Assessment of oncofertility content on reproductive endocrinology and infertility clinic websites

Abstract

<h3>Objectives:</h3> As the age of first pregnancy increases in the United States, young individuals with a cancer diagnosis are often challenged with time-sensitive issues surrounding fertility preservation and cancer treatment. Oncofertility has become increasingly important in the care of these individuals. The purpose of this study is to assess oncofertility content on fertility clinic websites as indicated by relevant keywords. Additionally, we sought to describe the relationship between oncofertility content and fertility clinic characteristics, including: private vs academic, size (cycles/year), state-mandated fertility insurance coverage, type of National Cancer Institute (NCI) designated cancer center, and distance from a NCI designated cancer center. <h3>Methods:</h3> In the Fall of 2020, websites of 381 fertility clinics that are members of the Society for Associated Reproductive Technology (SART) were surveyed. Each clinic website was reviewed systematically by two authors (K.S. and R.M) and discrepancies adjudicated by a third author (V.M). Extracted data included: clinic location, practice type (private vs academic), size (small ≤ 500 cycles/year, medium 501-1,000 cycles/year, and large >1000 cycles/year), type of NCI designated center (cancer center vs comprehensive cancer center), and the distance from an NCI cancer as determined by Google Maps. Additionally, we documented whether the clinic was located in a state that mandated reproductive & infertility services and/or included fertility preservation for "iatrogenic infertility" as reported by the American Society for Reproductive Medicine. The primary outcome was mention of keywords referring to oncofertility, including: oncofertility, fertility preservation, cancer, chemotherapy, ovarian suppression/shielding/preservation/transposition. Data were summarized using descriptive statistics and compared using chi-squared or t-test as appropriate. <h3>Results:</h3> Of the 381 fertility clinic websites analyzed, 322 (85%) contained at least one keyword regarding oncofertility. Most frequently used terms included cancer (79%), fertility preservation (78%), ovarian preservation (69%), chemotherapy (63%); while less used terms included oncofertility (24%), transposition (12%), suppression (9.4%), shielding (5.0%). There was an association between practice size and inclusion of onocofertility content (<i>p</i><.01). Practices that did ≥501 cycles per year were more likely to mention one of the oncofertility keywords (RR 1.2; 95% CI 1.1-1.3). The association of oncofertility website content with practice type, state-mandated fertility insurance coverage, and distance from an NCI designated cancer center were not statistically significant. <h3>Conclusions:</h3> Large clinic size was the only predictive factor for inclusion of oncofertility website content. Further studies are required to evaluate whether inclusion of oncofertility content on clinic websites impacts the use of these services by patients with cancer.