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September 10, 2025Open Access

A multidisciplinary evaluation of fertility preservation for oncology patients in Canada

RKRegina-Veronicka KalaydinaUniversity of British Columbia KLKiera LiblikQueen's University ADAmar P. DhillonUniversity of British Columbia

Key Points

Survey analysis found that only 26.8% of oncology patients in BC are referred to fertility preservation services, highlighting a significant gap.
Among practitioners, 43.6% acknowledged that treatment-related infertility is a common concern for patients, indicating a need for focused fertility counseling.
Multidisciplinary online survey collected responses from 120 healthcare providers across British Columbia, achieving a robust response rate of 74.2%.
The findings underscore the necessity for a dedicated fertility preservation program in BC, which is crucial for improving patient quality of life.

Abstract

Introduction: Infertility represents a devastating side effect of antineoplastic agents, particularly in adolescents and young adults (AYA). A paucity of practitioner-initiated fertility preservation (FP) counseling has resulted in low uptake of assisted reproductive technologies. There is no dedicated FP program in British Columbia (BC) and few across Canada, leaving patients without adequate support. This study aimed to identify, analyze, and prioritize the FP needs of BC oncology patients, predominantly AYAs, according to healthcare providers. Methods: An online survey developed by a multidisciplinary team was distributed to practitioners across the British Columbia Cancer Network from March to September 2023. Survey data were analyzed descriptively. Results: Overall, our survey response rate was 74.2%. Of 120 responses recorded in total, 89 — from 27 oncologists, 58 nurses/nurse practitioners, two family physicians, one fertility specialist, and one care aide — were included in the analysis While 43.6% of respondents indicated that their patients were likely to be impacted by treatment-related infertility, only 26.8% reported that their patients are usually referred to FP services, and 45.7% reported that their patients receive fertility counseling. Barriers to FP counseling included competing priorities, appointment length, lack of clinical knowledge, urgency to start treatment, perceived futility of FP, and perceived lack of financial resources. Facilitators of FP discussions were awareness, education, financial assistance, provider-initiated discussions, knowledgeable providers, and locally dedicated FP programs. Conclusions: This study represents the first characterization of interdisciplinary provider practices and beliefs surrounding FP among oncology patients in BC, highlighting the need for an FP program to improve patient care and quality of life. This data can be leveraged nationwide to inform the development and evolution of FP programs for this critically underserved patient population.

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