RESUMEN
PURPOSE: This study was designed to evaluate patient management and quality of information given by French oncologists to cancer women concerning fertility issues and possibilities of fertility preservation. METHODS: An online survey was sent to 1161 physicians in all major cancer centers throughout France between May 2012 and January 2013. RESULTS: A total of 102 responses were received and analyzed. Only 46% of all physicians surveyed reported discussing infertility risks with patients of reproductive age and 22% referred them to a fertility center before beginning treatments. Only 14% of practitioners considered themselves knowledgeable in FP techniques and ovarian transposition was the most frequently mentioned technique in consultation. CONCLUSION: This study is at the best of our knowledge the first nationwide survey to assess the state of the art in oncofertility management. It highlights inadequate management of fertility preservation for female patients in France. Physicians reported lacking knowledge and tools that would allow them to provide patients with appropriate information. A better collaboration between cancer and fertility centers needs to be organized in France as already organized in other countries.
Asunto(s)
Preservación de la Fertilidad/métodos , Infertilidad Femenina/epidemiología , Neoplasias/epidemiología , Oncólogos/psicología , Adulto , Femenino , Preservación de la Fertilidad/psicología , Preservación de la Fertilidad/tendencias , Francia/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , Infertilidad , Infertilidad Femenina/psicología , Neoplasias/fisiopatología , Neoplasias/psicología , Encuestas y CuestionariosRESUMEN
INTRODUCTION: The aim of our study was to compare the stage and severity of endometriosis in fertile and infertile women with congenital uterine malformations. MATERIAL AND METHODS: We performed an observational study from September 2007 to December 2015 in a tertiary care university hospital and assisted reproductive technology center. A total of 52 patients with surgically proven uterine malformations were included. We compared 41 infertile patients with uterine malformations with 11 fertile patients with uterine malformation. The main outcome was the stage, score and type of endometriosis in regard to infertility and class of uterine malformation. RESULTS: The rate of endometriosis did not differ between the two groups (43.9 vs. 36.4%). The mean revised American Fertility Society score was higher in infertile patients with uterine malformations (19.02 vs. 6, p < 0.05). No significant difference was found in the rate of superficial peritoneal endometriosis (43.9 vs. 37.5%). Endometrioma and deep infiltrating endometriosis were associated with uterine malformations in infertile women, respectively 14.6 and 0%. No difference in the characteristics of endometriosis was found regarding the class of malformation. CONCLUSIONS: The association of uterine malformations and infertility may increase the severity of endometriosis and raise the issue of their diagnosis and management.
Asunto(s)
Endometriosis/complicaciones , Infertilidad Femenina/etiología , Anomalías Urogenitales/complicaciones , Adulto , Estudios de Casos y Controles , Endometriosis/epidemiología , Femenino , Humanos , Infertilidad Femenina/epidemiología , Índice de Severidad de la Enfermedad , Anomalías Urogenitales/epidemiologíaRESUMEN
Fertility preservation strategies have been developed for men and women whose fertility is compromised for medical reasons, especially in case of cancer therapy. At present, many reliable options for preserving fertility are available. However, a part of these fertility preservation methods, despite being promising, are still considered experimental. Nevertheless, there are still situations where no methods can be offered. Remarkable scientific progress is currently underway to improve available techniques and to develop new technologies to solve problems with current fertility strategies. These new options may drastically change reproductive options for young patients facing germ cell loss and hence sterility. Therefore, oncofertility counseling by a specialist is recommended for all young cancer patients having to undergo treatment that may reduce fertility potential.