OBJECTIVE: As adolescent cancer patients may suffer from infertility following treatment, fertility counselling is essential. Our aim was to explore the current situation in four European countries in terms of (I) education about the risk for infertility, (II) counselling on fertility preservation, (III) patients' knowledge on fertility, (IV) sufficiency of information and (V) uptake of cryopreservation. METHODS: In total, 113 patients (13-20 years) at 11 study centres completed a self-report questionnaire three and six months after cancer diagnosis. Multivariate logistic regression was used to estimate odds ratios (OR) with 95% confidence intervals (CI). RESULTS: As many as 80.2% of participants reported having received education about the risk for infertility prior to treatment, 73.2% recalled counselling on fertility preservation. Only 52.3% stated they felt sufficiently informed to make a decision. Inability to recall counselling on fertility preservation (OR = 0.03, CI: 0.00-0.47) and female gender (OR = 0.11, CI: 0.03-0.48) was associated with lower use of cryopreservation, whereas older age was associated with higher use. CONCLUSION: Fertility counselling was available to a relatively high proportion of patients, and it did influence the utilisation of cryopreservation. However, many patients did not feel sufficiently informed. Further improvement is needed to enable adolescent cancer patients to make an informed decision on fertility preservation.

Berlin Institute of Health BIH Berlin Germany

Boyne Research Institute Drogheda Ireland

Charité Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt Universität zu Berlin Berlin Institute of Health Berlin Germany

Department of Paediatric Oncology Haematology and Immunology Medical Faculty Heinrich Heine University of Düsseldorf Düsseldorf Germany

Department of Paediatrics and Adolescent Medicine Medical University of Graz Graz Austria

Department of Paediatrics and Adolescent Medicine University Medical Center Ulm Ulm Germany

Department of Pediatrics Hematology and Oncology Medical University of Gdansk Gdansk Poland

German Cancer Research Centre Heidelberg Germany

Helios Kliniken Berlin Buch Klinik für Kinder und Jugendmedizin Chemnitz Germany

Medical University of Bialystok Białystok Poland

Motol Teaching Hospital Prague Czech Republic

Paediatric Oncology and Hematology University Hospital for Children and Adolescents University of Lübeck Lübeck Germany

University Hospital Brno and International Clinical Research Center Masaryk University Brno Czech Republic

University Hospital Essen Pediatrics 3 West German Cancer Centre Essen Germany

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Determinants of utilization of cryopreservation of germ cells in adolescent cancer patients in four European countries