Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Rates of fertility discussions and counselling before, during and after anticancer treatments: women deserve gender specific care (#326)

Verity Chadwick 1 , Michaela Kim 2 , Georgia Mills 2 , Catherine Tang 3 , Antoinette Anazodo 2 4 5 , Rachel Dear 2 6 , Rachael Rodgers 7 8 , Orly Lavee 2 9 , Samuel Milliken 2 9 , Georgia McCaughan 9 , John Moore 2 9 , Nada Hamad 8 9 10 , Joshua Hurwitz 11
  1. Royal North Shore Hospital, St Leonards, NSW, Australia
  2. School of Medicine, University of New South Wales, Sydney, NSW, Australia
  3. Department of Haematology and Flow Cytometry, Laverty Pathology, Macquarie Park, NSW, Australia
  4. Kids Cancer Centre, Sydney Children’s Hospital, Sydney, NSW, Australia
  5. Nelune Cancer Centre, Prince of Wales Hospital, Randwick, NSW, Australia
  6. Department of Oncology, St Vincent’s Hospital, Sydney, NSW, Australia
  7. Department of Reproductive Medicine, Royal Hospital for Women, Sydney, NSW, Australia
  8. School of Women’s and Children’s Health, University of New South Wales, Randwick, NSW, Australia
  9. Department of Haematology, St Vincent’s Hospital, Darlinghurst, NSW, Australia
  10. School of Medicine, University of Notre Dame, Daringhurst, NSW, Australia
  11. Medical Oncology, The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia

Introduction: Cancer treatment can significantly reduce reproductive potential in female patients. Despite best-practice recommendations, women are not commonly offered fertility preservation referrals.

Aim: To examine the incidence of fertility counselling in women of childbearing age receiving anticancer therapies.

Methods: Our group conducted a retrospective chart review at a major Australian cancer centre of premenopausal females aged 18-49 years diagnosed with cancer between 2017 and 2020. Data collected included demographics, cancer diagnosis, treatment(s) received, fertility history, timing and documentation of fertility discussions, referrals to specialist gynaecologists, and fertility outcomes.

Results: A total of 143 patients met inclusion criteria. Only 12.6% had a reproductive health history documented at the first consult, and just over half (58%) had a fertility preservation discussion at some point with their primary haematologist or oncologist. A quarter (25.9%) saw a specialist gynaecologist to discuss fertility preservation options, and 11.2% were offered a referral but declined. Of those with fertility-related outcomes documented, 21.0% had return of menses, 15.4% had >1 oocyte cryopreserved, 9.1% had already completed their families, 9.1% did not want children, 7.7% experienced premature menopause, 2.1% managed a successful pregnancy and birth, 1.4% had embryos cryopreserved, and 1.4% unsuccessfully attempted in vitro fertilisation.

Conclusion: In an Australian major cancer centre only a quarter of women of reproductive age with cancer saw a fertility preservation specialist. Promoting and facilitating reproductive counselling needs to be addressed by better relationships between fertility gynaecologists and oncologists/haematologists, implementation of technology systems ensuring fertility preservation discussions, and improved staff education.