Insights from a single-site study on female adolescent and young adult oncofertility documentation

PURPOSE: Cancer rates among adolescents and young adults (AYAs) have steadily increased. As survival improves, infertility risk from cancer treatment is a survivorship concern. Guidelines emphasize timely oncofertility counseling. However, clinical documentation remains inconsistent, limiting appropriate care coordination. This single-site study explored oncofertility documentation in the electronic medical record (EMR) for female AYAs at a single center in the United States. METHODS: We conducted a retrospective chart review of 30 females aged 18-39 (2018-2020) who desired or were unsure about fertility consultation. Data abstraction captured documentation of fertility preservation (FP) discussions, referrals, timing, provider type, and psychosocial care. Descriptive statistics summarized trends. RESULTS: Participants averaged 29.7 years (range 20-39). Most were White (80%), 66.7% had no children at diagnosis, and 73.3% desired future children. Breast cancer was the most common diagnosis (20%). Treatments included surgery (53.3%), hormone therapy (30%), radiation (23.3%), and chemotherapy (20%). Over half (56.7%) had no documentation of an FP discussion. When present, oncologists documented 46.2% of discussions. Referrals to reproductive specialists appeared in 40% of charts, and psychosocial support in 46.7%. Documentation varied by provider and EMR location. CONCLUSION: This single-site retrospective chart review identified variability in documentation of oncofertility discussions, referrals, and psychosocial care across providers and EMR locations. Larger, multi-site studies are needed to validate these findings and inform equitable documentation strategies.