Perspectives and Motivational Factors Surrounding Decision-Making in Women With Cancer Considering Fertility...

To assess perspectives of patients referred for urgent oncofertility consultation influencing whether to proceed or decline fertility preservation (FP).

An online survey was conducted in newly diagnosed cancer patients from August 2021 to July 2023 after an oncofertility consultation. Post-pubertal people with ovaries, a recent cancer diagnosis, and those who were referred for urgent oncofertility preservation consultation were eligible. Primary outcomes were patients' experiences and final treatment decisions; secondary outcomes included cycle outcomes.

Overall, 67/126 (53.2%) completed the survey and met our study criteria. Median age was 28 years (IQR 29-36). Most referrals were from medical (47.8%; 32/67) and surgical (35.8%; 24/67) oncologists with a median interval of 3 days (IQR 2-6) from referral to consultation. Breast (64.2%; 43/67) and hematological (11.9%; 8/67) cancers were most common. Overall, 55/67 (82.1%) proceeded with cryopreservation, 38/55 (69.1%) oocyte cryopreservation, 12/55 (21.8%) embryo cryopreservation, and 5/55 (9.1%) both. Of those planning chemotherapy/radiation, 42/56 (75%) chose gonadotropin-releasing hormone agonist. Of those who declined cryopreservation, 3 (25%) chose gonadotropin-releasing hormone agonist treatment as the only form of FP; 9/67 (13.4%) chose no FP treatment. The most common reasons for not cryopreserving included: no time to complete FP before cancer treatment (41.7%; 5/12) and delaying cancer treatment (41.7%; 5/12). The most common motivating factors for pursuing FP were concern for future fertility (72.4%; 42/58) and health care provider advice (48.2%; 28/58).

Most patients who received urgent oncofertility counselling proceeded with treatment. Common reasons for declining were timing of FP and delaying oncological treatment.