A retrospective study is being published today that gives us a better idea of the barriers to fertility preservation among women with cancer. In the study, about 1,000 women who were diagnosed with cancer between 1993 and 2007, were asked about their counseling on fertility preservation prior to potentially-sterilizing treatments such as chemotherapy, pelvic radiation, pelvic surgery, or bone marrow transplant. Though more than 60% of survivors remember being counseled on fertility, only 4% actually pursued fertility preservation. This study also identified what factors made it more or less likely to be counseled and proceed with fertility preservation.
The study by Letourneau, Smith, Ebbel, Craig, Katz, Cedars, and Rosen asked women with common non-gynecologic cancers that are often treated with chemotherapy that may damage fertility, to participate in a study. In a recent interview, Teresa K. Woodruff stated that “the study takes advantage of the California Cancer Registry, which is a good tool for retrospective studies.” The authors found the women who chose to participate in the study averaged about 31 years old at the time of cancer diagnosis and 54% desired to have children after treatment.
In the article, “Racial, Socioeconomic, and Demographic Disparities in Access to Fertility Preservation in Young Women Diagnosed With Cancer,” though more than 50% of survivors reported to receive counseling about fertility by their oncology team, age, a desire for future children, and education level were more likely to receive counseling. Women with a college degree or greater were 20% more likely to receive counseling than women without.
Of all women, only 4% actually underwent fertility preservation. Age, a desire for children, lack of children, and education were significantly associated with these treatments. Additional non-significant trends indicate that, older women (over 35), those with children, and Latina women were less likely to pursue preservation. In the study, none of the 31 African American women and 29 women who identified with a sexual orientation other than heterosexual underwent fertility preservation.
While this study in Cancer highlights that disparities between fertility counseling and preservation services are still prevalent, there is some good news. First of all, though 60% of women in the survey reported to receiving fertility counseling, these increased approximately 1% a year between 1993 and 2007. Similarly, fertility preservation procedures were not reported at all in 1993, increased to 2% in 2000, and since then have been rising slightly more than 1% per year.
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