Contraception and fertility counseling in patients receiving chemotherapy.

Abstract

e23055 Background: Cancer care advances allow more patients to pursue fertility. Unfortunately, treatments may have detrimental effects both on fertility and risks to fetus should pregnancy occur. This study examines patient perceptions of fertility and contraception counseling, as well as physician documentation thereof. Methods: After IRB approval, a cross-sectional study was performed identifying men and women, ages 18-50, seen between May 2017 and 2018 with newly diagnosed malignancy. Patients with previous sterilization procedures, a secondary or synchronous cancer, or prior lines of chemotherapy, were excluded. Consented patients received a survey regarding their perception receipt and quality of counseling. Demographic data, including contraception use, reproductive history, and physician documentation were obtained. Differences in receipt of counseling and perception of received counseling were evaluated using chi-square tests. Results: Of 179 patients identified, 53 ultimately participated. Majority were women (75 v 25%). Counseling documentation for contraception and fertility occurred in 5% and 32% of charts, respectively. Though 42% and 49% perceived receipt, respectively. Of those receiving counseling, it was perceived as sufficient by 64% regarding contraception and 72% regarding fertility. Race, gender, and reproductive history were not found to be associated to whether patients perceived counseling on contraception (p > 0.1). Men were more likely than women to be perceive counseling regarding fertility (85 v 43%, p = 0.010). However, both felt fertility counseling to be sufficient with similar rates of documentation. Caucasians were more likely to perceive receipt of fertility counseling and to perceive it to be sufficient, then African Americans (68 v 29% and 70 v 40%, respectively) at same rate of documentation (35%). Conclusions: Significant discrepancies in perception of contraception and fertility counseling were seen, though documentation rates were similar across all groups examined. Despite equal rates of physician documentation, gender and race were important factors for the perception of fertility counseling, while race was a factor to quality of perceived counseling.