Disparities in Fertility Preservation Use among Adolescent and Young Adult Women with Cancer

Citation

Meernik, Clare; Engel, Stephanie M.; Wardell, Ally; Baggett, Christopher D.; Gupta, Parul; Rodriguez-Ormaza, Nidia; Luke, Barbara; Baker, Valerie L.; Wantman, Ethan; & Rauh-Hain, Jose A., et al. (2023). Disparities in Fertility Preservation Use among Adolescent and Young Adult Women with Cancer. Journal of Cancer Survivorship, 17(5), 1435-1444. PMCID: PMC9378772

Abstract

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.

URL

http://dx.doi.org/10.1007/s11764-022-01187-y

Reference Type

Journal Article

Year Published

2023

Journal Title

Journal of Cancer Survivorship

Author(s)

Meernik, Clare
Engel, Stephanie M.
Wardell, Ally
Baggett, Christopher D.
Gupta, Parul
Rodriguez-Ormaza, Nidia
Luke, Barbara
Baker, Valerie L.
Wantman, Ethan
Rauh-Hain, Jose A.
Mersereau, Jennifer E.
Olshan, Andrew F.
Smitherman, Andrew B.
Cai, Jianwen
Nichols, Hazel B.

Article Type

Regular

PMCID

PMC9378772

Data Set/Study

North Carolina Central Cancer Registry

Continent/Country

United States of America

State

North Carolina

Race/Ethnicity

Black
White
Hispanic

Sex/Gender

Women

ORCiD

Olshan - 0000-0001-9115-5128