Fertility preservation counseling in reproductive-age women with cancer

The objective of this pilot study was to identify the number of patients of reproductive age with gynecologic and hematologic cancer who received fertility preservation consultation and to analyze their requirements and needs to improve the consultation.

This retrospective cross-sectional survey used a pseudonymized questionnaire to record demographics, cancer diagnosis and therapy, fertility preservation consultation and fertility preservation actions, as well as patients' requirements for an optimized fertility preservation consultation. Female patients aged between 18 and 45 with gynecologic, hematologic, and breast cancer who received fertility-sparing therapy were recruited at Charité hospital. The χ² tests were used to compare frequencies. Multiple logistic regression was performed to analyze influencing variables.

Between August 2022 and February 2024, 107 patients were recruited. Of all patients, 73% received fertility preservation consultation, and 56% were offered fertility preservation before starting therapy. Seventy-five percent were satisfied with their consultation. In multi-variate analysis, influencing factors such as age, origin, parity, partner status, completed family planning, cancer type, and therapy were examined. Women not born in Germany and women with completed family planning were less likely to receive fertility preservation consultation. Patients undergoing chemotherapy were more likely to be offered fertility preservation options. For an optimized consultation, most patients preferred an in-person consultation by their treating gynecologist at the hospital, together with their partners. Booklets, websites, and consultations with their general practitioner were suggested as additional sources of information. Most patients suggested a specialized fertility preservation consultation.

Most women of reproductive age with cancer received fertility preservation consultation, but only half were offered fertility preservation before therapy. Fertility preservation consultation should be improved by considering diversity and individual needs to include all patients of reproductive age with cancer.