Barriers to fertility preservation among pediatric oncologists.

OBJECTIVE: Limited research has been conducted on the extent to which fertility preservation is discussed by pediatric oncologists with patients and less is known about the discussion content. This study sought to examine factors that may influence the discussion with pediatric cancer patients and families.
METHODS: Qualitative data were collected using open-ended, in-depth interviews with 24 pediatric oncologists in Florida at 13 children's cancer centers, representing 87% of the centers in the state.
RESULTS: Providers practiced between 0.5 and 35 years, treated most types of pediatric cancers, and most were board certified in pediatric hematology/oncology. The main factors associated with a discussion of fertility preservation options were: (1) physician factors that contribute to communication issues with FP discussion (e.g., awareness and sense of comfort in discussing issues, perceptions of the priority); (2) parent factors (e.g., receptiveness and cultural background); (3) patient factors (e.g., receptiveness and age); and (4) institutional factors (e.g., referral sites and practice guidelines).
CONCLUSIONS: Pediatric oncologists may benefit from education about fertility preservation options for pediatric cancer patients, particularly females. PRACTICE IMPLICATIONS: Training on how to address parents' and patients' emotions, culture, and other factors may also promote the discussion. Although guidelines have been established, barriers related to availability and affordability of resources must also be addressed.