A multidisciplinary evaluation of fertility preservation for oncology patients in Canada
Bibliographic record
Abstract
INTRODUCTION: Infertility represents a devastating side effect of antineoplastic agents, particularly in adolescents and young adults (AYA). A paucity of practitioner-initiated fertility preservation (FP) counseling has resulted in low uptake of assisted reproductive technologies. There is no dedicated FP program in British Columbia (BC) and few across Canada, leaving patients without adequate support. This study aimed to identify, analyze, and prioritize the FP needs of BC oncology patients, predominantly AYAs, according to healthcare providers. METHODS: An online survey developed by a multidisciplinary team was distributed to practitioners across the British Columbia Cancer Network from March to September 2023. Survey data were analyzed descriptively. RESULTS: Overall, our survey response rate was 74.2%. Of 120 responses recorded in total, 89 - from 27 oncologists, 58 nurses/nurse practitioners, two family physicians, one fertility specialist, and one care aide - were included in the analysis. While 43.6% of respondents indicated that their patients were likely to be impacted by treatment-related infertility, only 26.8% reported that their patients are usually referred to FP services, and 45.7% reported that their patients receive fertility counseling. Barriers to FP counseling included competing priorities, appointment length, lack of clinical knowledge, urgency to start treatment, perceived futility of FP, and perceived lack of financial resources. Facilitators of FP discussions were awareness, education, financial assistance, provider-initiated discussions, knowledgeable providers, and locally dedicated FP programs. CONCLUSIONS: This study represents the first characterization of interdisciplinary provider practices and beliefs surrounding FP among oncology patients in BC, highlighting the need for an FP program to improve patient care and quality of life. This data can be leveraged nationwide to inform the development and evolution of FP programs for this critically underserved patient population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.005 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".