Journal
BONE MARROW TRANSPLANTATION
Volume 48, Issue 8, Pages 1091-1097Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/bmt.2013.13
Keywords
hematopoietic cell transplantation; autologous; allogeneic; fertility preservation; infertility; pregnancy
Categories
Funding
- Public Health Service from the National Cancer Institute, the National Heart, Lung and Blood Institute [U24-CA76518]
- National Institute of Allergy and Infectious Diseases
- NHLBI [5U01HL069294]
- NCI
- Health Resources and Services Administration (HRSA/DHHS) [HHSH234200637015C]
- Office of Naval Research [N00014-06-1-0704, N00014-08-1-0058]
- Allos, Inc.
- Amgen, Inc.
- Angioblast
- Ariad
- Be the Match Foundation
- Blue Cross and Blue Shield Association
- Buchanan Family Foundation
- CaridianBCT
- Celgene Corporation
- CellGenix
- GmbH
- Children's Leukemia Research Association
- Fresenius-Biotech North America, Inc.
- Gamida Cell Teva Joint Venture Ltd.
- Genentech, Inc.
- Genzyme Corporation
- GlaxoSmithKline
- HistoGenetics, Inc.
- Kiadis Pharma
- Leukemia and Lymphoma Society
- Medical College of Wisconsin
- Merck Co, Inc.
- Millennium: The Takeda Oncology Co.
- Milliman USA, Inc.
- Miltenyi Biotec, Inc.
- National Marrow Donor Program
- Optum Healthcare Solutions, Inc.
- Osiris Therapeutics, Inc.
- Otsuka America Pharmaceutical, Inc.
- RemedyMD
- Sanofi
- Seattle Genetics
- Sigma-Tau Pharmaceuticals
- Soligenix, Inc.
- StemCyte, A Global Cord Blood Therapeutics Co
- Stemsoft Software, Inc.
- Swedish Orphan Biovitrum
- Tarix Pharmaceuticals
- Teva Neuroscience, Inc.
- THERAKOS, Inc.
- Wellpoint, Inc.
- National Institute for Health Research [NF-SI-0611-10275] Funding Source: researchfish
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Physician practice variation may be a barrier to informing hematopoietic cell transplant (HCT) recipients about fertility preservation (FP) options. We surveyed HCT physicians in the United States to evaluate FP knowledge, practices, perceptions and barriers. Of the 1035 physicians invited, 185 completed a 29-item web-survey. Most respondents demonstrated knowledge of FP issues and discussed and felt comfortable discussing FP. However, only 55% referred patients to an infertility specialist. Most did not provide educational materials to patients and only 35% felt that available materials were relevant for HCT. Notable barriers to discussing FP included perception that patients were too ill to delay transplant (63%), patients were already infertile from prior therapy (92%) and time constraints (41%). Pediatric HCT physicians and physicians with access to an infertility specialist were more likely to discuss FP and to discuss FP even when prognosis was poor. On analyses that considered physician demographics, knowledge and perceptions as predictors of referral for FP, access to an infertility specialist and belief that patients were interested in FP were observed to be significant. We highlight variation in HCT physician perceptions and practices regarding FP. Physicians are generally interested in discussing fertility issues with their patients but lack educational materials.
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