To identify gaps in the delivery of oncofertility (cancer and fertility) care in Australia

Recommendations

• The impact of reproductive concerns on cancer patients requires a strategic focus by national cancer organisations to raise awareness and support for the implementation of approaches to address these concerns.

• Oncofertility Models of care need to be established to ensure that all cancer centres can implement the Australasian Oncofertility Charter Recommendations which include: Health professionals working in cancer need to be appropriately skilled to provide patients, parents and partners with information on fertility preservation options and provide fertility related support during and after fertility preservation treatments.

• Clear oncofertility referral pathways should be developed between each cancer centre and fertility/andrology centre to ensure that all patients have timely access to oncofertility services.

• Development of models of care to ensure that Paediatric and AYA patients have an opportunity to receive experimental fertility preservation procedures in a framework that provides ethical and psychological support under a clinical trials protocol.

• Patients in rural and regional locations need to be able to access fertility preservation consultation using telemedicine and the reproductive needs of those patients who require fertility preservation can be met by having satellite local sperm banking services for male patients and referral pathways into metropolitan fertility clinics for female patients who have decided to undergo this treatment prior to cancer treatment.

• Fertility related psychological distress needs to be identified in cancer patients and supported by adequate referral to allied health professionals during fertility preservation, during cancer treatment and in the survivorship period.

• An assessment of reproductive needs following successful cancer treatment needs to be included in the survivorship assessment.

• To address the current gap in knowledge, education programs should be developed and included in the core curriculum for training oncology medical, nursing and allied health staff. The aim would be to ensure that all staff in a cancer centre have basic knowledge on the gonadotoxic risk of cancer treatment including new novel immunotherapy as well as having information on current fertility preservation options and the pros and cons of oncofertility options in cancer patients of different ages.

• To address the current gap in communication skills which need to be developed. The aim would be to ensure that all staff in a cancer centre have the communication skills to deal confidently with the practical, psychological and ethical elements of oncofertility consultations.

• A competency framework should be developed to ensure that the recommendations from thirteen international guidelines are implemented.