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Provider barriers regarding fertility care
• Most oncologists agreed pubertal cancer patients be offered fertility referral (84%)1
– Only 46% referred male patients to fertility specialist before treatment >50% of time
• Most oncologists demonstrated knowledge of fertility preservation (FP) & discussed & felt comfortable discussing FP2
– Only 55% referred patients to an infertility specialist
– Identified barriers discussing FP
o Perception patients were too ill to delay care
o Patients were already infertile from prior therapy o Time constraints
o Inadequate access to infertility specialists
1Köhler et al. J Assist Reprod Genet. 2011; 2Loren et al. Bone Marrow Transpl. 2013.
Provider barriers regarding fertility care cont.
• Recent literature synthesis identified 5 themes influencing providers’ discussion of fertility preservation with young cancer patients:1
1. Lack of knowledge (about guidelines, costs, where to refer, conducting informed
consent with minors & parents, how to have these discussions)
2. Lack of comfort (embarrassment, especially talking about sex & masturbation)
3. Patient factors (less likely to talk with young patients, could not afford, who should be involved in conversation; more likely to discuss if patient brought it up)
4. Parent factors (raised ethical concerns about parent involvement)
5. Educational materials are lacking to share with patients & families
1Vindrola-Padros et al. Psycho-Oncology. 2016.
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