TY - JOUR
T1 - Disparities in fertility preservation use among adolescent and young adult women with cancer
AU - Meernik, Clare
AU - Engel, Stephanie M.
AU - Wardell, Ally
AU - Baggett, Christopher D.
AU - Gupta, Parul
AU - Rodriguez-Ormaza, Nidia
AU - Luke, Barbara
AU - Baker, Valerie L.
AU - Wantman, Ethan
AU - Rauh-Hain, Jose Alejandro
AU - Mersereau, Jennifer E.
AU - Olshan, Andrew F.
AU - Smitherman, Andrew B.
AU - Cai, Jianwen
AU - Nichols, Hazel B.
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2023/10
Y1 - 2023/10
N2 - Purpose: Women face multiple barriers to fertility preservation after cancer diagnosis, but few studies have examined disparities in use of these services. Methods: Women aged 15–39 years diagnosed with cancer during 2004–2015 were identified from the North Carolina Central Cancer Registry and linked to the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System. Women who cryopreserved oocytes or embryos for fertility preservation (n = 96) were compared to women who received gonadotoxic treatment but did not use fertility preservation (n = 7964). Conditional logistic and log-binomial regression were used to estimate odds ratios (ORs) or prevalence ratios (PRs) and 95% confidence intervals (CIs). Results: Few adolescent and young adult women with cancer in our study (1.2%) used fertility preservation. In multivariable regression, women less likely to use fertility preservation were older at diagnosis (ages 25–29 vs. 35–39: OR = 6.27, 95% CI: 3.35, 11.73); non-Hispanic Black (vs. non-Hispanic White: PR = 0.44, 95% CI: 0.24, 0.79); and parous at diagnosis (vs. nulliparous: PR = 0.24, 95% CI: 0.13, 0.45); or lived in census tracts that were non-urban (vs. urban: PR = 0.12, 95% CI: 0.04, 0.37) or of lower socioeconomic status (quintiles 1–3 vs. quintiles 4 and 5: PR = 0.39, 95% CI: 0.25, 0.61). Conclusions: Women with cancer who were older, non-Hispanic Black, parous, or living in areas that were non-urban or of lower socioeconomic position were less likely to use fertility preservation. Implications for Cancer Survivors: Clinical and policy interventions are needed to ensure equitable access to fertility services among women facing cancer treatment–related infertility.
AB - Purpose: Women face multiple barriers to fertility preservation after cancer diagnosis, but few studies have examined disparities in use of these services. Methods: Women aged 15–39 years diagnosed with cancer during 2004–2015 were identified from the North Carolina Central Cancer Registry and linked to the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System. Women who cryopreserved oocytes or embryos for fertility preservation (n = 96) were compared to women who received gonadotoxic treatment but did not use fertility preservation (n = 7964). Conditional logistic and log-binomial regression were used to estimate odds ratios (ORs) or prevalence ratios (PRs) and 95% confidence intervals (CIs). Results: Few adolescent and young adult women with cancer in our study (1.2%) used fertility preservation. In multivariable regression, women less likely to use fertility preservation were older at diagnosis (ages 25–29 vs. 35–39: OR = 6.27, 95% CI: 3.35, 11.73); non-Hispanic Black (vs. non-Hispanic White: PR = 0.44, 95% CI: 0.24, 0.79); and parous at diagnosis (vs. nulliparous: PR = 0.24, 95% CI: 0.13, 0.45); or lived in census tracts that were non-urban (vs. urban: PR = 0.12, 95% CI: 0.04, 0.37) or of lower socioeconomic status (quintiles 1–3 vs. quintiles 4 and 5: PR = 0.39, 95% CI: 0.25, 0.61). Conclusions: Women with cancer who were older, non-Hispanic Black, parous, or living in areas that were non-urban or of lower socioeconomic position were less likely to use fertility preservation. Implications for Cancer Survivors: Clinical and policy interventions are needed to ensure equitable access to fertility services among women facing cancer treatment–related infertility.
KW - Cancer survivors
KW - Cryopreservation
KW - Female
KW - Fertility preservation
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U2 - 10.1007/s11764-022-01187-y
DO - 10.1007/s11764-022-01187-y
M3 - Article
C2 - 35169982
AN - SCOPUS:85124714022
SN - 1932-2259
VL - 17
SP - 1435
EP - 1444
JO - Journal of Cancer Survivorship
JF - Journal of Cancer Survivorship
IS - 5
ER -