the patients. (ANOVA, p< 0.05)
Figure 3
Figure 3
Some of the respondents (38.82%) considered to start offering fertility preservation only if the patients are in reproductive age, willing to have children and have good prognosis. Only a small percentage (1.18%) of them admitted that they only would offer FP if they have enough time for discussion
See this image and copyright information in PMC

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