Surgeon perceptions on fertility counseling and preservation in children with cancer: A multicenter survey of North American Hospitals.

PURPOSE: Treatment of pediatric cancers often requires gonadotoxic therapies, making fertility preservation (FP) an essential component of comprehensive oncologic care. However, surgeon exposure to oncofertility care varies. This study evaluated pediatric surgeon knowledge, comfort, and perceptions regarding FP counseling and care.

METHODS

A cross-sectional survey was administered to lead surgeon investigators from 52 sites across North America participating in the Pediatric Surgical Oncology Research Collaborative (PSORC) to evaluate surgeon perceptions on FP. Surgeon knowledge and comfort levels providing FP services to patients with cancer diagnoses were ascertained.

RESULTS

Ninety-three percent of invited PSORC surgeons completed the survey. Most respondents desired further educational opportunities in pediatric oncofertility (92%) and supported incorporation of FP training into fellowship education (83%). Among surgeons without a dedicated FP program, 96% were interested in establishing one, and 43% reported active program development. A minority (10.4%) of respondents reported no fertility preservation counseling at all at their institutions. Surgeons at institutions with dedicated FP programs were significantly more comfortable performing FP procedures (p = 0.003) and risk stratifying patients (p = 0.042). They were also more knowledgeable about FP options (p = 0.003), outcomes of ovarian tissue cryopreservation (OTC) and testicular tissue cryopreservation (TTC) for fertility and hormone restoration (p = 0.005), and options for future hormone and fertility restoration (p = 0.002).

DISCUSSION: Significant opportunities exist to expand surgeon education, institutional resources, and multidisciplinary FP infrastructure. Respondents were highly motivated to increase educational opportunities and resources to improve fertility care for pediatric oncology patients.