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Allografting

Physician perceptions and practice patterns regarding fertility preservation in hematopoietic cell transplant recipients

Bone Marrow Transplantation volume 48, pages 1091–1097 (2013)Cite this article

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Abstract

Physician practice variation may be a barrier to informing hematopoietic cell transplant (HCT) recipients about fertility preservation (FP) options. We surveyed HCT physicians in the United States to evaluate FP knowledge, practices, perceptions and barriers. Of the 1035 physicians invited, 185 completed a 29-item web-survey. Most respondents demonstrated knowledge of FP issues and discussed and felt comfortable discussing FP. However, only 55% referred patients to an infertility specialist. Most did not provide educational materials to patients and only 35% felt that available materials were relevant for HCT. Notable barriers to discussing FP included perception that patients were too ill to delay transplant (63%), patients were already infertile from prior therapy (92%) and time constraints (41%). Pediatric HCT physicians and physicians with access to an infertility specialist were more likely to discuss FP and to discuss FP even when prognosis was poor. On analyses that considered physician demographics, knowledge and perceptions as predictors of referral for FP, access to an infertility specialist and belief that patients were interested in FP were observed to be significant. We highlight variation in HCT physician perceptions and practices regarding FP. Physicians are generally interested in discussing fertility issues with their patients but lack educational materials.

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Acknowledgements

The Center for International Blood and Marrow Transplant Research is supported by Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute, the National Heart, Lung and Blood Institute and the National Institute of Allergy and Infectious Diseases ; a Grant/Cooperative Agreement 5U01HL069294 from NHLBI and NCI; a contract HHSH234200637015C with Health Resources and Services Administration (HRSA/DHHS); two Grants N00014-06-1-0704 and N00014-08-1-0058 from the Office of Naval Research; and grants from Allos, Inc.; Amgen, Inc.; Angioblast; Anonymous donation to the Medical College of Wisconsin; Ariad; Be the Match Foundation; Blue Cross and Blue Shield Association; Buchanan Family Foundation; CaridianBCT; Celgene Corporation; CellGenix, GmbH; Children’s Leukemia Research Association; Fresenius-Biotech North America, Inc.; Gamida Cell Teva Joint Venture Ltd.; Genentech, Inc.; Genzyme Corporation; GlaxoSmithKline; HistoGenetics, Inc.; Kiadis Pharma; The Leukemia and Lymphoma Society; The Medical College of Wisconsin; Merck & Co, Inc.; Millennium: The Takeda Oncology Co.; Milliman USA, Inc.; Miltenyi Biotec, Inc.; National Marrow Donor Program; Optum Healthcare Solutions, Inc.; Osiris Therapeutics, Inc.; Otsuka America Pharmaceutical, Inc.; RemedyMD; Sanofi; Seattle Genetics; Sigma-Tau Pharmaceuticals; Soligenix, Inc.; StemCyte, A Global Cord Blood Therapeutics Co; Stemsoft Software, Inc.; Swedish Orphan Biovitrum; Tarix Pharmaceuticals; Teva Neuroscience, Inc.; THERAKOS, Inc.; and Wellpoint, Inc. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, or any other agency of the US Government.

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Authors and Affiliations

  1. Abramson Cancer Center University of Pennsylvania Medical Center, Philadelphia, PA, USA

    A W Loren

  2. Center for International Blood and Marrow Transplant Research, Milwaukee, WI, USA

    R Brazauskas & Z Wang

  3. Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    E J Chow & M L Sorror

  4. St James University Hospital, Leeds, UK

    M Gilleece

  5. University Hospital Basel, Basel, Switzerland

    J Halter

  6. Children’s National Medical Center, Washington, DC, USA

    D A Jacobsohn

  7. Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    S Joshi

  8. H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    J Pidala & G P Quinn

  9. Imperial College, London, UK

    J F Apperley

  10. University of Minnesota Medical Center, Minneapolis, MN, USA

    L J Burns

  11. All Children’s Hospital, St Petersburg, FL, USA

    G A Hale

  12. Oregon Health and Science University, Portland, OR, USA

    B M Hayes-Lattin

  13. Baylor College of Medicine Center for Cell and Gene Therapy, Houston, TX, USA

    R Kamble

  14. University of Hospitals Case Medical Center, Cleveland, OH, USA

    H Lazarus

  15. Roswell Park Cancer Institute, Buffalo, NY, USA

    P L McCarthy

  16. University of Central Florida, Orlando, FL, USA

    V Reddy

  17. Uniformed Services University, Bethesda, MD, USA

    A B Warwick

  18. Cleveland Clinic Foundation, Cleveland, OH, USA

    B J Bolwell

  19. Dana Farber Cancer Institute, Boston, MA, USA

    C Duncan

  20. Hopital Saint Louis, Paris, France

    G Socie

  21. Shands HealthCare & University of Florida, Gainesville, FL, USA

    J R Wingard

  22. National Marrow Donor Program, Minneapolis, MN, USA

    N S Majhail

Authors
  1. A W Loren
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  2. R Brazauskas
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  3. E J Chow
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  4. M Gilleece
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  5. J Halter
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  6. D A Jacobsohn
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  7. S Joshi
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  8. J Pidala
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  9. G P Quinn
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  10. Z Wang
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  11. J F Apperley
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  12. L J Burns
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  13. G A Hale
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  14. B M Hayes-Lattin
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  15. R Kamble
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  16. H Lazarus
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  17. P L McCarthy
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  18. V Reddy
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  19. A B Warwick
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  20. B J Bolwell
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  21. C Duncan
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  22. G Socie
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  23. M L Sorror
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  24. J R Wingard
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  25. N S Majhail
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Corresponding author

Correspondence to N S Majhail.

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The authors declare no conflict of interest.

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Supplementary Information accompanies the paper on Bone Marrow Transplantation website

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Loren, A., Brazauskas, R., Chow, E. et al. Physician perceptions and practice patterns regarding fertility preservation in hematopoietic cell transplant recipients. Bone Marrow Transplant 48, 1091–1097 (2013). https://doi.org/10.1038/bmt.2013.13

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  • DOI: https://doi.org/10.1038/bmt.2013.13

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