Physician Referral for Fertility Preservation in Oncology Patients: A National Study of Practice Behaviors

TLDR

Improving cancer survival has shifted focus to quality of life, with fertility being a critical concern for child‑bearing patients, yet most studies show that fewer than half receive information or referral for fertility preservation. This study examined the referral practices of oncologists in the United States. The authors surveyed a stratified random sample of US oncologists via a 53‑item mail and Internet questionnaire drawn from the AMA Physician Masterfile. Only 47% of oncologists routinely refer child‑bearing patients to reproductive endocrinologists, with higher referral rates among female physicians, those with positive attitudes, and those whose patients ask about fertility preservation, indicating that fewer than half adhere to ASCO guidelines.

Abstract

Cancer survival rates are improving, and the focus is moving toward quality survival. Fertility is a key aspect of quality of life for cancer patients of childbearing age. Although cancer treatment may impair fertility, some patients may benefit from referral to a specialist before treatment. However, the majority of studies examining patient recall of discussion and referral for fertility preservation (FP) show that less than half receive this information. This study examined the referral practices of oncologists in the United States.This study examined oncologists' referral practice patterns for FP among US physicians using the American Medical Association Physician Masterfile database. A 53-item survey was administered via mail and Internet to a stratified random sample of US physicians.Forty-seven percent of respondents routinely refer cancer patients of childbearing age to a reproductive endocrinologist. Referrals were more likely among female physicians (P = .004), those with favorable attitudes (P = .043), and those whose patients routinely ask about FP (odds ratio = 2.09; 95% CI, 1.31 to 3.33).Less than half of US physicians are following the guidelines from the American Society of Clinical Oncology, which suggest that all patients of childbearing age should be informed about FP.