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Addressing decisional conflict about fertility preservation: helping young female cancer survivors’ family planning decisions
  1. Madleina Müller1,
  2. Corinne Urech2,
  3. Jacky Boivin3,
  4. Verena Ehrbar2,
  5. Rebecca Moffat2,
  6. Rosanna Zanetti Daellenbach2,
  7. Christoph Rochlitz4,
  8. Sibil Tschudin2
  1. 1Faculty of Medicine, University of Basel, Basel, Switzerland
  2. 2Department of Gynecology and Obstetrics, University Hospital Basel, Basel, Switzerland
  3. 3School of Psychology, Cardiff University, Cardiff, UK
  4. 4Department of Medical Oncology, University Hospital Basel, Basel, Switzerland
  1. Correspondence to Dr Sibil Tschudin, Department of Gynecology and Obstetrics, University Hospital Basel, Basel 4031, Switzerland; sibil.tschudin{at}usb.ch

Abstract

Background Health professionals are challenged by a growing number of young long-term cancer survivors with their specific needs with regard to family planning. This study aimed at assessing decisional conflict (DC) in young female cancer patients regarding fertility preservation, identifying demographic, fertility and fertility preservation related factors, which may affect DC, and assessing the helpfulness of various decision-supports.

Methods A retrospective, cross-sectional, web-based survey via an online questionnaire available in three languages with specific items concerning cancer, fertility, fertility preservation and the validated Decisional Conflict Scale targeted at current or former female cancer patients aged 18–45 years, with cancer types or treatment potentially affecting reproductive function.

Results The 155 participating women showed considerable DC, especially with regard to missing information and support. DC was significantly lower in patients when the risk of infertility was discussed with a health professional, when they had undergone any procedure to preserve fertility, and when they had a university education. A longer time interval since cancer diagnosis was associated with higher DC. The most helpful decision-support tools were specialised websites and leaflets.

Conclusions Young female cancer patients’ DC with regard to fertility preservation is very high. Information and support seem to be deficient. More information through standardised information tools might be an effective strategy to lower their DC at the time when treatment decisions need to be taken, and to improve their reproductive health after they have overcome cancer in the future.

  • fertility preservation
  • decisional conflict
  • decision-making
  • cancer survivor
  • reproductive health

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Footnotes

  • Funding This study is financially supported by the Swiss Cancer League (KFS 3584-02-2015) and by the Swiss Bridge Foundation (Swiss Bridge Award 2013).

  • Competing interests None declared.

  • Ethics approval The ethical committee of the School of Psychology Cardiff gave approval for the first part of the survey and the ethical committee of Northwest and Central Switzerland (EKNZ) for the second part.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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