Chung J Pw, Lao T Th, Li T C
Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, Hong Kong.
Hong Kong Med J. 2017 Dec;23(6):556-61. doi: 10.12809/hkmj176840. Epub 2017 Nov 10.
Individuals can be exposed to gonadotoxic agents in the course of treatment for cancers and other medical conditions. Fertility preservation refers to strategies that aim to preserve fertility by protecting it against the damage inflicted by gonadotoxic treatment. Many young patients are prescribed gonadotoxic treatment without prior counselling. This study aimed to study the awareness of, attitude to, and knowledge about fertility preservation among clinicians in Hong Kong.
This was a cross-sectional study carried out between June and December 2016 using a self-administered questionnaire. The questionnaires were sent to clinicians in the departments of Clinical Oncology, Haematology, Obstetrics and Gynaecology, Paediatrics, and Surgery in various public hospitals of Hong Kong.
In this survey, 36.5% (167 of 457) of clinicians responded. Of the respondents, only 45.6% were familiar with fertility preservation. The factors considered most important for referral were, in decreasing order of importance, prognosis of the patient, patient's desire to have children, time available before commencing gonadotoxic treatment, type of cancer, and type of gonadotoxic treatment. The majority of clinicians did not refer their patients for fertility preservation due to a lack of available time before treatment, considerable risk of recurrence, poor prognosis, financial constraints, need for cancer treatment as top priority at the time, and lack of awareness of such service. Almost all agreed that a dedicated centre should be set up for fertility preservation and 76.5% agreed that fertility preservation should be provided as a public service.
Awareness among clinical practitioners of fertility preservation remains weak. Education of clinicians and the establishment of a dedicated fertility preservation centre are required.
个体在癌症及其他疾病的治疗过程中可能会接触到性腺毒性药物。生育力保存是指旨在通过保护生育力免受性腺毒性治疗造成的损害来保存生育力的策略。许多年轻患者在未接受事先咨询的情况下就被开具了性腺毒性治疗药物。本研究旨在调查香港临床医生对生育力保存的知晓度、态度和知识。
这是一项于2016年6月至12月期间开展的横断面研究，采用自填式问卷。问卷被发送给香港各公立医院临床肿瘤学、血液学、妇产科、儿科学和外科学科室的临床医生。
在本次调查中，36.5%（457名中的167名）临床医生做出了回应。在回应者中，只有45.6%熟悉生育力保存。被认为对转诊最为重要的因素，按重要性降序排列依次为患者的预后、患者生育子女的意愿、开始性腺毒性治疗前的可用时间、癌症类型以及性腺毒性治疗类型。大多数临床医生未将患者转诊至生育力保存相关机构，原因包括治疗前没有可用时间、复发风险相当高、预后不佳、经济限制、当时癌症治疗为首要优先事项以及对这类服务缺乏认知。几乎所有人都同意应设立一个专门的生育力保存中心，76.5%的人同意生育力保存应作为一项公共服务提供。
临床医生对生育力保存的认知仍然薄弱。需要对临床医生进行教育并设立一个专门的生育力保存中心。
