Addressing Fertility in Adolescent and Young Adult Oncology Patients: A Descriptive Study.

Purpose: Adolescents and young adults (AYA) undergoing cancer therapy may be at risk for infertility as a consequence of their treatment and should be informed of their risk of infertility and referred to infertility specialists at the time of diagnosis. The overall aim of the study was to describe fertility consult practices in AYA patients at a single institution.

Methods: We conducted a retrospective chart review over a 2-year time period collecting data on newly diagnosed or relapsed AYA oncology patients aged 10-30 years. Records of 57 charts were reviewed for documentation of initiation and completion of a fertility consult before starting cancer treatment. Demographic and medical data were collected to determine infertility risk stratification. Analyses included descriptive statistics, chi-squared analysis, and logistic regression analysis.

Results: Documentation of discussion of fertility risk before the initiation of therapy was noted in 19% of charts (n = 10). There was no statistically significant relationship between documentation of the initiation or completion of a fertility consult and infertility risk. Demographic and medical factors were not associated with higher odds of having completed a fertility consult. Documentation of the initiation of a fertility consult was associated with higher odds that a consult was completed (p < 0.001).

Conclusion: Strategies are needed to improve documentation of discussions of infertility risk. Utilizing technology, promoting staff education, and developing enhancements in electronic medical record can provide triggers to promote documentation of the initiation of fertility consults. Implementing a fertility navigator could facilitate consultation and coordination of care for fertility preservation services.