Young Women With Cancer Who Want Children Do Not Get The Info They Need: Study

The study, recently published in the JAMA Network Open and conducted with a small group of doctors in 2014 and 2015, suggests that one of the main reasons doctors avoid the conversations is a lack of familiarity with the topic.

One doctor said oncologists were "truly poorly informed" and "remarkably ignorant about” fertility preservation. Another said clinicians were only aware of fertility "in a sort of theoretical way." Perhaps most startling, one doctor said, "I have slightly more information [about fertility preservation] than a layperson."

The doctors also admitted that many were insufficiently knowledgeable about the risks of treatment, “did not understand fertility preservation processes, had no sense of timelines for how the processes work, had little or no understanding of the available technologies or their costs, and did not know where or how to refer patients for consultation,” the study said.

But “this is a rapidly changing field,” explained author study Dr. Nancy Baxter, who’s in the Department of Surgery at St. Michael's Hospital in Toronto. “For some cancer treatments, it can be difficult to predict fertility after treatment.”

The Importance of Young Women Getting Needed Information

Women who may want to have biological children in the future need to be aware that, in many cases, there are options to increase their chances. In a previous interview with SurvivorNet, reproductive endocrinologist Dr. Jaime Knopman said that the sooner after a cancer diagnosis these fertility conversations start, the better.

“For fertility preservation most of the time I see women right at the time of their diagnosis,” Dr. Knopman siad. “Usually they see an oncologist, they’re told they have cancer, and within a couple of days they’re sitting in our office talking about what options are available to them to preserve their fertility.”

Dr. Knopman, citing the studies that show over 50% of women are never even told that they have fertility-preservation options, said, “I think you need to be your own advocate, and I’ve learned that not only as a doctor, but as a patient and as a mom. If you don’t ask for things, a lot of times, you’re not going to get them.”

Advice on Fertility Preservation

Whether a women is able to take part in some sort of fertility-preservation technique will depend on the type of cancer she has, and what stage it’s at. For women who are eligible, time is of the essence. The main options are to freeze either eggs or embryos, and there are pros and cons to each approach.

Dr. Jaime Knopman explains fertility preservation options after a cancer diagnosis.

Dr. Knopman said that she is more in favor of women freezing their eggs, because it gives them more control over the situation. When an embryo is frozen, whether it be with donor sperm or with a partner’s sperm, the solution is more permanent — you can’t un-fertilize the egg, Dr. Knopman said. If a couple decides they no longer want to have a child together, or due to treatment, a woman loses the ability to carry a pregnancy — the frozen embryo might be useless.

When eggs are frozen, women do have  a bit more freedom over what they choose to do with these eggs.

“Egg freezing gives you opportunity,” she said. “Those are your eggs. You can do whatever you want with them, and it gives you control. You have those frozens … whatever happens in the future, those are your eggs.”

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