Identifying barriers individuals face in accessing fertility care after a gynecologic cancer diagnosis

Autor: Julia Schlossman, Michelle Vu, Alexandra Samborski, Karolina Breit, Kelly Thevenet-Morrison, MaryAnn Wilbur
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Gynecologic Oncology Reports, Vol 49, Iss , Pp 101267- (2023)
Druh dokumentu: article
ISSN: 2352-5789
DOI: 10.1016/j.gore.2023.101267
Popis: Objective: To (1) identify the major barriers premenopausal individuals face in accessing fertility care at the time of gynecologic cancer diagnosis and (2) to assess patient experiences pertaining to fertility. Methods: We distributed an online survey about cancer diagnosis and fertility goals to patients ages 18–40 who had been treated for ovarian, endometrial, or cervical cancer at a single, large academic hospital. Descriptive statistics were used to analyze survey results. Patients who completed the survey were given the option to participate in a follow-up virtual interview. We conducted semi-structured interviews to discuss their fertility goals and barriers to these. Grounded theory was used to qualitatively analyze the interviews. Results: Fifty-five patients completed the survey, and 20 patients participated in the interview. The median age at diagnosis was 32 years old. Seventy-three percent of patients recalled that at the time of their diagnosis they were considering future childbearing, and 32% underwent fertility preservation. Patients reported the emotional response to their diagnosis as a barrier to receiving fertility care, with patients reporting lack of control (80%), shock (55%), and confusion (45%). Patients also identified inadequate counseling (60.0%), lack of time (60.0%), economic constraints (55.0%) and prioritization of cancer treatment (55.0%) as barriers. Nearly all patients had a positive interview experience and expressed desire to help patients in similar situations. Conclusion: Many premenopausal patients diagnosed with gynecologic malignancies are considering future childbearing at the time of diagnosis. Both logistical and emotional barriers prevent them from undergoing fertility preservation before initiating oncologic treatment.
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