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Fertility Preservation Services for Women With Newly Diagnosed Cancer

A National Assessment

Winkelman, William D., MD*; Rosen, Mitchell P., MD; Mok-Lin, Evelyn, MD

American Journal of Clinical Oncology: October 2018 - Volume 41 - Issue 10 - p 1031–1035
doi: 10.1097/COC.0000000000000420
Original Articles: Health policy

Objective: To study the resources available for cancer patients once referred for fertility preservation.

Materials and Methods: Cross-sectional study clinics that are members of the Society for Assisted Reproductive Technology assess support for fertility preservation.

Results: Surveys were distributed to a total of 1135 members at 394 Society for Assisted Reproductive Technology clinics. Responses were received from 99 individuals representing a total of 84 unique clinics (21.3%). Most clinics (76%) are able to see new cancer patients within 24 to 48 hours after a referral. Clinics most commonly offer oocyte freezing and embryo freezing (96% and 98%, respectively), with a significantly smaller portion of clinics offering ovarian tissue freezing (26%). Although most clinics offer fertility preservation for breast cancer, hematologic cancers and ovarian cancer, only 31% of clinics offer fertility preservation for pediatric premenarchal cancers. Clinics that receive >20 referrals from oncology centers annually are more likely to be in the Northeast and have an academic affiliation. These clinics are more likely to provide support for patients during their cancer treatment, more likely to have long-term follow-up with cancer patients and similarly more likely to have cancer patients return to take advantage of their treatment.

Conclusions: There are significant geographic and clinic variations in support for fertility preservation. Clinics overall are able to expeditiously see patients to avoid delays in oncologic treatment. Clinics that provide additional support and long-term care tend to have a larger oncologic volume and have more patients who utilize their fertility treatment upon completion of cancer therapy.

*Department of Obstetrics and Gynecology, Mount Auburn Hospital, Cambridge, MA

Department of Obstetrics, Gynecology and Reproductive Medicine, University of California San Francisco, San Francisco, CA

The authors declare no conflicts of interest.

Reprints: William D. Winkelman, MD, Boston Urogynecology Associates, 725 Concord Ave., Cambridge, MA 02138. E-mail:

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