Abstract

We sought to explore front line physicians’ attitudes, knowledge and practice behaviours surrounding fertility preservation for paediatric female cancer patients, and to characterize the perceived value of ovarian tissue cryopreservation (OTC) for prepubertal female patients. A cross-sectional survey using an anonymous online questionnaire was distributed to all paediatric haematologist-oncologists and paediatric gynaecologists practicing in Canada. Almost all (20/22) physicians who completed the survey “usually” or “always” discuss the impact of diagnosis and treatment on future fertility with their patients. The main barriers to discussing fertility preservation and/or referring to reproductive specialists were reported as poor patient prognosis, the need to initiate immediate therapy and the fact that fertility preservation in the paediatric population remains experimental. However, all physicians surveyed indicated a perceived benefit of OTC, in that re-implanted ovarian tissue may allow for future fertility. Common reported concerns about OTC include possible delay in cancer treatment, increased anxiety for patients or their families and the significant cost. Despite these concerns, the majority (16/22) of providers felt that OTC should be considered medically necessary for prepubertal female patients and receive provincial funding. Front line physicians treating paediatric female cancer patients often discuss the impact of therapy on future fertility, but are less likely to discuss fertility preservation techniques or refer to reproductive specialists because of multiple barriers. There remains a clear interest in establishing OTC as a valuable and accessible fertility preservation technique for this population in Canada.

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