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Infertility associated with cancer can have significant psychological impacts to cancer patients and survivors, necessitating appropriate fertility-related psychological support. This literature review details the psychological impact of infertility in cancer patients and survivors, and discusses fertility counselling as described in current international guidelines; as either the provision of fertility information or psychosocial support. Fertility counselling has a role in assisting with fertility treatment decision-making, but also in supporting patients with the emotional distress associated with potential infertility at the time of cancer diagnosis, and infertility in survivorship. The necessity of psychological support for fertility patients is outlined, alongside recommendations for adolescent and young adult patients, and family members of cancer patients involved in fertility and oncological care. Moving forward, a clear guidelines for fertility counselling of cancer patients in the context of fertility preservation may be beneficial, in removing ambiguity as to whom conducts counselling, what counselling involves, and what level of psychosocial support may be most effective in supporting cancer patients longitudinally.

Aims: To systematically review the literature on the components of oncofertility care as defined by patient and clinician representatives, and identify the barriers, facilitators and challenges so as to improve the implementation of oncofertility services. Methods: A systematic scoping review was conducted on oncofertility models of care (MOC) literature published in English between 2007-2017, relating to ten domains of care identified through consumer research (communication, oncofertility decision aids, age appropriate care, referral pathways, documentation, training, supportive care during treatment, reproductive care after cancer treatment, psychosocial support and ethical practice of oncofertility care). A wide range of electronic databases were searched. Preferred reporting items for systematic reviews and meta-analyses and the international prospective register of systematic reviews was followed. Results: A total of 842 potentially relevant studies were identified and screened and the final 147 papers were reviewed with data extraction. The results identified a number of themes for improving MOC in each domain, including the importance of patients receiving communication of a higher quality and in different formats on their fertility risk and FP options; improving provision of oncofertility care in a timely manner; improving access to age appropriate care; defining the role and scope of practice of all health care professionals (HCPS) and improving communication between different HCPs. Different forms of decision aid were found useful to assist patients to understand FP options and weigh up choices. Conclusions: This analysis identifies core components for delivery of oncofertility MOC. The provision of services requires planning to ensure services have reliable referral pathways that are age appropriate and include care into survivorship. In order for this to happen, collaboration needs to occur between clinicians, allied HCPs and executives across both publ

Background: Despite international evidence about fertility preservation (FP), several barriers still prevent the implementation of equitable FP practice. Currently, oncofertility competencies do not exist. The aim of this study was to develop an oncofertility competency framework that defines the key components of oncofertility care, develops a model for prioritizing service development, and defines the roles that health care professionals (HCPs) play. Materials and Method: A quantitative modified Delphi methodology was used to conduct two rounds of an electronic survey, querying and synthesizing opinions about statements regarding oncofertility care with HCPs and patient and family advocacy groups (PFAs) from 16 countries (12 high and 4 middle income). Statements included the roles of HCPs and priorities for service development care across ten domains (communication, oncofertility decision aids, age-appropriate care, referral pathways, documentation, oncofertility training, reproductive survivorship care and fertility-related psychosocial support, supportive care, and ethical frameworks) that represent 33 different elements of care. Results: The first questionnaire was completed by 457 participants (332 HCPs and 125 PFAs). One hundred and thirty-eight participants completed the second questionnaire (122 HCPs and 16 PFAs). Consensus was agreed on 108 oncofertility competencies and the roles HCPs should play in oncofertility care. A three-tier service development model is proposed, with gradual implementation of different components of care. A total of 92.8% of the 108 agreed competencies also had agreement between high and middle income participants. Conclusion: FP guidelines establish best practice but do not consider the skills and requirements to implement these guidelines. The competency framework gives HCPs and services a structure for the training of HCPs and implementation of care, as well as defining a model for prioritizing oncofertility service developm

BACKGROUND Fertility preservation (FP) is an important quality of life issue for cancer survivors of reproductive age. Despite the existence of broad international guidelines, the delivery of oncofertility care, particularly amongst paediatric, adolescent and young adult patients, remains a challenge for healthcare professionals (HCPs). The quality of oncofertility care is variable and the uptake and utilization of FP remains low. Available guidelines fall short in providing adequate detail on how oncofertility models of care (MOC) allow for the real-world application of guidelines by HCPs. OBJECTIVE AND RATIONALE The aim of this study was to systematically review the literature on the components of oncofertility care as defined by patient and clinician representatives, and identify the barriers, facilitators and challenges, so as to improve the implementation of oncofertility services. SEARCH METHODS A systematic scoping review was conducted on oncofertility MOC literature published in English between 2007 and 2016, relating to 10 domains of care identified through consumer research: communication, oncofertility decision aids, age-appropriate care, referral pathways, documentation, training, supportive care during treatment, reproductive care after cancer treatment, psychosocial support and ethical practice of oncofertility care. A wide range of electronic databases (CINAHL, Embase, PsycINFO, PubMed, AEIPT, Education Research Complete, ProQuest and VOCED) were searched in order to synthesize the evidence around delivery of oncofertility care. Related citations and reference lists were searched. The review was undertaken following registration (International prospective register of systematic reviews (PROSPERO) registration number CRD42017055837) and guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). OUTCOMES A total of 846 potentially relevant studies were identified after the removal of duplicates

OBJECTIVE:Despite recommendations internationally for the timely provision of fertility information, cancer patients report unmet information needs, with poor provision and inadequate written information to assist in fertility preservation decision-making. Patient decision aids may be a useful resource in this setting to inform patients and guide decision-making. A systematic review of the literature on decision aids for fertility preservation in cancer patients would determine the effectiveness of these tools in supporting decision-making about fertility preservation and indicate their current use in clinical care. METHODS: A systematic review was conducted in March 2018, within electronic search databases Medline, EMBASE, PSYCH Info, PubMed, and Web of Science. An initial search identified 718 potentially relevant articles from databases and screening of relevant reference lists. RESULTS: A total of 12 papers, detailing 11 studies with a total of 772 participants, evaluating 9 decision aids, were included within the review. PtDAs were shown to significantly increase fertility preservation knowledge and decrease decisional conflict. Overall satisfaction with decision aids was high. Currently only two reviewed decision aids are available for cancer patients. Another tool has been integrated into a web page and one implementation study has been completed. CONCLUSIONS: Patient decision aids can serve as effective complements to current fertility counselling practices by increasing information satisfaction and decision-making outcomes. More research is needed into the appropriateness of these resources for patients across the reproductive-age range. Future implementation studies may assist in aiding dissemination of these tools into clinical practice.

AIMS: To explore the access to oncofertility care and the reproductive concerns (RC) and psychological distress (PD) that cancer patients experienced at diagnosis, compared to controls and patient/parents. METHODS: Questionnaires were administered to capture information about patient’s repro- ductive experiences, RC and PD at diagnosis. RESULTS: 30 patients with cancer were recruited from the Australasian Oncofertility Registry. 10 parents or partners of patients and 50 age-matched controls were recruited. 7.5% of patients and controls had known infertility. 28% of female patients and controls and 8.3% of male cancer patients and controls had risk factors for infertility. 90% patients recalled having a discussion about infertility risks with cancer clinician; 70% had a discussion with fertility specialist ad 86% of them underwent FP. Referrals for FP were more likely in 15-19 year olds (87%) and 20-24 years olds (83%) than in 25-45 years old (56%) (P=0.07); all males and 81% of females underwent FP once referred. Participants all reported high levels of RC however the patient’s reported signi cantly lower RC than controls (P=0.18) and parents (P=0.13). Cancer patients reported signi cantly lower PD compared with controls. Perceived barriers to FP in cancer patients were low, with most patients ‘never’ or ‘rarely’ experiencing any barriers. Cancer patients and parents both felt that fertility specialists and cancer doctors (66.7%, 40%) provided the most helpful support. Patients reported not receiving oncofertility support from cancer nurses (43%) fertility nurses (47%), counsellors (73.3%) psychologists (80%) and social workers (86,7%). CONCLUSION: Having access to oncofertility services reduces barriers and improves com- munication. Although cancer patients had high RC they had low levels of PD compared with parents/partners and controls showing the potential bene ts of oncofertility referral and support. While the access to oncofertility care was of a high standar

BACKGROUND: Fertility preservation (FP) is an important quality of life issue for cancer survivors of reproductive age. Despite the existence of broad international guidelines, the delivery of oncofertility care, particularly amongst paediatric, adolescent and young adult patients, remains a challenge for healthcare professionals (HCPs). The quality of oncofertility care is variable and the uptake and utilization of FP remains low. Available guidelines fall short in providing adequate detail on how oncofertility models of care (MOC) allow for the real-world application of guidelines by HCPs. OBJECTIVE AND RATIONALE: The aim of this study was to systematically review the literature on the components of oncofertility care as defined by patient and clinician representatives, and identify the barriers, facilitators and challenges, so as to improve the implementation of oncofertility services. SEARCH METHODS: A systematic scoping review was conducted on oncofertility MOC literature published in English between 2007 and 2016, relating to 10 domains of care identified through consumer research: communication, oncofertility decision aids, age-appropriate care, referral pathways, documentation, training, supportive care during treatment, reproductive care after cancer treatment, psychosocial support and ethical practice of oncofertility care. A wide range of electronic databases (CINAHL, Embase, PsycINFO, PubMed, AEIPT, Education Research Complete, ProQuest and VOCED) were searched in order to synthesize the evidence around delivery of oncofertility care. Related citations and reference lists were searched. The review was undertaken following registration (International prospective register of systematic reviews (PROSPERO) registration number CRD42017055837) and guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). OUTCOMES: A total of 846 potentially relevant studies were identified after the removal of duplicates. All titles an

OBJECTIVE: Cancer patients experience reproductive concerns from diagnosis through to survivorship. However, research has yet to investigate the degree of fertility-related psychological distress at different treatment time points: diagnosis, treatment, and survivorship. Currently, cancer patients are offered fertility counselling at the time of diagnosis, to assist fertility preservation decision making. A systematic review of the short-term and long-term psychological impact of infertility in cancer patients would inform on an improved, longitudinal model of psychological care. METHODS: A systematic review of the literature was conducted in January 2018 utilising electronic databases Medline, EMBASE, PSYCH Info, Web of Science, and SCOPUS. An initial search identified 708 potentially relevant studies. Literature was assessed that reported on fertility-related psychological distress experienced by male and female cancer patients of reproductive age (<45 years) across oncology treatment time points. RESULTS: A total of 47 papers were included within the final review. Fertility-related psychological distress persists from diagnosis through to survivorship, with cancer patients reporting a range of negative emotional experiences brought about by threatened infertility. In survivorship, reproductive concerns, unfulfilled desire for a child, nulliparous status, and early menopause were linked to higher rates of mental health disorders and psychological distress. CONCLUSIONS: Fertility-related psychological distress is prevalent and persistent in cancer patients and survivors. As such, patients and survivors would greatly benefit from fertility-related psychological support implemented into standard practice from diagnosis through to survivorship. A revised model of care is proposed.

Background: Fertility preservation (FP) is an important quality of life issue for cancer survivors of reproductive age. Despite the existence of broad international guidelines, the delivery of oncofertility care remains a challenge for healthcare professionals (HCPs), particularly amongst paediatric, adolescent and young adult patients. The quality of oncofertility care is variable and the uptake and utilisation of FP remains low. Available guidelines fall short in providing adequate detail on how oncofertility models of care allow for the real-world application of guidelines by HCPs. Objective and rationale: To systematically review the literature on the components of oncofertility care as defined by patient and clinician representatives, and identify the barriers, facilitators and challenges so as to improve the implementation of oncofertility services. Search methods: A systematic scoping review was conducted on oncofertility models of care (MOC) literature published in English between 2007-2016, relating to ten domains of care identified through consumer research (communication, oncofertility decision aids, age appropriate care, referral pathways, documentation, training, supportive care during treatment, reproductive care after cancer treatment, psychosocial support and ethical practice of oncofertility care). A wide range of electronic databases (CINAHL, Embase, PsycINFO, PubMed, AEIPT, Education Research Complete, ProQuest and VOCED) were searched in order to synthesise the evidence around delivery of oncofertility care. Related citations and reference lists were searched. The review was undertaken following registration (International prospective register of systematic reviews (PROSPERO) registration number CRD42017055837) and guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Outcomes: A total of 846 potentially relevant studies were identified after the removal of duplicates. All titles and abstracts were sc

Summary of published literature

Aims: To systematically review the literature on the components of oncofertility care as defined by patient and clinician representatives, and identify the barriers, facilitators and challenges so as to improve the implementation of oncofertility services. Methods: A systematic scoping review was conducted on oncofertility models of care (MOC) literature published in English between 2007-2017, relating to ten domains of care identified through consumer research (communication, oncofertility decision aids, age appropriate care, referral pathways, documentation, training, supportive care during treatment, reproductive care after cancer treatment, psychosocial support and ethical practice of oncofertility care). A wide range of electronic databases were searched. Preferred reporting items for systematic reviews and meta-analyses and the international prospective register of systematic reviews was followed. Results: A total of 842 potentially relevant studies were identified and screened and the final 147 papers were reviewed with data extraction. The results identified a number of themes for improving MOC in each domain, including the importance of patients receiving communication of a higher quality and in different formats on their fertility risk and FP options; improving provision of oncofertility care in a timely manner; improving access to age appropriate care; defining the role and scope of practice of all health care professionals (HCPS) and improving communication between different HCPs. Different forms of decision aid were found useful to assist patients to understand FP options and weigh up choices. Conclusions: This analysis identifies core components for delivery of oncofertility MOC. The provision of services requires planning to ensure services have reliable referral pathways that are age appropriate and include care into survivorship. In order for this to happen, collaboration needs to occur between clinicians, allied HCPs and executives across both publ

Decline in fertility potential brought about by a cancer diagnosis or cancer treatment is one of the biggest impacts to cancer patients’ long term quality of life. As such, the emerging discipline of oncofertility advocates for the timely provision of fertility information and referral for fertility preservation to all cancer patients of reproductive age (<45 years). Objective To systematically review the literature on fertility support needs for cancer patients of a reproductive age (14-45 years of age) and clinician reported provisions of fertility care, to asses cancer patients fertility-related support needs. Method A systematic review of the literature was conducted in May 2016 through the searching of electronic databases identi ed 351 potentially relevant studies. The papers were divided into two categories; papers on patient-reported fertility support needs were reviewed within one systematic review. Papers on clinician-reported provisions of fertility care were reviewed for a second systematic review. Results Thirty studies were included within the nal patient-reported review. A number of studies indicated that cancer patients place great important on their fertility care and have unmet support needs. Patients were satis ed and felt supported when additional care was taken to ensure fertility information and service needs were met. Twenty-three studies were included within the nal clinician-reported review. Although many clinicians are broadly informed about the risk to their patients’ fertility brought about by cancer treatment, there are many factors which hinder the appropriate discussion, referral or service utilisation needed in order to provide adequate fertility-related care and support to patients of reproductive age. Conclusions Patients desire for clinicians to support their concerns through the provision of adequate information, access to fertility services, taking time to discuss fertility treatment and concerns, specialised psychological suppor