51 research outputs found
A survey of fertility preservation options available to cancer patients around the globe
Purpose: Oncofertility focuses on providing fertility and endocrine-sparing options to patients who undergo life-preserving but gonadotoxic cancer treatment. The resources needed to meet patient demand often are fragmented along disciplinary lines. We quantify assets and gaps in oncofertility care on a global scale. Methods: Survey-based questionnaires were provided to 191 members of the Oncofertility Consortium Global Partners Network, a National Institutes of Health–funded organization. Responses were analyzed to measure trends and regional subtleties about patient oncofertility experiences and to analyze barriers to care at sites that provide oncofertility services. Results: Sixty-three responses were received (response rate, 25%), and 40 were analyzed from oncofertility centers in 28 countries. Thirty of 40 survey results (75%) showed that formal referral processes and psychological care are provided to patients at the majority of sites. Fourteen of 23 respondents (61%) stated that some fertility preservation services are not offered because of cultural and legal barriers. The growth of oncofertility and its capacity to improve the lives of cancer survivors around the globe relies on concentrated efforts to increase awareness, promote collaboration, share best practices, and advocate for research funding. Conclusion: This survey reveals global and regional successes and challenges and provides insight into what is needed to advance the field and make the discussion of fertility preservation and endocrine health a standard component of the cancer treatment plan. As the field of oncofertility continues to develop around the globe, regular assessment of both international and regional barriers to quality care must continue to guide process improvements
Survey of Third-Party Parenting Options Associated With Fertility Preservation Available to Patients With Cancer Around the Globe
Purpose: In the accompanying article, “Analysis of Fertility Preservation Options Available to Patients With Cancer Around the Globe,” we showed that specific fertility preservation services may not be offered at various sites around the world because of cultural and legal barriers. We assessed global and regional experiences as well as the legal status of third-party reproduction and adoption to serve as a comprehensive international data set and resource for groups that wish to begin oncofertility interventions. Methods: We provide data on the legalities of third-party assisted reproductive technologies and other family-building options in the 28 oncofertility-practicing countries surveyed. Results: We found regional and country differences that will be important in the development of tailored resources for physicians and for patient brochures that are sensitive to these local restrictions and cultural norms. Conclusion: Because many patients first consult Web-based materials, the formal assessment of the availability of these options provides members of the global oncofertility community with data to which they might otherwise not have ready access to better serve their patients
Survey of third-party parenting options associated with fertility preservation available to patients with cancer around the globe
bstract
PURPOSE In the accompanying article, “Survey of Fertility Preservation Options Available to Patients With Cancer
Around the Globe,” we showed that specific fertility preservation services may not be offered at various sites
around the world because of cultural and legal barriers. We assessed global and regional experiences as well as
the legal status of third-party reproduction and adoption to serve as a comprehensive international data set and
resource for groups that wish to begin oncofertility interventions.
METHODS We provide data on the legalities of third-party assisted reproductive technologies and other familybuilding options in the 28 oncofertility-practicing countries surveyed.
RESULTS We found regional and country differences that will be important in the development of tailored
resources for physicians and for patient brochures that are sensitive to these local restrictions and
cultural norms.
CONCLUSION Because many patients first consult Web-based materials, the formal assessment of the availability
of these options provides members of the global oncofertility community with data to which they might otherwise
not have ready access to better serve their patients
Adjuvant Growth Hormone for Ovulation Induction with Gonadotropins in the Treatment of a Woman with Hypopituitarism
Objective. To report the prestimulation use of adjuvant GH for gonadotropin ovulation induction in a woman with hypopituitarism and GH deficiency who previously failed to respond. Design, Patients, and Measurements. A 31-year-old nulliparous woman presented with hypopituitarism and GH deficiency after failing ovulation induction with high dose gonadotropins. A trial of GH was undertaken for 5 months prior to ovulation induction resulting in normalization of IGF-I levels. Results. Women with hypopituitarism are known to have lower pregnancy rates after ovulation induction with need for higher doses of gonadotropins. A small subset of these patients do not ovulate. This patient had successful ovulation induction and pregnancy with prestimulation GH. Conclusions. This case suggests that the use of adjuvant GH in a GH-deficient patient several months before the use of human menopausal gonadotropin results in ovulation and pregnancy
Fertility preservation practices among Ontario oncologists. J Cancer Educ 2012;27:362–8
Abstract This study explores the attitudes, knowledge, and referring behaviors in fertility preservation among Ontario physicians providing adult cancer care. Ontario physicians with specialties in medical oncology, radiation oncology, gynaecologic oncology, and urology were invited to complete a 48-item questionnaire. A total of 152 questionnaires were available for analysis with a response rate of 23.7%. Seventy-four percent of the physicians indicated that they rarely or never modified cancer treatment due to concern about future fertility. Differences were found in fertility preservation knowledge among respondents in different medical specialties (p < 0.01) and clinical settings (p < 0.05). The frequency of initiating a referral was strongly associated with knowing where to refer patients (p<0.001). The odds of knowing where to refer cancer patients was higher for physicians who work in a teaching hospital (p< 0.01) and a cancer centre (p<0.01) compared with those who primarily work in a community setting. About 45% did not know where to refer female patients, and 69.7% rarely ever made a fertility preservation consultation referral for their female patients. The majority of respondents had positive attitudes despite their lack of current knowledge in cryopreservation services and fertility preservation options through assisted reproductive technologies. Our findings provide further insights of the relevance of considering physicians' medical backgrounds and practice settings when designing training modules to raise their awareness in fertility preservation issues
“Just what the doctor ordered”: Factors associated with oncology patients’ decision to bank sperm
Introduction: The purpose of this cross-sectional study was to
explore factors associated with oncology patients’ decision to bank
sperm prior to cancer treatment.
Materials and Methods: Patients who were referred to the oncology
sperm banking program between January 2009 and March 2010
were invited to complete an 18-item questionnaire during one of
their sperm banking visits.
Results: Of the 157 cancer patients referred to the Mount Sinai
Oncology Sperm and Tissue Bank for sperm banking during the
15-month period, 79 questionnaires were returned (50% response
rate). Of the respondents, 89% were informed about sperm banking
by their physician. Future family planning was cited as the main
reason to bank. Cost was not a barrier for the vast majority of
respondents. Forty percent of respondents banked sperm within 4
days prior to initiating cancer treatment. Most respondents relied
on their physician for verbal information on sperm banking. Eightyone
percent were unaware of any patient organizations that have
educational materials on oncology fertility preservation.
Conclusion: Sperm banking prior to cancer treatment is the only
proven method of preserving fertility for cancer patients. The two
main determinants associated with deciding whether to bank sperm
were: the physician’s recommendation and the patient’s desire
for future fatherhood. Physicians play a key role in influencing
patients’ decisions. The recommendation to bank sperm is a persuasive
message if patients are clearly informed about their potential
risk of infertility post-cancer treatment, and that sperm banking
is an effective way of preserving fertility. Providing patients with
education materials might enhance compliance in sperm banking
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