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      Fertility status perception, fertility preservation and desire to have children in cancer survivors: French VICAN survey


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          To report fertility status perception, fertility preservation and desire to have children in French cancer survivors 2 and 5 years after diagnosis.


          A total of 427 women and 115 men self-reported treatment-induced infertility, fertility status, access to gamete conservation, desire to have children and pregnancy/live births.


          A total of 96.5% of men and 92.9% of women were thought to be fertile at diagnosis and 38% desired to have children. A total of 57.8% of men and 67.4% of women declared that no fertility preservation had been discussed before treatment. After 2 years, 26.8% of patients still desired to have children. After 5 years, 18 live births have been reported.


          Despite a legal obligation and technical progress, there is a lack of information given to patients.

          Lay abstract

          We conducted a study on the status of fertility counseling and preservation before cancer treatment in patients under 40 years old. Despite a legal requirement in France and advancements in the field, we demonstrate that there remains a lack of information given to patients and a low rate of fertility preservation.

          Most cited references30

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          Pretreatment fertility counseling and fertility preservation improve quality of life in reproductive age women with cancer.

          The post-treatment quality of life (QOL) impacts of receiving precancer-treatment infertility counseling and of pursuing fertility preservation have not been described in large-scale studies of reproductive age women with cancer. In total, 1041 women who were diagnosed between ages 18 and 40 years responded to a retrospective survey and reported whether they received infertility counseling before cancer treatment and whether they took action to preserve fertility. Five cancer types were included: leukemia, Hodgkin disease, non-Hodgkin lymphoma, breast cancer, and gastrointestinal cancer. Validated QOL scales were used: the Decision Regret Score, the Satisfaction with Life Scale (SWLS), and the brief World Health Organization QOL questionnaire. Overall, 560 women (61%) who received treatment that potentially could affect fertility were counseled by the oncology team, 45 (5%) were counseled by fertility specialists, and 36 (4%) took action to preserve fertility. Pretreatment infertility counseling by a fertility specialist and an oncologist resulted in lower regret than counseling by an oncologist alone (8.4 vs 11.0; P < .0001). The addition of fertility preservation (6.6 vs 11.0; P < .0001) also was associated with even lower regret scores than counseling by an oncologist alone. Further improvements also were observed in SWLS scores with the addition of fertility specialist counseling (23.0 vs 19.8; P = .09) or preserving fertility (24.0 vs 19.0; P = .05). Receiving specialized counseling about reproductive loss and pursuing fertility preservation is associated with less regret and greater QOL for survivors, yet few patients are exposed to this potential benefit. Women of reproductive age should have expert counseling and should be given the opportunity to make active decisions about preserving fertility. Copyright © 2011 American Cancer Society.
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            Oocyte vitrification as an efficient option for elective fertility preservation.

            To provide a detailed description of the current oocyte vitrification status as a means of elective fertility preservation (EFP).
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              Toxicity of chemotherapy and radiation on female reproduction.

              One of the most devastating consequences of cancer treatment in the young female population is ovarian damage, resulting in diminished fertility potential. The extent of damage is related to age, chemotherapeutic regimen, and dose of pelvic radiation received. It is crucial that physicians know the impact each of these factors has on future fertility to advice patients on fertility preservation options. Anticancer drugs injure the female reproductive system through ovarian follicular and stromal damage. Although the exact mechanisms of damage remain unclear, it is essential to better understand these mechanisms to develop methods to diminish ovarian injury.

                Author and article information

                Future Sci OA
                Future Sci OA
                Future Science OA
                Future Science Ltd (London, UK )
                December 2018
                05 October 2018
                : 4
                : 10
                : FSO343
                [1 ]Department of Obstetrics, Gynecology & Reproductive Medicine, Plateforme Cancer et Fertilité ONCOPACA-Corse/CECOS, APHM, La Conception Hospital, Marseille, France
                [2 ]Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé &Traitement de l'Information Médicale, Marseille, France
                [3 ]GRePS Lyon 2 Université, University of Lyon, Bron, France
                [4 ]ORS PACA, Southeastern Health Regional Observatory, Marseille, France
                [5 ]Aix Marseille Univ, APHM, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Hop Timone, BioSTIC, Biostatistique et Technologies de l'Information et de la Communication, Marseille, France
                [6 ]Aix Marseille Univ, IMBE UMR7263, CNRS, IRD, Avignon Université, Marseille, France
                Author notes
                *Author for correspondence: anne-deborah.bouhnik@ 123456inserm.fr
                © 2018 Jegaden Margaux

                This work is licensed under a Creative Commons Attribution 4.0 License

                : 31 January 2018
                : 27 July 2018
                : 05 October 2018
                Research Article

                fertility counseling,fertility preservation,fertility status,french cancer survivors,gamete preservation,health politic,oncofertility,parenthood,vican,young adult cancer survivors


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