Multicenter review of fertility preservation and contraceptive information provided to cancer patients.

Abstract

e19640 Background: Cancer treatments can adversely affect fertility. Guidelines are available to help physicians both in approaching this topic and in making recommendations as fertility preservation options are constantly developing. Patients desire information on how treatments affect fertility. Assessing patients' awareness of these issues is necessary to guide future discussions with patients being treated with cytotoxic agents. Methods: An anonymous survey of patients, 50 years or less, having chemotherapy in 3 institutions in Cork, Ireland (population 400,000) was undertaken with prior ethics approval. We aimed to assess if fertility issues had been addressed prior to chemotherapy administration and if the patient was satisfied with the discussion. We also examined the degree of patient concern about fertility issues, the utilization of contraception and fertility preserving methods and patient perception of their efficacy. Results: Forty-eight patients participated; mean age 36.5 years (standard deviation: 9.6 years). Thirty-nine patients were female (81%). Half of the patients (24/48) had breast cancer and 79% (38/48) had a primary tumor. Most patients were single (41.6%) and 56.3% already had children. Of those surveyed, 31.3% wanted or strongly wanted more children (27% were unsure). A majority (77%) reported that their doctor had discussed fertility issues and these patients were more likely to feel that their concerns had been addressed (p<0.0001). Younger patients were more likely to have discussed fertility issues (p=0.0095). Only 18.8% (9/48) of patients were using contraception. Those using contraception were more likely to have discussed fertility issues with their doctor (p=0.05). If fertility issues were discussed, so too were contraception and the ability to have children (p<0.0005). Some patients (10.4%) were unaware that chemotherapy can affect fertility and many were unsure (39.6%). No associations were seen between fertility discussion and cancer type, stage, marital status or gender. Conclusions: It is important that fertility and contraceptive issues are raised in patients having chemotherapy in order to address concerns and influence contraceptive practices. No significant financial relationships to disclose.