Different Fertility Advice for Men Vs Women with Cancer

Posted on the 13 June 2012 by Jean Campbell

Are men and women receiving different fertility advice following a cancer diagnosis?

That’s my question after reviewing a small study out of the University of Aberdeen, UK, where that was found to be the case.

The study report was recently published in BJOG: An International Journal of Obstetrics and Gynaecology.

Since my childbearing years were behind me when I was diagnosed with breast cancer, fertility counseling was not a part of my initial consult following my diagnosis. I’ve since done research with fertility organizations that provide information to young women following a cancer diagnosis. I have not been successful in finding any statistics on the numbers of women of childbearing years who received,  or have not received fertility information at their initial treatment consult following diagnosis.

If any of you, my readers, want to share your experience in accessing fertility preservation, I will be happy to share your information on this site. Such information can only be a help to others finding themselves in a similar situation. Please email your information about your experience to me at jean@noboobsaboutit.org.

The study, conducted at the University of Aberdeen, School of Medicine and Dentistry UK reviews perceptions and use of fertility preservation techniques in both men and women of reproductive age recently diagnosed with cancer.

Sixteen men and 18 women aged 17-49 took part along with 15 health professionals in this first study to explore the experience of discussing future fertility at the time of cancer diagnosis Patients were receiving treatment for cancers between August 2008 and June 2010.

Patient interviews took place soon after a first consultation following a cancer diagnosis.

During this interview, topics discussed included: patients’ perceptions and understanding of the initial diagnosis, the prognosis and their future reproductive choices; perceived quality and source of information received, communication and support; and the role of partners, family members, friends and healthcare professionals.

Participating staff were asked about their opinions on the information given to younger people with cancer, their knowledge and views of the treatments available with respect to fertility preservation and their perceptions of patients’ priorities.

Men and women were given different information reflecting the varying fertility preservation options available, perceived success rates and subsequent delay in accessing cancer treatment.

Men were encouraged to store sperm, even if they had children already. Almost all the men had a discussion with staff about sperm banking and a local protocol was in place for immediate referral.

However, in contrast, few women interviewed could remember fertility preservation being discussed and there was no protocol in place.

From the staff interviews, the main reason why staff did not discuss fertility preservation with the majority of women was their belief that treatment was perceived to be more urgent. The study also found that health professionals did not discuss future fertility in detail because they felt patients were given a wealth of information during their first visit and that fertility would not be affected if treatment using first line drugs was successful.

Valerie Peddie, Fertility Nurse Specialist/Research Midwife, School of Medicine and Dentistry, University of Aberdeen, and co-author of the paper said, “It has been widely argued that at the time of diagnosis, patients should be provided with accurate information about the potential risk of impaired fertility after treatment for cancer irrespective of whether local facilities for gamete cryopreservation exist.

“However in reality, the immediate emphasis is often on treatment, with little time available to discuss future fertility or options for fertility preservation. Our study demonstrated significant gaps in the information provided to young women diagnosed with cancer and suggests the need for an early appointment with a fertility expert.”

BJOG Deputy Editor-in-Chief, Pierre Martin-Hirsch, added: “This is a unique study as it looks specifically at younger men and women’s experiences. However it is a small scale study and more research needs to be conducted in a larger population. Following that, care pathways should be developed looking at fertility and cancer treatment.”

Source: Peddie V, Porter M, Barbour R, Culligan D, MacDonald G, King D, Horn J, Bhattacharya S. Factors affecting decision making about fertility preservation after cancer diagnosis: a qualitative study. BJOG 2012; DOI: 10.1111/j.1471-0528.2012.03368.x