期刊
CURRENT OPINION IN SUPPORTIVE AND PALLIATIVE CARE
卷 10, 期 1, 页码 87-94出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/SPC.0000000000000185
关键词
cancer; fertility; fertility preservation; infertility; reproductive health
资金
- National Cancer Institute
- Memorial Sloan Kettering Cancer Center [P30 CA008748]
Purpose of reviewWith increasing survival rates, fertility is an important quality of life concern for many young cancer patients. There is a critical need for improvements in clinical care to ensure patients are well informed about infertility risks and fertility preservation options and to support them in their reproductive decision-making prior to treatment.Recent findingsSeveral barriers prevent fertility from being adequately addressed in the clinical context. Providers' and patients' incomplete or inaccurate understanding of infertility risks exacerbate patients' reproductive concerns. For female patients in particular, making decisions about fertility preservation before treatment often leads to decision conflict, reducing the likelihood of making informed, value-based decisions, and posttreatment regret and distress. Recent empirically based interventions to improve provider training around fertility issues and to support patient decision-making about fertility preservation show promise.SummaryProviders should be knowledgeable about the infertility risks associated with cancer therapies and proactively address fertility with all patients who might one day wish to have a child. Comprehensive counseling should also include related issues such as contraceptive use and health implications of early menopause, regardless of desire for future children. Although the negative psychosocial impact of cancer-related infertility is now well accepted, limited work has been done to explore how to improve clinical management of fertility issues in the context of cancer care. Evidence-based interventions should be developed to address barriers and provide psychosocial and decision-making support to patients who are concerned about their fertility and interested in fertility preservation options.
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