A national survey, of oncologists has found that while most report discussing fertility preservation with patients of childbearing age, only a quarter of them are referring patients to reproductive specialists or distributing educational materials, and most were unaware of current guidelines regarding fertility preservation for people with cancer.

"We send patients to get wigs before they lose their hair during chemotherapy. We give medications to prevent nausea. Discussing fertility preservation should be something else that we do early in a patient’s care, rather than waiting until infertility occurs," explained lead author Prof. Gwendolyn P. Quinn, associate member at the H. Lee Moffitt Cancer Center and Research Institute in Miami.

In 2006 the American Society of Clinical Oncology (ASCO) issued guidelines recommending that oncologists address the risks of infertility with patients treated during their reproductive years and be prepared to discuss fertility preservation options (such as sperm and embryo cryopreservation) or refer appropriate and interested patients to reproductive specialists.

The survey was distributed to 1,979 oncologists and 613 completed it (a 33 per cent response rate). Among oncologists completing the survey, 79 per cent reported that they address fertility issues with their patients of childbearing age - though Dr. Quinn said such discussions vary widely: from brief mentions, such as, “you may become sterile as a result of cancer treatment” to in-depth discussions about the risks of infertility and referrals to reproductive endocrinologists. Gynecological or medical/hematological oncologists were 2.1 times more likely than other specialists (including radiation, surgical, and orthopedic oncologists) to report feeling comfortable discussing fertility preservation with their patients.

Less than 25 per cent of physicians reported referring a patient to a fertility specialist or distributing educational materials regarding fertility preservation. Many physicians said that they did not discuss fertility preservation because they believed that the patient had a poor prognosis. Only 38 per cent of physicians said they were aware of ASCO’s guidelines regarding infertility.