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Optimizing the Decision-Making Process About Fertility Preservation in Young Female Cancer Patients: The Experience of the Portuguese Centre for Fertility Preservation

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Pediatric and Adolescent Oncofertility

Abstract

The reproductive future of young and childless cancer patients is at risk, and fertility preservation (FP) methods are available to attempt to ensure their potential for biological parenthood after cancer treatments. Oncofertility is a new research and intervention field that unites health professionals from several fields to explore options for the reproductive future of cancer patients.

The present paper aimed to describe the experience of the Portuguese partner of Oncofertility Consortium®, the Portuguese Centre for Fertility Preservation (PCFP), in terms of the provision of support for the reproductive choices of young female cancer patients.

The literature reveals the important role of the decision-making process about fertility preservation among female cancer patients of reproductive age who face the risk of cancer-related infertility. However, these women also report significant information gaps and a lack of referrals to specialists in reproductive medicine to allow them to make informed decisions about the preservation of their fertility.

The Portuguese Centre for Fertility Preservation is the sole center in Portugal that provides all the female fertility preservation techniques to cancer patients facing possibly gonadotoxic treatments. Since 2010, more than 140 young female cancer patients from several Portuguese oncological institutions have been referred to this center to make their decisions. A multidisciplinary team counsels these patients and focuses not only on decision-making about fertility preservation but also on supporting these patients’ reproductive decisions throughout their life course, regardless of whether they preserve their fertility. The team of the Portuguese Centre for Fertility Preservation has developed and adapted several information and decision-making resources, including some materials from the Oncofertility Consortium®, for patients, the general population, and health professionals. Furthermore, some members are involved in innovative research projects whose results will be able to be translated into clinical practice.

Through a multidisciplinary approach, the Portuguese Centre for Fertility Preservation team has been working to optimize the decision-making process of young female patients with regard to the preservation of their fertility as well as their reproductive decisions after the completion of treatment. To our knowledge, this is the first proposal of a prospective intervention model to counsel and support these patients in terms of their reproductive future. This model emphasizes the role of the psychologist in emotionally supporting these patients and better supporting their decisions about fertility preservation. Health professionals from oncology and reproductive medicine need to work together to better inform and counsel all young female patients early enough for fertility preservation before beginning cancer treatments. General and updated Portuguese guidelines for the intervention in oncology, including discussions with young cancer patients about their reproductive future, are needed.

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Acknowledgments

This study is part of the Fertility preservation in female cancer patients: Decision-making process of patients, individual adaptation after cancer treatments and practices of oncologists research project, which is part of the Relationships, Development and Health Research Group of the R&D Cognitive and Behavioral Center for Research and Intervention of the University of Coimbra (PEst-OE/PSI/UI0730/2014). Cláudia Melo is supported by a scholarship from the Portuguese Foundation for Science and Technology (SFRH/BD/84677/2012).

We would like to thank Teresa Woodruff, director of the Oncofertility Consortium®, for her generosity and for her vital assistance and input in discussions about several topics related to intervention with cancer patients regarding their reproductive future.

We are also grateful to all cancer patients who participated anonymously in the online survey about their level of satisfaction with their experience at the Portuguese Centre for Fertility Preservation. These opinions are very important to better understand patients’ perceptions of their clinical experience and were fundamental in consolidating the model of intervention that we propose in the present publication.

Finally, we would like to thank the clinical staff of the Reproductive Medicine Department (all the doctors, the embryologists, the nurses, and the clinical secretaries) who collaborate to provide better support for these patients’ needs.

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Authors and Affiliations

  1. Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802, Coimbra, Portugal

    Cláudia Melo & Maria Cristina Canavarro

  2. Unit of Psychological Intervention, Maternity Dr. Daniel de Matos, Coimbra Hospital and University Centre, Coimbra, Portugal

    Cláudia Melo & Maria Cristina Canavarro

  3. Faculty of Medicine, University of Coimbra, Coimbra, Portugal

    Teresa Almeida-Santos

  4. Portuguese Centre for Fertility Preservation, Reproductive Medicine Department, Coimbra Hospital and University Centre, Coimbra, Portugal

    Teresa Almeida-Santos

Authors
  1. Cláudia Melo
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  2. Maria Cristina Canavarro
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  3. Teresa Almeida-Santos
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Correspondence to Cláudia Melo .

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Editors and Affiliations

  1. Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, USA

    Teresa K. Woodruff

  2. Northwestern University, Chicago, Illinois, USA

    Yasmin C. Gosiengfiao

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Melo, C., Canavarro, M.C., Almeida-Santos, T. (2017). Optimizing the Decision-Making Process About Fertility Preservation in Young Female Cancer Patients: The Experience of the Portuguese Centre for Fertility Preservation. In: Woodruff, T., Gosiengfiao, Y. (eds) Pediatric and Adolescent Oncofertility. Springer, Cham. https://doi.org/10.1007/978-3-319-32973-4_19

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  • DOI: https://doi.org/10.1007/978-3-319-32973-4_19

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