McDougall Sophia, Vogt Katharina S, Wilkinson Anna, Skull Jonathan, Jones Georgina L
Intercalated Medical Student, Medical School, The University of Sheffield, Sheffield, UK.
Department of Psychology, Leeds Beckett University, Leeds, UK.
J Obstet Gynaecol. 2020 Feb;40(2):252-259. doi: 10.1080/01443615.2019.1621823. Epub 2019 Aug 8.
This service evaluation aimed to appraise the delivery of a fertility preservation service for women with cancer which was established in 2005 as part of an Assisted Conception Unit. First, the ACU-database was interrogated between 08/2005 and 01/2017; revealing 174 women received referrals over the 12-year period with a steady referral increase each year. Demographic analyses revealed factors, such as being partnered, to be strong indicators of whether women would seek FP or not. To improve service provision, women who had consented to be contacted for audit, administrative and research purposes, received questionnaires to ascertain their perspectives on the FP decision-making process, their outcomes and ACU after-care. The majority perceived their experience as excellent due to the care they received from ACU staff, speed and efficiency in service delivery. The increasing number of referrals since 2005 is reassuring. However, this audit also highlighted shortcomings of the service, such as limited awareness of the fertility counselling service and lack of after-care.IMPACT STATEMENT There has been an increase in women diagnosed with cancer undergoing fertility preservation (FP) before starting potential gonadotoxic treatment. Offering FP to these women is essential as the ability to have future children is often perceived as equally as important as survivorship, and a source of hope for the future. This study presents a service evaluation, across a 12-year period, of delivering FP services to women with cancer in one UK Assisted Conception Unit (ACU). Women's experiences of the service were evaluated to enhance service delivery and make recommendations for clinical practice. The current service evaluation demonstrated increased rates of FP referral over a 12-year period for women with cancer. While this increasing number is reassuring and reflecting increased awareness among professionals and patients; shortcomings in the care pathway were also found: women reported limited opportunity to see fertility counsellors and desired better after care. This information may also be of benefit to other ACUs seeking to enhance and improve service provision in the care of women with cancer, contemplating fertility preservation.
本服务评估旨在评价为癌症女性提供的生育力保存服务，该服务于2005年作为辅助生殖单元的一部分设立。首先，对2005年8月至2017年1月期间辅助生殖单元的数据库进行了查询；结果显示，在这12年期间有174名女性接受了转诊，且转诊人数逐年稳步增加。人口统计学分析显示，诸如是否有伴侣等因素是女性是否会寻求生育力保存的有力指标。为了改善服务提供，同意为审核、管理和研究目的而被联系的女性收到了问卷，以确定她们对生育力保存决策过程、结果及辅助生殖单元后续护理的看法。由于她们从辅助生殖单元工作人员那里得到的护理、服务提供的速度和效率，大多数人认为她们的经历非常好。自2005年以来转诊人数的增加令人欣慰。然而，本次审核也凸显了该服务的不足之处，比如对生育咨询服务的认知有限以及缺乏后续护理。影响声明 被诊断患有癌症的女性在开始可能具有性腺毒性的治疗前进行生育力保存（FP）的人数有所增加。为这些女性提供生育力保存至关重要，因为拥有未来子女的能力通常被认为与生存同样重要，并且是未来希望的源泉。本研究呈现了一项在12年期间，为英国一个辅助生殖单元（ACU）的癌症女性提供生育力保存服务的服务评估。对女性的服务体验进行了评估，以改善服务提供并为临床实践提出建议。当前的服务评估表明，在12年期间癌症女性的生育力保存转诊率有所提高。虽然这一增长令人欣慰且反映出专业人员和患者的认知有所提高；但在护理路径中也发现了不足之处：女性报告称看生育咨询师的机会有限，并且希望得到更好的后续护理。这些信息可能对其他寻求加强和改善为考虑生育力保存的癌症女性提供服务提供的辅助生殖单元也有益处。
