Fertility preservation methods are underused in France according to a survey of patients two after their cancer.
6% of cancers occur in people aged 15 to 44 in France. For these young adults, starting a family is often a major post-cancer challenge. When announcing their illness, most men and women under 45 consider themselves capable of procreating and a parental plan is frequent (37% of men, 31% of women). Among those under 35, this desire is even more present since it can affect up to 75% of cancer patients living as a couple.
But cancer, and especially its treatments like chemotherapy or radiation, can have a negative impact on fertility. However, developments in medicine now make it possible to offer the possibility of medically assisted procreation to fulfill the desire for a child, including after cancer. However, according to the results of the VICAN 2 surveys carried out by the National Cancer Institute (INCa) and Inserm, the freezing of spermatozoa, eggs or even embryos is currently under-used in France. .
Only 2.2% of women were able to keep their gametes
In this survey, which gathered the testimonies of more than 4,300 patients two years after their cancer, one of the chapters thus made it possible to study the consequences of cancer on fertility. The authors of this analysis therefore questioned participants under the age of 45 on access to fertility preservation techniques and their parental plans. The idea of this “fertility” component was to shed light on measure 21 of the 2009-2013 Cancer Plan, which mentioned the need to guarantee equal access to innovations allowing the preservation of fertility.
In the end, a lot of progress remains to be made. On the one hand, only 2/3 of the patients concerned were offered to keep their gametes. And in the end, this conservation was only achieved in 15.8% of men who were fertile at the time of diagnosis, and for only 2.2% of women before treatment for their cancer was carried out. This very low use in women could be explained by the more complex and experimental nature of the available fertility preservation techniques.
Listen to Anne Burstin, Director General of the Inca: ” Too infrequently, fertility preservation consultations are offered, especially to women. We will work with all professionals to make them aware of this need. “
Lack of information among doctors
The lack of information is also present among health professionals. Indeed, certain innovative techniques, such as the conservation of ovarian tissue, remain poorly understood. A study conducted among oncologists practicing in PACA-Corsica indicates that 54% have never referred a patient for an oncofertility consultation and that they rarely inform patients of the possibilities of preservation due to a lack of information, especially in women
Finally, according to INCa, the other difficulty lies in the fact that it is sometimes difficult to know precisely from the diagnosis, the prognosis of patients and the impact of treatments on their fertility. Thus, in 2004-2005, during the first national survey two years after a diagnosis of cancer, a third of the people questioned declared themselves infertile because of their treatment. Among them, 30% of women and 13% of men indicated that they had not been informed of this risk before the start of treatment. However, the public authorities remain mobilized on the subject. In 2013, the “Fertility and cancer” report published jointly by INCa and the Biomedicine Agency already highlighted the inadequacy of taking into account the risks of infertility to which patients are exposed when it is should be systematic. In addition, standardized information should soon be offered through the systematic delivery of brochures or the design of computerized tools that can improve information for the patients and healthcare professionals concerned.
.
