Onco-Fertility Needs Assessment of Adolescent Young Adult Cancer Survivors in Saskatchewan, Canada

Introduction: Infertility is a major concern for pediatric and adolescent/young adult (AYA) cancer patients due to gonadotoxic treatments. Timely onco-fertility counselling and referral to fertility preservation (FP) specialists are now standards of care. In Saskatchewan, there is only one fertility clinic serving 1.2 million residents across 651,900 km². We aimed to capture the experiences of a cohort of AYA cancer survivors followed in our tertiary pediatric hospital.

Methods: Eligible patients (aged 15-39 years at study, >5 years off-treatment) completed a survey capturing demographics, experiences, and perceived barriers; medical records were reviewed retrospectively for clinical variables. Descriptive statistics were reported.

Results: Thirty-two participants completed surveys (mean age: 21.2y, range: 15.1–35.8y; 56% male; 92% cis-gendered; 69% White; 31% Indigenous/First Nations/Metis). 31% were identified as high risk for infertility. 45% recalled a fertility-related discussion as part of their cancer care (29% before treatment initiation). 28% reported a formal FP referral. Barriers to accessing FP included having to undergo additional procedures, and lack of procedure options (e.g., pre-pubertal at diagnosis).

Conclusions: Historic rates of onco-fertility counselling and FP referral were low. These data can serve as a baseline to measure practice changes in onco-fertility care in Saskatchewan.