Critical appraisal:Razzano A, Revelli A, Delle Piane L, Salvagno F, Casano S, Randaccio S, et al 2014 2

Critical Appraisal

Article being appraised

Razzano A, Revelli A, Delle Piane L, Salvagno F, Casano S, Randaccio S, et al. Fertility preservation program before ovarotoxic oncostatic treatments: role of the psychological support in managing emotional aspects. Gynecol Endocrinol 2014 Nov;30(11):822-4 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25054374.

Applicable clinical question

What is the effect of oncofertility programs or health professional education on the number of clinician-patient discussions about fertility preservation following a cancer diagnosis?

Key Facts

Study Design

case series

Study aims:

To determine the emotional impact of offering a FPP based on oocyte or ovarian tissue cryostorage to young women affected by cancer using STAI testing (stress and anxiety) and post-consultation interview. There was a particular focus on the role played by psychologists in bridging between technical and emotive aspect of fertility consultations.

Number of Patients:

48

48 women aged 18–40 years (mean age 28±7.8) with a recent diagnosis of malignancy (breast cancer, n=20; oncohematologic diseases, n=20; other solid cancers, n=8), to whom a fertility preservation program based on the cryostorage of mature oocytes (n=37) or ovarian tissue fragments (n=11) was offered.

Reported outcome(s):

Questionnaire about emotional aspects of fertility preservation procedure counselling, semi-structure interview, and STAI (state anxiet-SAI and trait anxiety-TAI) self administered tests.

Results of outcome(s):

Majority of patients were completely satisfied with information received, also with doctors empathy. Most were satisfied with collaboration between treatment oncologist and fertility team, although 4.2% were "not satisfied".
Just over half the patients described FP as important part of cancer therapy, as "opening a window towards the future", and "an option not to be wasted". Only 2 patients descibed FP as an additional complication of therapy (but underwent FP anyway).
71% of patients considered the addition of a psychologist to the appointment as helpful.
Overall patients reported that cancer Dx is painful psychological experience, and that major worries about the future pervade all patients.
Most patients were not aware that anti-cancer treatments can cause irreversible infertility.

Most patients had moderately high anxiety levels (above the cu toff of 40 points), with state anxiety (SAI) slightly higher than trait anxiety (TAI) both when the test was administered at the hospital (T1) and after returning home (T2) (Table 3). The personal re-elaboration of the information about FPP slightly increased both SAI and TAI).

Includes an economic evaluation

no