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Fertility preservation practices for female oncofertility differ significantly across the USA: results of a survey of SREI members

  • Fertility Preservation
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Abstract

Purpose

The field of oncofertility has maintained an important focus on improving access, yet standardized practices are lacking. To assess how female cancer patients are provided oncofertility care, we sought to determine provider-level differences and whether there are physician or practice characteristics that predict these variations.

Methods

A cross-sectional survey was sent to SREI members. The survey included fifteen questions about physician practice characteristics and oncofertility cryopreservation protocols. Topics included ovarian stimulation protocols, fertilization techniques, stage of embryo cryopreservation, routine use of pre-implantation genetic testing for aneuploidy (PGT-A), and ovarian tissue cryopreservation (OTC). Statistical analyses assessed whether practice setting, geographic region, time in practice, and mandatory state insurance coverage had effects on cryopreservation protocols.

Results

A total of 141 (17%) from diverse REI practice backgrounds completed the survey. The median number of new female oncofertility consults per year was 30 (range 1 to 300). Providers in academic settings treated more patients (median 40 vs. 15, p < 0.001). Providers in academic settings more often use gonadotropin-releasing hormone agonists (85% vs. 52%, p < 0.001) and perform OTC (41% vs. 4%, p < 0.001). Providers in academic practices were less likely to perform intracytoplasmic sperm injection in every cycle (37% vs. 55%, p = 0.032) and less likely to usually advise PGT-A (21% vs. 36%, p = 0.001). Mandated state insurance coverage had no effect on oncofertility practices.

Conclusion

Oncofertility practices vary among providers. Factors such as practice setting and region may affect the services provided. We do not yet know the best practices in oncofertility patients, and future research is needed.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Utah Health, 675 Arapeen Drive, Suite 205, Salt Lake City, UT, 84105, USA

    Leah J. Cooper, Douglas Fair, Erica Johnstone & Joseph M. Letourneau

  2. Department of Surgery, University of Utah School of Medicine, Salt Lake City, USA

    Benjamin R. Emery & Kenneth Aston

  3. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, USA

    Mitchell P. Rosen

Authors
  1. Leah J. Cooper
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  2. Benjamin R. Emery
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  4. Douglas Fair
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  6. Erica Johnstone
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  7. Joseph M. Letourneau
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by LC and JL. The first draft of the manuscript was written by LC. All authors commented on previous versions of the manuscript and read and approved the final manuscript.

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Correspondence to Leah J. Cooper.

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Cooper, L.J., Emery, B.R., Aston, K. et al. Fertility preservation practices for female oncofertility differ significantly across the USA: results of a survey of SREI members. J Assist Reprod Genet 39, 1749–1757 (2022). https://doi.org/10.1007/s10815-022-02567-0

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