Pre-Treatment Fertility Preservation Counseling Improves Cancer Patients’ Quality of Life
Oct 31, 2017
HIGHLIGHTS FROM THE AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE’S 2017 SCIENTIFIC CONGRESS & EXPO
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San Antonio, TX- Studies presented at the American Society for Reproductive Medicine’s Scientific Congress and Expo described how pre-cancer treatment counseling for fertility preservation can improve patients’ long-term well-being and the characteristics and challenges of pediatric fertility preservation programs.
For women newly diagnosed with cancer, pre-treatment fertility preservation counseling (FPC) reduces their anxiety, distress, and reproductive concerns- and these effects last at least a year after treatment. In a prospective cohort study, researchers from the University of California San Francisco and Kaiser surveyed 139 women, average age 34, newly diagnosed with cancer. The surveys, based on validated instruments, measured decisional regret, reproductive concerns after cancer, anxiety, and distress and were administered to the patients at five time points: before and after fertility preservation, before and after cancer treatment, and one year after completing cancer treatment. In pre-treatment cancer patients, the decision whether to pursue fertility preservation or not pursue it resulted in similar scores for decisional regret. However, after cancer treatment, patients electing not to preserve their fertility reported greater regret than those who did, with an even larger difference in feelings of regret reported one year post treatment. Despite any regret, FPC before cancer treatment led to a reduction in levels of anxiety, distress and reproductive concerns which continued for over a year after cancer treatment.
Pediatric fertility preservation (FP) programs differ in many respects- for example in the services they offer, their funding structures and patient costs. To identify the differences and commonalities of their pediatric fertility preservation programs and the barriers facing them, members of the Pediatric Initiative Network (PIN) of the Oncofertility Consortium contributed to a survey.
All 12 programs offered services to post-pubertal adolescents. Nine of 12 offered services to pre-pubertal children, with 6 programs offering ovarian tissue freezing and 4 programs offering testicular tissue freezing to these patients. All 12 programs offered egg and sperm cryopreservation and all 12 programs would provide fertility preservation services to cancer patients either pre- or post-chemotherapy. Addressing needs aside from those of cancer patients, 8 of the 12 programs offer fertility preservation to pediatric patients with high risk of gonadal failure, 6 provide services to transgender patients, and 5 work with patients who have disorders of sexual development.
Lack of financial support is the most common barrier confronting pediatric fertility preservation programs, cited by 73% of programs. Other difficulties mentioned were inconsistent referrals (55% of programs) and the IRB approval process (45% of programs). Only 9% of programs found reimbursements to be a problem.
ASRM President Richard J. Paulson, MD commented, “Providing fertility preservation counseling and services for adults and children diagnosed with cancer can make a significant difference in their future quality of life. More funding, professional education, and consensus guidelines aimed at the multi-disciplinary nature of these treatments are needed to expand fertility preservation opportunities to all patients who need them.”
O-222 N. Sinha et al,” IMPROVEMENT IN QUALITY OF LIFE WITH FERTILITY PRESERVATION BEGINS AFTER CANCER TREATMENT AND PERSISTS ONE YEAR AFTER CANCER TREATMENT”
O-209 M. Moravek et al,” IT TAKES A VILLAGE: CHARACTERISTICS OF AND BARRIERS TO PEDIATRIC FERTILITY PRESERVATION PROGRAMS WITHIN THE PEDIATRIC INITIATIVE NETWORK (PIN) OF THE ONCOFERTILITY CONSORTIUM”
ASRM is a multidisciplinary organization dedicated to the advancement of the science and practice of reproductive medicine. The Society accomplishes its mission through the pursuit of excellence in education and research and through advocacy on behalf of patients, physicians, and affiliated health care providers. The Society is committed to facilitating and sponsoring educational activities for the lay public and continuing medical education activities for professionals who are engaged in the practice of and research in reproductive medicine. www.asrm.org