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Practices and Attitudes Regarding Women Undergoing Fertility Preservation: A Survey of the National Physicians Cooperative.
- Source :
-
Journal of adolescent and young adult oncology [J Adolesc Young Adult Oncol] 2017 Sep; Vol. 6 (3), pp. 444-449. Date of Electronic Publication: 2017 May 01. - Publication Year :
- 2017
-
Abstract
- Purpose: To describe physician attitudes and variations in oncofertility treatment strategies.<br />Methods: An exploratory online survey administered between December 1, 2014 and January 27, 2015 to 185 members of the National Physicians Cooperative (NPC).<br />Results: Twenty-eight percent (52 of 185) of NPC members responded to the online survey. Fifty percent of respondents were obstetrician-gynecologists working largely in academic medical centers. Thirty-eight percent stated that 14 was the youngest age they felt comfortable performing oocyte retrievals with 35% stating that any age was acceptable as long as they were postpubertal. Short stimulation protocols, utilizing a gonadotropin-releasing hormone (GnRH) antagonist (86%), were more common than long stimulation or microdose Lupron flare protocols (23% and 18%), respectively, which utilize a GnRH agonist. Random start protocols were used by 77% and over 90% perform luteal phase starts. When using random start protocols, 64% use gonadotropins only and 32% start GnRH antagonists alone for several days before starting gonadotropins. Fifty-five percent of physicians were comfortable stimulating ovarian cancer patients only after clearance from an oncologist. Aromatase inhibitors (77%) were significantly more common than tamoxifen (24%) for stimulation in breast cancer patients (pā=ā0.0006). When considering ovarian stimulation after chemotherapy, 24% expressed comfort only if blood counts are normal, 38% tend to wait 3 months. Regarding experimental treatment, 83% report discussing the use of GnRH agonists alone and 64% of clinics offer ovarian tissue cryopreservation.<br />Conclusions: This study underlines the wide variation that exists in stimulation and phase start techniques, patient selection, comfort levels, and cancer type-specific decision making.
- Subjects :
- Adult
Female
Health Knowledge, Attitudes, Practice
Humans
Infertility, Female psychology
Pregnancy
Surveys and Questionnaires
Young Adult
Attitude of Health Personnel
Fertility Preservation psychology
Fertility Preservation statistics & numerical data
Infertility, Female prevention & control
Practice Patterns, Physicians' statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 2156-535X
- Volume :
- 6
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of adolescent and young adult oncology
- Publication Type :
- Academic Journal
- Accession number :
- 28459598
- Full Text :
- https://doi.org/10.1089/jayao.2017.0016