Aims: In the adolescent and young adult (AYA) groups, effects of cancer and treatment on fertility can be a continuing source of distress. The study aims to explore factors that may influence discussions regarding fertility in this population.
Methods: A three year retrospective review (2012-2014) of medical records of young cancer patients aged 14-25 years, was undertaken in five cancer centres affiliated with the Youth Cancer Service in Queensland. Data were extracted, risk ratios (RR) calculated and analysis undertaken with chi-square statistic.
Results: Medical records of 347 patients were reviewed. According to these records, 217 (61%) patients had received gonadotoxic treatment. Of these patients, males (n=128) were significantly more likely to receive gonadotoxic treatment than females (n=89), (RR 1.3, p=0.003); have a documented risk of infertility discussion (RR 1.3 p=0.005), and to have documented fertility preservation (RR 2.4, p=<0.001). Sperm cryopreservation was documented in 67 (52%) of males. Sixteen (18%) females had documented ovarian suppression prescribed. Oocyte and embryo preservation was documented in six females. Compared to other diagnoses, patients with soft tissue sarcomas (n=15) were the least likely to have risk of infertility discussions documented (RR 0.46, p=<0.03), and Non-Hodgkin’s lymphoma (n=23) were the most likely (RR 1.35, p= <0.001).
Conclusions: We acknowledge the limitation of our findings due to the retrospective nature of the study. The findings highlight important differences, with inferences as to why some disparities exist. It also suggests that fertility discussion may be highly dependent on tumour type and the technicalities of preservation techniques.