Fertility preservation treatment options: What do patients actually understand about their choices?

Abstract

9109 Background: Young women with cancer are referred to discuss fertility preservation (FP), but due to time pressure and complexity of FP treatments, their comprehension of FP may be poor. We conducted a multi-center study to evaluate factors associated with knowledge about fertility preservation (FP) treatment following FP consultation. Methods: A survey instrument was developed to assess a patient's understanding of FP options after FP consultation. Information was collected about demographics, support systems, decisional conflict and perceived risks. A pilot group evaluated the survey and results were used to refine the content. The revised instrument was completed by consecutive new patients (ages 18-41) between 2008 and 2010, 3-12 months after initial FP consultation. Each correct answer was given one point to yield a knowledge score (KS) (maximum = 22). Results: Among 94 eligible subjects, 72 were successfully contacted and 51 completed the survey (71%). Median KS was 12 (range 4-19). Higher KS was noted in women who were college educated (12.4 vs. 9.2; p<0.01), Caucasian (12.3 vs. 10, p=0.03), had someone present at FP consultation (12.4 vs. 10.6, p=0.05), discussed FP options with someone (12.4 vs. 9.5, p<0.01), and used specific websites (eg FertileHope; 12.6 vs. 10.7, p=0.02). KS trended higher in subjects who discussed their FP options with their oncologist (p=0.06) and those who had contact with the FP provider following consultation (p=0.09). KS was not correlated with age, income, receiving FP treatment or decisional conflict. Conclusions: Post-consultation knowledge about FP options was poor, possibly due to stress and information complexity. Our data suggest that patients may have improved comprehension if they bring someone with them to the consultation, discuss options with someone after the visit, and reference specific FP websites. These actions may improve a patient's overall understanding about FP options.