Fertility Attitudes and Cancer Treatment Study (FACTS).

Abstract

112 Background: Approximately 140,000 people under 45 year old are diagnosed with cancer annually in the US. Survivorship is high and many of these individuals desire future fertility. Although fertility preservation (FP) services are increasing, utilization rates remain low. Methods: We conducted a 2-phase study to identify factors for FP decisions among newly diagnosed males and females receiving fertility consultation, 18-45 years old. Phase 1 was a chart review; Chi-square and t-tests were used to determine potential factors associated with FP decision. Phase 2 consisted of face-to-face interviews. Content analysis was used to identify relevant themes associated with reasons, priorities, support, and satisfaction for FP decision. Results: In Phase 1, 108 charts were reviewed; FP utilization rate was 50%. Those who chose FP were more likely to be male (73.6% vs. 26.4%, p < 0.001), Caucasian (90.6% vs. 9.4%, p = 0.042), have a solid tumor (98.1% vs. 1.9% p = 0.032), and a shorter time from diagnosis to fertility consult (29.5 vs. 58.8 days, p = 0.017). Age, relationship, education, parity, or treatment plan did not differ with FP decision. In phase 2, we assessed reasons why patients chose FP; 27 participants were interviewed. Primary reasons for choosing FP were: future fertility and access to FP services. Main reasons for not choosing FP were: concerns with future conception and lack of access to FP services. Cost ranked 4thamong reasons to not choose FP; however 50% of patients overcame the cost to prioritize future fertility. Males top priorities were: future parenthood, cancer treatment, and survivorship QOL. Females top priorities were: future parenthood, decisional conflict, and cancer treatment. Patients greatest concerns with FP were: birth defects, future conception, and success of FP. Conclusions: Future fertility is a priority for newly diagnosed young adults. All patients should receive a referral to a reproductive specialist, regardless of patient factors or diagnosis. While patients expressed feeling well-informed to make FP decisions following fertility consult, some still had concerns with the safety and success of FP. Adequate FP consultation should include discussion of all treatment options and concerns for FP.