Supportive Care in Cancer

, Volume 25, Issue 4, pp 1079–1085 | Cite as

Physicians’ practice of discussing fertility preservation with cancer patients and the associated attitudes and barriers

  • Emi TakeuchiEmail author
  • Masashi Kato
  • Saho Wada
  • Saran Yoshida
  • Chikako Shimizu
  • Yoko Miyoshi
Original Article



The aim of this study is to describe physicians’ clinical practice of discussing fertility issues with cancer patients and determine the factors associated with such discussion.


In this cross-sectional study, a nationwide Internet survey was conducted among physicians who provided daily medical care to cancer patients at hospitals or clinics. Participants answered a questionnaire assessing characteristics, discussion practices, attitudes, and barriers regarding fertility preservation.


Among the 180 participants, 42% discussed fertility issues with patients daily, and 30% had experience in referring patients to fertility preservation specialists. A multivariate logistic regression analysis showed that those who agreed or strongly agreed with the statements “physicians are responsible for discussing fertility preservation” (OR = 2.04, 95% CI 1.14–3.63, p < 0.05) and “patients who have an exceedingly aggressive disease and need immediate cancer treatment should not be told about fertility issues” (OR =1.84, 95% CI 1.09–3.10, p < 0.05) were nearly twice as likely to discuss fertility issues with patients.


Compared to Western countries, fertility issues are less likely to be discussed in Japan. To increase opportunities for patients to discuss fertility issues, the ASCO guidelines should be widely understood. Additionally, these results suggest that physicians who are more likely to discuss fertility issues might feel more conflicted about whether they in fact should discuss such issues with patients with poor prognosis or insufficient time for cancer treatment.


Cancer survivor Fertility Discussion Barrier Attitude 



This study was supported by a Health Labour Sciences Research Grant (H26-016) from the Ministry of Health, Labour and Welfare.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The need for informed consent was waived by the Institutional Review Board and Ethics Committee of the National Cancer Center of Japan, but we explained to them the research purpose, procedure, privacy protection, and right to voluntary participation.

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Center for Cancer Control and Information Services, National Cancer Center, Japan (2015) Gan Toroku/ Tokei. Accessed 1 Oct 2015
  2. 2.
    Lee SJ, Schover LR, Partridge AH, Patrizio P, Wallace WH, Hagerty K, Beck LN, Brennan LV, Oktay K (2006) American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J Clin Oncol 24:2917–2931. doi: 10.1200/JCO.2006.06.5888 CrossRefPubMedGoogle Scholar
  3. 3.
    Loren AW, Mangu PB, Beck LN, Brennan L, Magdalinski AJ, Partridge AH, Quinn G, Wallace HW, Oktay K (2013) Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 31:2500–2510. doi: 10.1200/JCO.2013.49.2678 CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Kubo A, Koido K, Sawada M, Ryushima Y, Shimizu C, Kato T, Ando M, Kinoshita T, Murakoshi K, Yokote N, Fujiwara Y, Yamamoto H (2012) [Survey on oncologists-provided information on treatment-related infertility to breast cancer patients]. Gan to kagaku ryoho. Cancer & chemotherapy 39:399–403Google Scholar
  5. 5.
    Shimizu C, Bando H, Kato T, Mizota Y, Yamamoto S, Fujiwara Y (2013) Physicians’ knowledge, attitude, and behavior regarding fertility issues for young breast cancer patients: a national survey for breast care specialists. Breast cancer 20:230–240. doi: 10.1007/s12282-011-0328-8 CrossRefPubMedGoogle Scholar
  6. 6.
    Quinn GP, Vadaparampil ST, Bell-Ellison BA, Gwede CK, Albrecht TL (2008) Patient–physician communication barriers regarding fertility preservation among newly diagnosed cancer patients. Soc Sci Med 66:784–789. doi: 10.1016/j.socscimed.2007.09.013 CrossRefPubMedGoogle Scholar
  7. 7.
    Vadaparampil S, Quinn G, King L, Wilson C, Nieder M (2008) Barriers to fertility preservation among pediatric oncologists. Patient Educ Couns 72:402–410. doi: 10.1016/j.pec.2008.05.013 CrossRefPubMedGoogle Scholar
  8. 8.
    Overbeek A, Van Den Berg M, Louwé L, Wendel E, Kuile M, Kaspers G, Stiggelbout A (2014) Practice, attitude and knowledge of Dutch pediatric oncologists regarding female fertility. Neth J Med 72:264–270PubMedGoogle Scholar
  9. 9.
    Clayton H, Quinn GP, Lee JH, King LM, Miree CA, Nieder M, Vadaparampil ST (2008) Trends in clinical practice and nurses’ attitudes about fertility preservation for pediatric patients with cancer. In: Oncology nursing forum 35:249–255. doi: 10.1188/08.ONF.249-255 CrossRefGoogle Scholar
  10. 10.
    Quinn GP, Vadaparampil ST, Gwede CK, Miree C, King LM, Clayton HB, Wilson C, Munster P (2007) Discussion of fertility preservation with newly diagnosed patients: oncologists’ views. J Cancer Surviv 1:146–155. doi: 10.1007/s11764-007-0019-9 CrossRefPubMedGoogle Scholar
  11. 11.
    Buske D, Sender A, Richter D, Brähler E, Geue K (2016) Patient-physician communication and knowledge regarding fertility issues from German oncologists’ perspective—a quantitative survey. J Cancer Educ 31:115–122. doi: 10.1007/s13187-015-0841-0 CrossRefPubMedGoogle Scholar
  12. 12.
    Adams E, Hill E, Watson E (2013) Fertility preservation in cancer survivors: a national survey of oncologists’ current knowledge, practice and attitudes. Brit J Cancer 108:1602–1615. doi: 10.1038/bjc.2013.139 CrossRefPubMedGoogle Scholar
  13. 13.
    Loren AW, Brazauskas R, Chow EJ et al (2013) Physician perceptions and practice patterns regarding fertility preservation in hematopoietic cell transplant recipients. Bone Marrow Transpl 48:1091–1097. doi: 10.1038/bmt.2013.13 CrossRefGoogle Scholar
  14. 14.
    Quinn GP, Vadaparampil ST, Lee JH, Jacobsen PB, Bepler G, Lancaster J, Keefe DL, Albrecht TL (2009) Physician referral for fertility preservation in oncology patients: a national study of practice behaviors. J Clin Oncol 27:5952–5957. doi: 10.1200/JCO.2009.23.0250 CrossRefPubMedGoogle Scholar
  15. 15.
    Arafa MA, Rabah DM (2011) Attitudes and practices of oncologists toward fertility preservation. J Pediat Hematol Onc 33:203–207. doi: 10.1097/MPH.0b013e3182068047 CrossRefGoogle Scholar
  16. 16.
    Wallace WHB, Kelsey TW, Anderson RA (2016) Fertility preservation in pre-pubertal girls with cancer: the role of ovarian tissue cryopreservation. Fertil And Steril 105:6–12. doi: 10.1016/j.fertnstert.2015.11.041 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Emi Takeuchi
    • 1
    • 2
    Email author
  • Masashi Kato
    • 1
    • 3
    • 4
  • Saho Wada
    • 4
  • Saran Yoshida
    • 5
  • Chikako Shimizu
    • 6
  • Yoko Miyoshi
    • 7
  1. 1.Department of Consultation, Counseling and Support Service CenterNational Cancer Center HospitalTokyoJapan
  2. 2.Center of Palliative MedicineKeio University HospitalTokyoJapan
  3. 3.Center for Cancer Control and Information ServicesNational Cancer CenterTokyoJapan
  4. 4.Department of Psycho-oncologyNational Cancer Center HospitalTokyoJapan
  5. 5.Graduate School of Education/Faculty of EducationTohoku UniversitySendaiJapan
  6. 6.Department of Breast and Medical OncologyNational Cancer Center HospitalTokyoJapan
  7. 7.Department of PediatricsOsaka University School of MedicineOsakaJapan

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