Clinicians approach the discussion of post-cancer fertility options in significantly different ways with male and female patients.
For male and female patients diagnosed with cancer, physician-initiated discussions of fertility preservation differ significantly in timing and urgency.
Few physicians in the study were aware that an in vitro fertilization cycle could be abridged if necessary.
Men and women diagnosed with cancer receive very different information about fertility preservation, according to a small qualitative interview study from the United Kingdom.
Investigators found that although men were almost universally encouraged at the time of diagnosis to consider sperm banking, even if they already had children, few women could remember discussing fertility preservation at the first or subsequent office visits. Furthermore, for many of the men, a protocol existed for immediate referral to a fertility specialist, whereas no such protocol was in place for the women.
Published online May 30 in BJOG: An International Journal of Obstetrics and Gynecology, the study involved 16 men and 18 women, aged 17 to 49, who had recently been diagnosed with cancer, as well as 15 health professionals involved in cancer care.
Some participants suggested that differences in the method of fertility preservation explained the gap in information. Although sperm cryopreservation is a simple, noninvasive, highly successful strategy, embryo cryopreservation requires a male partner. Further, options such as ovarian tissue or oocyte cryopreservation are invasive, are largely considered experimental, and might delay cancer treatment. Few were aware that an in vitro fertilization cycle could be significantly abridged, if required.
Many of the healthcare professionals noted that they did not discuss fertility in detail at the first visit because patients are often overwhelmed. Others felt justified in not discussing fertility at the first visit because they said that fertility is not usually affected by first-line chemotherapy.
Although the findings cannot be generalized widely because of the small number of study participants and the very specific setting of the study, the authors write that their findings suggest the need for an early appointment with a fertility specialist immediately after a cancer diagnosis so that men and women can make informed decisions.
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