Fertility Preservation Information Research Articles

Behavior, attitude, perception, and knowledge regarding fertility preservation among Chinese pediatric oncologists: a survey in China.

Clinical specialists are supposed to inform childhood cancer patients of infertility risk and conduct fertility preservation (FP). However, little is known about whether doctors in China are fully prepared. This study aimed to investigate behavior, attitude, perception, and knowledge regarding FP among pediatric oncological specialists in a nation wide survey, to set the stage for improvements in current clinicalpracticepatterns. This study was conducted on physicians and surgeons specialized in pediatric oncology using a questionnaire through theWeChat platform. The behavior, attitude, perception, and knowledge were assessed by Likert questions and results were quantified to obtainscores. Data were then described and analyzed using R and GraphPad. Totally 373 specialists in pediatric tumors were included in the analysis. Hematologists, oncological surgeons, and reproductive medicine specialists won most trusts to be responsible for FP job. Most respondents did not have habits of delivering FP information or cooperating with FP specialists during treatment though they were well equipped with FP knowledge and desired for uniform national guideline for FP procedures. The severity of illness was regarded as the primary barrier of FP delivery. When a doctor was more educated and experienced, he was more likely to have better performance in FP. The total score, the knowledge score, and the single score concerning frequency of patients' inquiry showed aggregational trend on geographic distribution. Chinese pediatric oncologists demonstrated unsatisfactory practice behaviors based upon this self-reporting survey, although their attitude towards FP was generally positive.

Perspectives and needs for fertility preservation decision-making in childbearing-age patients with breast cancer: A qualitative study

ObjectiveTo explore the perspectives and needs related to fertility preservation decision-making in patients of childbearing age with breast cancer. MethodsSemistructured face-to-face interviews were conducted in a tertiary hospital in Baoding, China from July to October 2023. Purposive sampling was used to ensure the diversity of samples. The interview guide is based on the literature review and the discussions within the research team. A traditional content analysis approach was used for data analysis. ResultsA total of 18 participants were interviewed. Three themes emerged from the data: conflicts between subjective desires and concerns, coexistence of objective benefits and challenges, and decision-making support needs. The conflicts between subjective desires and concerns included five sub-themes, the coexistence of objective benefits and challenges also included five sub-themes, and the decision-making support needs included two sub-themes. ConclusionsPatients faced a difficult trade-off between desires and concerns, benefits, and challenges regarding fertility preservation decisions, with numerous unmet needs. Healthcare professionals should prioritize patients' fertility desires, providing timely fertility preservation information and adequate counseling after a cancer diagnosis. This approach can help alleviate unnecessary concerns, facilitate satisfactory decision-making, and improve patients' quality of life.

Fertility Preservation Knowledge and Attitudes Among Medical Students as Future Practitioners [ID 2683445

INTRODUCTION: Medical students are the next generation of physicians and provide a current snapshot of medical education. The objective of the study was to gain insight into the knowledge and attitudes regarding fertility preservation among medical students. METHODS: Medical students at The University of Kansas School of Medicine (KUSM) participated in a prospective, cross-sectional web-based survey study. Survey questions included knowledge-based questions based on the American Society for Reproductive Medicine fertility preservation guidelines, and attitudes towards fertility preservation were measured using Likert scales. This study was IRB approved. RESULTS: Most respondents (N=123; response rate: 14.1%) were aged 20–29 years (94.3%; n=116) and were pursuing family medicine (18.7%; n=23). In terms of training, 16.5% of respondents (n=20) reported having formal lectures on fertility preservation and 31.7% (n=38) on assisted reproduction technology. More than 45% of clinical students reported not being exposed to reproductive endocrinology and infertility or fertility preservation on clinical rotations (n=32/70). Only 1.6% of respondents (n=2) correctly answered at least 75% of knowledge questions about fertility preservation. Almost half (49.5%; 51/103) of respondents reported discomfort discussing fertility preservation with patients needing fertility preservation. Patient prognosis, finances, and age were the top factors influencing the professional decision to provide a patient with fertility preservation information. CONCLUSION: Students indicate poor familiarity and comfort with discussing fertility preservation, which in the future, may reduce and/or delay patient access to this option. Thus, medical student curriculum focused on reproductive endocrinology and fertility preservation represents an important educational opportunity to improve patient care and outcomes.

Current Status and Issues of Collaboration Between Physicians and Pharmacists in Fertility Preservation.

Purpose: This study addresses the critical issue of fertility preservation among young patients with cancer in Japan, recognizing the brief decision-making window and the need for comprehensive support. Pharmacists, well-versed in the side effects of anticancer drugs, can play a vital role in this support process. However, the extent of pharmacists' involvement in fertility preservation remains unclear. We aimed to investigate pharmacists' roles in addressing cancer treatment-induced fertility concerns and their collaboration with physicians, offering insights into enhancing pharmacist participation in fertility preservation. Methods: A survey conducted between April and July 2022 targeted doctors and pharmacists at cancer treatment hospitals, along with pharmacists affiliated with the Japanese Society of Pharmaceutical Health Care and Sciences. Results: Our findings indicated that although pharmacists had limited knowledge about gonadotoxicity and fertility, they expressed readiness to conduct research and provide information when consulted. Approximately 10%-20% of the pharmacists participated in explaining the primary disease at diagnosis. Pharmacists played a more prominent role after establishing chemotherapy regimens, with less involvement in its formulation. Notably, treatment decision case conferences emerged as crucial forums for gathering patient data, confirming treatment plans, and identifying those in need for fertility preservation information. Roughly half of the pharmacists attended these conferences, suggesting a need for increased participation. Conclusion: Enhancing physician-pharmacist collaboration could be pivotal for effective fertility preservation. This requires augmenting the knowledge and awareness of both professions and encouraging greater participation in case conferences to create a conducive environment for addressing this critical aspect of cancer care.

Trans Reproductive Imaginaries: Access and Barriers to Fertility Preservation and Family Creation

Transgender and non-binary (trans) people face unique challenges when considering decision-making about their reproductive futures. These may include navigating gendered parenthood roles and the potential impacts of medical gender affirmation on their fertility. While fertility preservation offers a way of having biologically related children, barriers to accessing these services among trans people have been identified in literature. This qualitative study sought to understand how trans young adults view and experience fertility preservation, in relation to their desire for family and parenthood. Through a thematic analysis of in-depth interviews with 13 trans and non-binary people in Aotearoa New Zealand, we identified four themes: variability in seeking accurate fertility preservation information; the compounding costs of trans reproduction; experiencing and anticipating cisnormativity in reproductive health services; and (re)imagining family. Overall, participants expressed diverse views on fertility preservation, informed by interpersonal and structural factors. Notably, we found discrepancies between uptake of sperm and egg cryopreservation due to public funding disparities, despite participants agreeing services should be offered equitably to all trans people. These structural barriers require further attention in healthcare, policy and community settings when working with trans young adults considering fertility preservation.

Knowledge and intentions to use fertility preservation among urban Chinese cancer patients: A study from Hong Kong.

To assess the knowledge levels and fertility preservation (FP) intentions of urban Chinese cancer patients. A cross-sectional study was conducted on Hong Kong Chinese male and female cancer patients aged 18-54 years (N = 325) who were recruited by a local non-governmental organization for cancer patients between July 2020 to January 2021. Patients completed a self-administered questionnaire on knowledge, perceptions, and intentions to use FP services/seek FP-related information. Multivariable logistic regression was used to explore the correlates of intention to seek additional FP information and intention to undergo FP treatments. Although cancer patients demonstrated a good knowledge of the available FP treatment options, they were less knowledgeable about the legal restrictions of these procedures. Only one in seven cancer patients first became aware of FP through a health provider and the majority of cancer patients felt they did not have adequate knowledge about FP to make informed FP decisions at the current time. Yet, over one-third of cancer patients would consider FP options even if their cancer or cancer treatment had < 5% chance of causing infertility, and 13.4% of females and 14.6% of males would delay their cancer treatment by ≥ 3 months to undergo FP procedures. However, for both sexes, the main perceived barrier to obtaining FP was its financial cost. Patients with older-aged spouses were less likely to seek FP treatments or seek more information about FP. There is an unmet need for more FP information and FP services for reproductive-aged cancer patients in East Asian populations. Greater integration of FP services into cancer treatment requires a reduction of cost barriers, greater provision of timely FP information, and improved referral systems.

P-575 What do Portuguese women know about fertility preservation options?

Abstract Study question What do Portuguese women know, and what attitudes do they reveal regarding fertility preservation? Summary answer There is a lack of knowledge concerning fertility preservation options and a solid desire to access more information. What is known already Fertility preservation techniques increase the possibility of conceiving a biological child later, whether for social or medical reasons, but it should be noted that they do not ensure success. Previous studies showed an insufficient knowledge of the population regarding cryopreservation techniques, their implications, and their benefits. Additionally, a high percentage of participants who do not consider using fertility preservation stated that it might be related to a lack of knowledge regarding fertility issues. It has been pointed out that people would like more information about fertility preservation and consider that reliable sources of information should be available to the public. Study design, size, duration Cross-sectional study. Participants' recruitment was set through online advertisement, using social media platforms and private messages, and participants were solicited to share the study link with two more women (Exponential Non-Discriminative Snowball Sampling method). The online advertisement comprised detailed information about the study’s aims and procedures, inclusion criteria, and the voluntary and anonymous nature of the participation. Data collection took place online between March and May 2022. Participants/materials, setting, methods 257 women aged 18-45. Participants completed a 9-items questionnaire. These questions addressed: a) knowledge concerning fertility preservation (e.g., Are you aware of the existence of any of the following fertility preservation options?); b) attitudes towards fertility preservation (e.g., Would you consider any of the following fertility preservation techniques?); and c) whether they would like to get more information on this topic (e.g., Would you like to receive more information about fertility preservation options?). Main results and the role of chance Eighty-eight (34.2%) participants were aware of the oocytes and embryos cryopreservation techniques, 60(23.3%) only knew the oocytes cryopreservation, 58(22.6%) were aware of oocytes, embryos, and ovarian tissue cryopreservation, 37(14.4%) did not know any of the previously mentioned techniques. Most women (n = 177; 68.9%) were not actively considering fertility preservation, 36(14.0%) would consider oocyte cryopreservation, 34(13.2%) would be willing to pursue it, but would need more information, 9(3.5%) would consider embryos cryopreservation and 1(0.4%) would consider ovarian tissue cryopreservation. Of those contemplating fertility preservation, 45(17.5%) would do it to prevent the effect of age on fertility, 21(8.2%) would do it due to the absence of a partner. Regarding the concerns about fertility preservation, the participants were worried about the costs (n = 26; 10.1%), age (n = 25; 9.7%), hormonal injections and other fertility drugs (n = 10; 3.9%) and the desire for spontaneous pregnancy (n = 8; 3.1%). The participants not considering preserving their fertility mentioned the main reasons were that they never thought about it (n = 56; 21.8%), did not want to get pregnant (n = 34; 13.2%), age (n = 32; 12.5%), the desire for spontaneous pregnancy (n = 28; 10.9%) and the costs (n = 16; 6.2%). Most participants agreed that fertility and fertility preservation information should be provided during medical consultations or at school. Limitations, reasons for caution The recruitment and data collection process (social media and online survey) have limitations, such as sampling bias, self-selection concerns, or under-representation of the population (e.g., exclusion of participants not using social media or online platforms), limiting the chance of making generalisations. Wider implications of the findings Making available more information regarding fertility preservation may warrant that more women have the opportunity to consider this option and make informed decisions regarding their reproductive life. Trial registration number not applicable

Fertility and fertility preservation knowledge in Portuguese women

ABSTRACT Background Knowledge about fertility and factors affecting it, for example, the impact of age, seem to be lacking, even in highly educated populations. The same applies to fertility preservation knowledge, pointing to the relevance of increasing fertility preservation awareness and education among young women. Objective To describe general fertility knowledge and factors affecting fertility, fertility preservation knowledge and attitudes, and the desire to access more information on this topic in a sample of reproductive-age Portuguese women. Methods The sample comprised 257 Portuguese women aged 18–45, mostly single and nulliparous. A questionnaire was developed explicitly for this study and disseminated through social media advertisements. Results Career building/development and financial stability were the more endorsed options for delaying childbearing, with 90 (35%) and 68 (26.5%), respectively. Most participants considered becoming a mother important (n = 185; 72%). More than halve provided an incorrect answer regarding the age range of women being more fertile (n = 132; 51.4%) and the age range of fertility decline (n = 168; 65.4%). Participants were aware of the influence of lifestyle and sexual health factors as well as the effect of age. Oocytes cryopreservation was the technique participants knew more (n = 206; 80.1%), but 177 (68.9%) showed no interest in using it. Most participants agreed that fertility and fertility preservation information should be provided during medical consultations or at school. Conclusions More information regarding fertility and fertility preservation is relevant to ensure that more women can make informed decisions concerning their reproductive life.

Websites about, not for, adolescents? A systematic analysis of online fertility preservation information for adolescent and young adult cancer patients.

Fertility preservation is an increasingly important topic in adolescent and young adult cancer survivorship, yet treatments remain under-utilized, possibly due to lack of awareness and understanding. The internet is widely used by adolescents and young adults and has been proposed to fill knowledge gaps and advance high-quality, more equitable care. As a first step, this study analyzed the quality of current fertility preservation resources online and identified opportunities for improvement. We conducted a systematic analysis of 500 websites to assess the quality, readability, and desirability of website features, and the inclusion of clinically relevant topics. The majority of the 68 eligible websites were low quality, written at college reading levels, and included few features that younger patients find desirable. Websites mentioned more common fertility preservation treatments than promising experimental treatments, and could be improved with cost information, socioemotional impacts, and other equity-related fertility topics. Currently, the majority of fertility preservation websites are about, but not for, adolescent and young adult patients. High-quality educational websites are needed that address outcomes that matter to teens and young adults, with a priority on solutions that prioritize equity. Adolescent and young adult survivors have limited access to high-quality fertility preservation websites that are designed for their needs. There is a need for the development of fertility preservation websites that are clinically comprehensive, written at appropriate reading levels, inclusive, and desirable. We include specific recommendations that future researchers can use to develop websites that could better address AYA populations and improve the fertility preservation decision making process.

Factors influencing perceived communication quality for successful fertility preservation counseling for adolescent and young adult cancer patients and their caregivers in Korea.

Although relatively new in Asian countries, fertility preservation (FP) discussions are crucial for adolescent and young adult (AYA) cancer patients. This study highlights patients' and their caregivers' perceptions of communications quality during FP discussions in Korea. Participants were AYA patients and their caregivers (each: n = 34). The study examined the clinical pathways for FP and used surveys to collect details on discussion characteristics and satisfaction levels during FP discussions at the Yonsei Cancer Center, Seoul, Korea. Quality and degree of satisfaction with FP discussions were measured on a scale ranging from 1 to 7. Two caregivers did not complete the survey. All respondents reported high overall satisfaction; however, several factors were related to low satisfaction with information quality. Caregivers who received both verbal communication and nonverbal communication tools (e.g., pamphlets, Internet resources) were more satisfied with the information quality than those who only received verbal communication. Regarding provider type, both respondent groups reported high overall satisfaction with physicians, rather than other types of care providers. Regarding the number of discussion sessions, respondents reported an improved understanding of FP and better communication and information quality if they participated in more than one discussion session. The FP process for AYA cancer patients can be improved by adjusting the type of provider, number of discussion sessions, and types of information. This will form the cornerstone of effective FP communication in Korea.

Has oncofertility information for male patients improved? Objective assessment of internet-based fertility preservation resources at NCI cancer centers from 2015 to 2020.

Fertility preservation is a critical patient counseling component following cancer diagnosis. The aim of this study was to compare change and quality of fertility preservation information available to patients on the websites of National Cancer Institute (NCI)-designated cancer centers over 5years (2015 to 2020) for both women and men. All NCI-designated cancer center websites were queried for information on oncofertility in 2020 publicly available to patients using the methodology and rubric previously employed in 2015. Data was evaluated based on each center's city, county, and state by demographic data obtained from the US Census. Additionally, the yearly number of in vitro fertilization (IVF) cycles performed in the city, county, and state of each NCICC was included using websites of clinics reporting data to the Society for Assisted Reproductive Technology. Significantly NCICCshave a standalone pages for fertility preservation in 2020 compared with 2015 (p = 0.004). There is a statistically significant association between discussion of male fertility and the number of fertility centers in the county and state of the NCICC (p = 0.04 and p = 0.001).NCICCs in counties in the highest quartile of per capita income were significantly more likely to address male fertility (p = 0.03). Oncofertility information on NCICC websites has improved between 2015 and 2020. The impact of cancer treatment on male fertility, while improved, is still limited, particularly in counties with lower per capita income.

Perceptions of Oncology Nurses Regarding Fertility Preservation and Providing Oncofertility Services for Men of Childbearing Age with Cancer.

This study investigated the knowledge, thoughts, and attitudes of oncology nurses in China regarding fertility preservation for male cancer patients of childbearing age, and for offering counseling or oncofertility services for the men in their care. Data was collected from 18 oncology nurses in Southwest China through voluntary self-report and in-depth interviews. The qualitative interview data were analyzed using a descriptive phenomenology method based on the lived experience of the nurses. The interviewees commonly reported 6 main concerns regarding fertility preservation (FP): their insufficient knowledge and inadequate nursing education; the importance of offering such services to cancer patients; legal vulnerability if FP information is withheld from patients; the role of the nurse in counseling; and barriers to discussing FP in practice. Nurses had a positive attitude toward FP, but most had no practical role in routinely informing male patients of their options, and the nurses believed that discussion of FP was outside their scope of practice. This study offers insight into the perceptions of oncology nurses in a developing country regarding the provision of FP services for adult male cancer patients. These results lead us to recommend that local fertility nurses should be given new training regarding FP. Furthermore, nurse-led clinics are desirable. Future research should focus on the effectiveness of nurse participation in FP counseling and referral, and how to improve the professional confidence of oncology nurses for addressing FP issues.

Access to fertility preservation for trans and non-binary people in Aotearoa New Zealand

There is a growing need for healthcare professionals to discuss fertility preservation options with trans and non-binary people before commencing medical transition as part of informed consent-based models of care. In this article, we adapt the Five-A framework of healthcare access to examine fertility preservation information and services. To do so, we present an analysis of data from Counting Ourselves, the first comprehensive national survey in Aotearoa New Zealand of trans and non-binary people’s health and the first study exploring their access to cryopreservation information and services. Among 419 participants who had received gender-affirming hormones or surgery, 33.7% received information about options for fertility preservation and 15.8% accessed fertility preservation services. Findings from the study indicate the need for greater understanding of trans and non-binary people’s desire for genetically related children, and what type of information and form of delivery would be most helpful to ensure equitable outcomes in relation to decision-making around fertility and future family-building.

Access to male fertility preservation information and referrals at National Cancer Institute Cancer Centers.

Cancer treatment can lead to infertility, which is a significant source of financial and emotional distress for cancer patients and survivors. Given that future fertility and sexual function are critical quality of life issues, we hypothesise that access to subspecialist care is not uniformly distributed. Therefore, we sought to identify access gaps in male sexual health and infertility care at NCI cancer centres across US Census Regions. All 64 clinical NCI cancer centre websites were examined for language related to male sexual health and fertility. A phone-based survey was used to establish cancer centre referral patterns to andrologists and sperm banks. We utilised the Society for the Study of Male Reproduction member directory to determine geographic locations for andrologists relative to each centre. We found that the presence of information regarding male sexual health information was not associated with region. The presence of andrologists within 5-miles of a CC was significantly higher in the Northeast compared to all other census regions. Our work describes the access gap in fertility services at NCI cancer centres and how this differs by region of the country. These data can inform patients, and encourage centres to provide improved access to oncofertility care.

We need to do better: Readability analysis of online patient information on cancer survivorship and fertility preservation

ObjectiveNational Institute of Health recommends that patient education material should be written at no greater than 6th-grade level. Cancer survivorship and fertility preservation discussion with patients is recommended by many national societies and being done more frequently. We sought to analyze online patient information on cancer survivorship and fertility preservation to see if they meet the criteria set by national guidelines. MethodsOnline patient information on cancer survivorship and fertility preservation was collected and analyzed by six of the most common readability tests. Only websites in English and free to access were used. ResultsA total of 15 separate websites for cancer survivorship and fertility preservation was used. All websites failed to meet national guidelines. Cancer survivorship information was written at a high school senior and a 12th-grade level. Fertility preservation information was written at a high school-senior and junior college level. ConclusionOnline patient information on cancer survivorship and fertility preservation did not meet national guidelines. Testing across six of the most used readability indexes showed that information is challenging to understand for the general patient population. Policy statementThis article shares an insight into the complex and growing fields of cancer survivorship and fertility preservation. Educating patients about their condition is critical and improves outcomes and participation in shared decision making. Healthcare policy should focus on implementing a system that will provide culturally and linguistically appropriate information in the community for patients about their disease.

COT-05 Experience of fertility preservation in 3 male cases and 1 female case with high-grade glioma

High-grade glioma (HGG) has a low survival rate, and fertility preservation (FP) has rarely been discussed in the field of Japanese neurosurgery. We report on 4 reproductive patients, including 2 male patients who became biological fathers. Case 1 was a 23-year-old man with anaplastic oligodendroglioma (AO) of the right frontal lobe. Temozolomide maintenance therapy (TMZ-MT) was completed 42 courses after the initial surgery for economic reasons. 21 months later, a local recurrent lesion appeared, so TMZ-MT was restarted after removal this lesion. When he married at 32 years old, the couple wished a desire for childbearing. The TMZ-MT was stopped at 47 courses from the resumption and they aimed for spontaneous pregnancy. At 5 months after discontinuation of TMZ-MT, Gd-enhanced lesions increased again, so we changed the course to in vitro fertilization and resumed TMZ-MT. The couple had a biological baby at his 33 years and 10 months old. Case 2 was a 33-year-old married man with AO of the right parietal lobe. After partial removal, the FP information was explained and cryopreservation of sperm was performed. As of 23 months after the first operation, he became a biological father by in vitro fertilization. Case 3 was a 31-year-old married man with diffuse midline glioma (H3K27M mutant) in the cervical spinal cord. After partial removal, we provided FP information in the same manner, but the couple did not chose cryopreservation of sperm due to his mRS 5. Case 4 was a 24-year-old female with anaplastic astrocytoma of the brain stem. FP information was provided after stereotactic biopsy, but she chose to start radiochemotherapy without cryopreservation of eggs. Patients of reproductive age with HGG, especially oligodendroglial tumors who have a higher survival rate than astrocytic tumors, should be positively informed about FP before treatment begins.

HAVE ONCOFERTILITY INFORMATION FOR PATIENTS IMPROVED? OBJECTIVE ASSESSMENT OF INTERNET BASED FERTILITY PRESERVATION RESOURCES AT NCI CANCER CENTERS FROM 2015-2020

Fertility preservation is a critical patient counseling component following cancer diagnosis. The aim of this study was to compare change and quality of fertility preservation information available to patients on the websites of National Cancer Institute (NCI) designated cancer centers over five years (2015 to 2020) for both women and men.

THE STATE OF FERTILITY PRESERVATION COUNSELING FOR WOMEN WITH CYSTIC FIBROSIS REPORTED BY CYSTIC FIBROSIS PROVIDERS

Fertility preservation (FP) counseling is part of comprehensive care provided to women of childbearing age undergoing oncologic treatments; however, this is not standard for patient populations with other chronic conditions. The purpose of this study was to examine the current state of FP counseling for women with cystic fibrosis (CF) from the perspective of their healthcare providers, with the goal of identifying the gaps, barriers, and facilitators to implementation of counseling in clinical practice. This knowledge can lead to the development of FP guidelines for women with CF and enhance shared decision making by broadening their reproductive options. This study utilized a quantitative, exploratory, cross-sectional design. Healthcare providers (e.g., physicians, nurse practitioners, clinic coordinators, pharmacists, social workers, nurses) were recruited from CF Foundation accredited clinics throughout the United States and via snowball sampling. Participants completed a web-based, anonymous FP survey with 39 items that took approximately 30 minutes to complete. Participants received $20 for their participation. The descriptive statistics were provided using R software. Fifty healthcare providers completed the survey (Mage= 40.8, SD=11.1). The majority of the healthcare providers were female (n=45). Despite the fact that 92% (n=46) of the providers felt that FP discussions should be standard for all female patients with CF, 28% (n=14) of providers reported that FP topics were not discussed with female patients with CF at any age. Most providers felt that initiation of FP discussions was the responsibility of the healthcare team (n=34), but some felt that patients should initiate the FP discussions (n=11). Lack of knowledge (n=17) and lack of time (n=12) were the two most substantial barriers to FP discussions by healthcare providers. According to the providers, the two best facilitators for FP discussions in clinic would be having national guidelines or standards (n=41) and integrating partnerships with sexual and reproductive health specialists (n=39) as part of comprehensive CF care delivery. Having educational materials to foster FP discussions between providers and patients was another facilitator reported (n=50). Healthcare providers preferred having educational information and resources shared via online format (n=46) and written pamphlets (n=44). Fertility preservation counseling is an important part of comprehensive care for women with CF; however, many women do not receive FP information. This national sample of CF healthcare providers reported that they lacked the knowledge and time to discuss FP with their patients. Removing the barriers and optimizing the facilitators to encourage FP discussions between women with CF and their providers will broaden these women’s reproductive options by facilitating fully informed decision making to improve overall health outcomes.

Timing and Delivery of Fertility Preservation Information to Transgender Adolescents, Young Adults, and Their Parents

PurposeThis study aimed to examine transgender adolescents and young adults’ (AYA) and their parents’ preferences regarding fertility preservation (FP) information provision and discussion timing. MethodsData were derived from two separate studies: an online survey and semistructured qualitative interviews. Survey data were analyzed using descriptive statistics and interview data using conventional content analysis. ResultsSurvey participants (AYA: 88% and parents: 93%) preferred gender clinic physicians provide FP information, and nearly one-third endorsed mental health professionals (AYA: 28% and parents: 26%) or fertility specialists (AYA: 23% and parents: 30%). Interview participants’ FP discussion timing preferences ranged from the initial clinic visit, follow-up visits, before medical intervention, to mentioning FP early but deferring in-depth discussion to follow-up visits. ConclusionsGender clinic physicians, mental health professionals, and fertility specialists should be prepared to discuss FP with transgender AYA and their parents. Opinions varied regarding when to provide FP information; therefore, discussion timing may need to be individualized.

Availability of Fertility Preservation Information on the Websites of U.S. News and World Report Top-Ranked Pediatric Cancer Programs.

Purpose: To evaluate the availability of fertility preservation (FP) services and educational resources on the websites of top-ranked U.S. pediatric cancer programs. Methods: Cross-sectional survey of information and resources related to FP on websites from top-ranked pediatric cancer programs according to the 2018-2019 U.S.-News & World Report (USNWR) ranking. Factors that predicted the website availability of FP information or a fertility team were analyzed, as was availability in Spanish and for specific groups by sex and puberty status. As a surrogate marker of comprehensive oncological services, the availability of resources for psychological support was compared to FP. Results: A fertility team was referenced on the website of 36% of programs, but only 32% provided FP educational resources for patients. Among them, 100%, 93.8%, 93.8%, and 68.8% provided specific information for postpubertal females, prepubertal females, postpubertal males, and prepubertal males, respectively. The majority (93.8%) did not provide information in Spanish. The ranking on USNWR (p < 0.05) and patient volume (p < 0.05) positively correlated with the availability of FP information and fertility team on the program's website. Information regarding psychological support was provided more often than information regarding FP (96% vs. 32%, p < 0.05). Conclusion: The majority of the top-ranked pediatric cancer programs in the United States do not list FP resources or a fertility team on their website. The lack of resources is particularly concerning for the Spanish-speaking population, as well as for prepubertal males. This may be potentially hindering access to FP and contributing to health care disparities.