Abstract
Study question
What is the real accessibility of fertility preservation techniques and its perception by patients in the Czech Republic?
Summary answer
Fertility preservation options are not offered on a routine basis and often are not part of a treatment plan. Patients wish to be adequately informed.
What is known already
Every year, more than 82.000 people in the Czech Republic develop cancer. The incidence of newly diagnosed cancers in individuals in their reproductive age represents 4.4% of all newly diagnosed oncological diseases. Because the prognosis of treatment in this group of patients is very favourable, the priority in treatment is the emphasis on quality of life after surviving. One of the important parameters of quality of life for many people is the ability to reproduce and the possibility of having a genetic bond to their children.
Study design, size, duration
This qualitative study was conducted in 2019 and relied on explorative in-depth semi-structured interviews. Participants were chosen through occasional sampling.
Participants/materials, setting, methods
We interviewed 13 cancer patients/survivors in their reproductive age (aged 21 to 36; 7 females and 6 males); 4 close family members of young cancer patients; and 8 experts from relevant professional fields. Data gathered from semi-structured interviews were analysed by interpretative phenomenological analysis.
Main results and the role of chance
Cancer was perceived as a threat to life and one’s safety. It causes uncertainty and a feeling of loss of control. It also has a negative impact on a self-concept. Loss of fertility was perceived as a “injury of personality”. The possibility of maintaining fertility has increased the subjectively experienced quality of life.
They make decisions under great time pressure, in a mentally demanding situation. They are usually in the early stages of coping with the diagnosis. The main factors that influenced the respondents’ decision were the amount and quality of information, psychological stress and time pressure.
Patients and their families are interested in being informed about the risks that the disease and its treatment pose to their reproductive health. They want to be able to decide whether to undergo any of the fertility protection techniques. They want to keep their future open. It is therefore desirable that, within oncofertility, we focus on the process of passing on information and supporting decision-making on issues of fertility and its protection. A tool that could be a good informational platform may be so-called decision aid – a tool used to inform patients about available treatments, along with potential benefits, risks and costs.
Limitations, reasons for caution
As all qualitative data, our findings cannot be generalized. Selection bias could have occurred because it is likely that those interested and open to sharing participated.
Wider implications of the findings: Oncofertility treatment is highly relevant and should be offered and discussed with all patients in their reproductive age. Addressing fertility preservation options should be a part of cancer treatment plan of all these patients.
Trial registration number
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Pretreatment fertility counseling and fertility preservation improve quality of life in reproductive age women with cancer
