lists, expert consultation, and conference abstracts. Eligible studies focused on pediatric and adolescent oncology patients or survivors, their parents, and/or pediatric oncology providers and their knowledgeof, beliefs about, orattitudes toward fertility preservation aftera cancer diagnosis. Studies were assessed for methodological quality, datawas extracted using a standardized form, and synthesized using the Cochrane guidelines for multi-level, simultaneous syntheses of quantitative and qualitative data. Results: 1233 papers were identified and 36 were included in the final review. 24 studies provided quantitative data (patients: 8, parents: 4, providers: 7, multiple perspectives: 5). 11 studies were qualitative (patients: 7, parents: 0, providers: 3, multiple perspectives: 2). The majority of cancer patients wanted information about treatment related fertility effects and fertility preservation options early in their course of their cancer treatment. Patients recalled receiving this information 30-87% of the time. A higher proportion of patients had heard about fertility issues before treatment in later studies. Many patients (35-64%) were dissatisfied with the information received and identified ways of improving the provision of fertility preservation information. Examples include offering options for parental involvement in initial discussions and offering continued support for fertility preservation decision-making before, during, and after cancer treatment. Parents of pubertal and pre-pubertal cancer patients find many fertility preservation options acceptable despite being experimental, especially if they do not cause a delay in treatment. Providers are aware of the importance of fertility issues for their patients and their families, they are knowledgeable about fertility preservation options, and identify age, pubertal status, critical illness, and uncertainty as potential barriers to communication about and referral for fertility preservation services. Conclusions: Adolescent oncology patients and their parents desire candid and timely fertility preservation related information and referral for fertility preservation procedures. Providers are aware of fertility preservation options and resources, but identify systemrelated and personal barriers to discussionswith adolescent patients and families regarding fertility preservation. Future research should focus on patients and families to determine the optimal setting, method, and delivery of fertility preservation related information. Sources of Support: None.
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