Expanding urgent oncofertility services for reproductive aged women at Cancer Centers remote from a tertiary level ART Centre by Use of Telehealth and an on site Nurse Navigator
Women and Children
Many cancer treatments may cause infertility and young cancer patients may not have begun or completed childbearing. Assisted reproductive technology (ART) enables fertility preservation (FP) through the freezing of eggs and embryos. This project will overcome FP barriers for young women at the Thunder Bay North West Regional Cancer Program (NWRCP) by implementing Telehealth consultation between an ‘oncofertility’ team (an oncologist and a FP trained RN), partnered with Mount Sinai Fertility (MSF) in Toronto. Eligible women will undergo urgent Telehealth fertility consultation with the MSF team. Those opting for FP will have monitoring with an experienced local gynecologist and travel to MSF for freezing of eggs/embryos prior to cancer treatment. This project will serve as a model for other cancer care programs to provide accessible FP services for women with cancer who are geographically isolated from fertility services.
Objectives: To improve access to oncofertility consultation and FP procedures for young women newly diagnosed with cancer at a centre remote from a fertility centre by using Telehealth and a multidisciplinary team.
Methods: This project will train a local oncology RN to become an ‘oncofertility champion’ and Nurse Navigator. This individual will identify women who may benefit from fertility consultation, and arrange Telehealth consultation with MSF. In patients choosing FP, pre-treatment assessment and cycle monitoring will be performed by a local gynecologist and results relayed daily to MSF. The patient will travel to Toronto once for ovum retrieval and oocytes/embryos will be frozen.
We will determine the annual number of reproductive aged women (20-40) diagnosed with cancer at the Thunder Bay NWRCP who are at risk for fertility damage from planned therapy, the number who pursue a fertility consultation and undergo FP. All women will be asked to complete a validated survey evaluating experience, reasons for choosing/declining consultation or FP treatments and satisfaction with the process at the time of recruitment and 6 months after the completion of their cancer treatment. A survey of oncologists’ impression and experience with the programme will be conducted as well.
Interim Results: Patient recruitment began in February 2016. To date, 12 patients have consented to the study and participated in the survey, and 2 patients have elected to proceed with fertility consultation. Several patients had already completed their families but still consented to complete the pre-treatment surveys.
Conclusions: This pilot project can serve as a model for other cancer centres remote from a fertility centre to reduce barriers to fertility preservation options for women who face fertility-impairing cancer treatment.