Suboptimal quality of female oncofertility care is associated with lowered quality of life

Female adolescent and young adult cancer patients should be informed about infertility risks due to cancer treatment. However, quality of female oncofertility care is far from optimal. It is not known whether this suboptimal quality of care is associated with patient-reported outcome measures (PROMs), particularly quality of life, decisional conflict, regret, and reproductive concerns. A multicenter cross-sectional survey study was conducted to measure the association between quality of oncofertility care and PROMs in female cancer survivors from six hospitals across the Netherlands. Quality indicators were used to assess quality of care, and validated scales to assess PROMs. Quality indicator and PROM scores were calculated, and possible associated determinants were analyzed by T-tests and multilevel multivariate analyses. Female cancer survivors (N = 121) received suboptimal quality of care with 8 out of 11 quality indicators scoring < 90% adherence. When survivors were informed about infertility risks, were offered fertility preservation counseling, and received digital/written information, their physical quality of life was highest (51.05 vs. 44.05), and levels of decisional conflict (24.55 vs. 48.22) and regret (12.50 vs. 28.67) were lowest, compared to non-adherence. Quality of life and decision regret were significantly influenced by relationship status, strength of wish to conceive, and type of cancer. Receiving high-quality integrated female oncofertility care is associated with an improved quality of life, and with less decisional conflict and regret in female cancer survivors. As quality of oncofertility care is suboptimal, tailored strategies should be developed to guideline-specific barriers, to improve quality of care and, most importantly, quality of life in female cancer survivors.