Preserving fertility in women with cancer (PreFer): Decision‐ making and patient‐reported outcomes in women offered egg and embryo freezing prior to cancer treatment

Katharina Vogt, Jane Hughes, Anna Wilkinson, Neda Mahmoodi, Jonathan Skull, Hilary Wood, Sophia McDougall, Pauline Slade, Diana M Greenfield, Alan Pacey, William Ledger, Georgina Jones

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective
Women of childbearing age with new cancer diagnoses have to make rapid decisions about fertility preservation (FP) before starting cancer treatment (CT). The aim of the PreFer study was to explore this FP decision‐making process and its impact on patient‐reported outcomes (PROMs) and health‐related quality of life (HRQoL).

Methods
A prospective, mixed‐methods design was used (questionnaires, in‐depth interviews). Interviews were analysed using thematic analysis. Fifty‐eight women with new cancer diagnoses were recruited. Comparisons were made between women who declined FP referral in oncology (Group1) and women who chose referral (Group2). Group 2 was further split into those who had some FP (2A) and those who did not (2B). Questionnaires and PROMs were administered prior to and after the fertility consultation, before the start of CT and 3 months post CT. Interviews were conducted with one participant from Group 2.

Results
HRQoL was negatively affected, particularly depression. Women's lack of understanding about the relationship between CT and fertility were evident. Five themes emerged from the interviews as barriers and facilitators to the FP decision‐making process.

Conclusion
The results indicate that better information and support resources aimed at women to support their decision making are needed, such as patient decision‐aids. Women from Group 1 were found to suffer significantly worse depression compared with the general UK population, highlighting the need for psychological support in the FP care‐pathway and for research exploring the contributions of depression and hopelessness to the decision‐making process.
LanguageEnglish
Pages2725-2732
Number of pages8
JournalPsycho-Oncology
Volume27
Issue number12
Early online date24 Aug 2018
DOIs
Publication statusPublished - Dec 2018
Externally publishedYes

Fingerprint

Fertility Preservation
Freezing
Ovum
Fertility
Decision Making
Embryonic Structures
Interviews
Neoplasms
Referral and Consultation
Depression
Therapeutics
Decision Support Techniques
Patient Reported Outcome Measures
Quality of Life
Psychology
Research
Population

Cite this

Vogt, Katharina ; Hughes, Jane ; Wilkinson, Anna ; Mahmoodi, Neda ; Skull, Jonathan ; Wood, Hilary ; McDougall, Sophia ; Slade, Pauline ; M Greenfield, Diana ; Pacey, Alan ; Ledger, William ; Jones, Georgina. / Preserving fertility in women with cancer (PreFer) : Decision‐ making and patient‐reported outcomes in women offered egg and embryo freezing prior to cancer treatment. In: Psycho-Oncology. 2018 ; Vol. 27, No. 12. pp. 2725-2732.
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abstract = "ObjectiveWomen of childbearing age with new cancer diagnoses have to make rapid decisions about fertility preservation (FP) before starting cancer treatment (CT). The aim of the PreFer study was to explore this FP decision‐making process and its impact on patient‐reported outcomes (PROMs) and health‐related quality of life (HRQoL).MethodsA prospective, mixed‐methods design was used (questionnaires, in‐depth interviews). Interviews were analysed using thematic analysis. Fifty‐eight women with new cancer diagnoses were recruited. Comparisons were made between women who declined FP referral in oncology (Group1) and women who chose referral (Group2). Group 2 was further split into those who had some FP (2A) and those who did not (2B). Questionnaires and PROMs were administered prior to and after the fertility consultation, before the start of CT and 3 months post CT. Interviews were conducted with one participant from Group 2.ResultsHRQoL was negatively affected, particularly depression. Women's lack of understanding about the relationship between CT and fertility were evident. Five themes emerged from the interviews as barriers and facilitators to the FP decision‐making process.ConclusionThe results indicate that better information and support resources aimed at women to support their decision making are needed, such as patient decision‐aids. Women from Group 1 were found to suffer significantly worse depression compared with the general UK population, highlighting the need for psychological support in the FP care‐pathway and for research exploring the contributions of depression and hopelessness to the decision‐making process.",
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Vogt, K, Hughes, J, Wilkinson, A, Mahmoodi, N, Skull, J, Wood, H, McDougall, S, Slade, P, M Greenfield, D, Pacey, A, Ledger, W & Jones, G 2018, 'Preserving fertility in women with cancer (PreFer): Decision‐ making and patient‐reported outcomes in women offered egg and embryo freezing prior to cancer treatment', Psycho-Oncology, vol. 27, no. 12, pp. 2725-2732. https://doi.org/10.1002/pon.4866

Preserving fertility in women with cancer (PreFer) : Decision‐ making and patient‐reported outcomes in women offered egg and embryo freezing prior to cancer treatment. / Vogt, Katharina; Hughes, Jane; Wilkinson, Anna; Mahmoodi, Neda; Skull, Jonathan; Wood, Hilary; McDougall, Sophia; Slade, Pauline; M Greenfield, Diana; Pacey, Alan; Ledger, William; Jones, Georgina.

In: Psycho-Oncology, Vol. 27, No. 12, 12.2018, p. 2725-2732.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Preserving fertility in women with cancer (PreFer)

T2 - Psycho-Oncology

AU - Vogt, Katharina

AU - Hughes, Jane

AU - Wilkinson, Anna

AU - Mahmoodi, Neda

AU - Skull, Jonathan

AU - Wood, Hilary

AU - McDougall, Sophia

AU - Slade, Pauline

AU - M Greenfield, Diana

AU - Pacey, Alan

AU - Ledger, William

AU - Jones, Georgina

PY - 2018/12

Y1 - 2018/12

N2 - ObjectiveWomen of childbearing age with new cancer diagnoses have to make rapid decisions about fertility preservation (FP) before starting cancer treatment (CT). The aim of the PreFer study was to explore this FP decision‐making process and its impact on patient‐reported outcomes (PROMs) and health‐related quality of life (HRQoL).MethodsA prospective, mixed‐methods design was used (questionnaires, in‐depth interviews). Interviews were analysed using thematic analysis. Fifty‐eight women with new cancer diagnoses were recruited. Comparisons were made between women who declined FP referral in oncology (Group1) and women who chose referral (Group2). Group 2 was further split into those who had some FP (2A) and those who did not (2B). Questionnaires and PROMs were administered prior to and after the fertility consultation, before the start of CT and 3 months post CT. Interviews were conducted with one participant from Group 2.ResultsHRQoL was negatively affected, particularly depression. Women's lack of understanding about the relationship between CT and fertility were evident. Five themes emerged from the interviews as barriers and facilitators to the FP decision‐making process.ConclusionThe results indicate that better information and support resources aimed at women to support their decision making are needed, such as patient decision‐aids. Women from Group 1 were found to suffer significantly worse depression compared with the general UK population, highlighting the need for psychological support in the FP care‐pathway and for research exploring the contributions of depression and hopelessness to the decision‐making process.

AB - ObjectiveWomen of childbearing age with new cancer diagnoses have to make rapid decisions about fertility preservation (FP) before starting cancer treatment (CT). The aim of the PreFer study was to explore this FP decision‐making process and its impact on patient‐reported outcomes (PROMs) and health‐related quality of life (HRQoL).MethodsA prospective, mixed‐methods design was used (questionnaires, in‐depth interviews). Interviews were analysed using thematic analysis. Fifty‐eight women with new cancer diagnoses were recruited. Comparisons were made between women who declined FP referral in oncology (Group1) and women who chose referral (Group2). Group 2 was further split into those who had some FP (2A) and those who did not (2B). Questionnaires and PROMs were administered prior to and after the fertility consultation, before the start of CT and 3 months post CT. Interviews were conducted with one participant from Group 2.ResultsHRQoL was negatively affected, particularly depression. Women's lack of understanding about the relationship between CT and fertility were evident. Five themes emerged from the interviews as barriers and facilitators to the FP decision‐making process.ConclusionThe results indicate that better information and support resources aimed at women to support their decision making are needed, such as patient decision‐aids. Women from Group 1 were found to suffer significantly worse depression compared with the general UK population, highlighting the need for psychological support in the FP care‐pathway and for research exploring the contributions of depression and hopelessness to the decision‐making process.

KW - females

KW - fertility preservation

KW - mixed methods

KW - prospective study

KW - reproductive age

U2 - 10.1002/pon.4866

DO - 10.1002/pon.4866

M3 - Article

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SP - 2725

EP - 2732

JO - Psycho-Oncology

JF - Psycho-Oncology

SN - 1057-9249

IS - 12

ER -