Fertility preservation in women with cancer in Brazil: Infertility specialists' perceptions and attitudes.

person Warne Pedro Andrade gynecology and obstetrics of the School of medicine of the Federal University of Minas Gerais, Nova Lima, Brazil info_outline Warne Pedro Andrade, Rivia Mara Lamaita, Renata Lack Rannige, Angelica Nogueira Rodrigues, Agnaldo Lopes silva-Filho

Authors person Warne Pedro Andrade gynecology and obstetrics of the School of medicine of the Federal University of Minas Gerais, Nova Lima, Brazil info_outline Warne Pedro Andrade, Rivia Mara Lamaita, Renata Lack Rannige, Angelica Nogueira Rodrigues, Agnaldo Lopes silva-Filho Organizations gynecology and obstetrics of the School of medicine of the Federal University of Minas Gerais, Nova Lima, Brazil, Rede Mater Dei, Nova Lima, Brazil, Universidade Federal de Minas Gerais, Nova Lima, Brazil, Grupo Oncoclinicas- School of Medicine of the Federal University of Minas Gerais, Nova Lima, Brazil, Department of Gynecology and Obstetrics of the School of Medicine of the Federal University of Minas Gerais, Nova Lima, Brazil Abstract Disclosures Research Funding No funding received None. Background: Oncofertility is a universal right and a global oncology priority. However, there is a lack of communication between infertility specialists and their clinical oncologists on topics relating to fertility preservation. The present study aims to evaluate the perceptions and attitudes of infertility specialists regarding fertility preservation in women with cancer in Brazil. Methods: An online questionnaire was sent to infertility specialists affiliated to the Brazilian Federation of Associations of Gynecology and Obstetrics (FEBRASGO, in the Portuguese acronym). Results: A total of 100 (30.9%) of 323 FEBRASGO infertility specialists responded, most located in the southern and southeastern Brazilian states. Experience in Human Reproduction ranged from one to 40 years (mean ± standard deviation: 15.5 ±10.2 years). Considering women with cancer in reproductive age in whom fertility preservation was indicated, 60.3% ±28.8% of them performed the procedure (ranging from 10 to 100%). Three main barriers to fertility preservation were appointed: cost (41%), knowledge and acceptance of medical oncologists (35%) and accessibility (9%). Most infertility specialists (58%) considered age above 40 years as the limit for fertility preservation in women with cancer. Breast and ovarian cancers, leukemia, and lymphoma were considered the most relevant types to be considered for fertility preservation, while lung, thyroid, gastric and brain. Conclusions: This is the first Brazilian study on specialists' impressions on cancer patient's access to fertility preservation. While most Brazilian cancer patients are treated in the public health system, most fertility specialists are in the private sector. Currently, the model of care is fragmented and a more integrated workflow between cancer and fertility experts is fundamental to improve fertility sparing access. Further studies are needed on the topic, also including clinical oncologists, hematologists, breast cancer specialists, and patients.