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Supportive Care in Cancer
Published in: Supportive Care in Cancer 8/2016

01-08-2016 | Original Article

Cancer and fertility preservation in Puerto Rico: a qualitative study of healthcare provider perceptions

Authors: Karen E. Dyer, Gwendolyn P. Quinn

Published in: Supportive Care in Cancer | Issue 8/2016

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Abstract

Purpose

This study aims to examine healthcare provider perceptions of cancer-related infertility and fertility preservation (FP) in an underserved population and to highlight cognitive and structural barriers to use.

Methods

In-depth, semi-structured interviews were conducted with a sample of 16 healthcare providers participating in a larger ethnographic study on cancer survivorship and cancer-related infertility in Puerto Rico, an unincorporated US territory. Interviews were conducted in-person, audio-recorded, transcribed verbatim, and coded using the constant comparative method.

Results

Providers identified several barriers to FP in Puerto Rico: high cost in relation to income levels, lack of insurance coverage, gaps in provider knowledge of fertility clinics and financial assistance, lower prioritization of quality-of-life needs leading to inconsistent physician disclosure of fertility risks, geographical location of fertility clinics, and logistical challenges to maintaining FP offerings. Two factors act as facilitators: a high value placed on patient-provider communication and relationships and the formation of local alliances between the oncology and reproductive medicine fields, potentially leading to increased cross-specialty communication and referral.

Conclusions

Infertility is a continuing source of distress for cancer patients and survivors, and barriers to FP vary cross-culturally. In Puerto Rico, context-specific factors indicate potential areas of intervention. Greater awareness of fertility risks and options can be fostered through physician training in conjunction with organizational measures targeting cost barriers.
Footnotes
1
Since data collection concluded for this study, new collaborative initiatives have taken place: for example, fertility specialists were invited to present to the PR oncology/hematology professional association about the impact of cancer treatment on reproductive capacity and locally available fertility preservation services.
 
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Metadata
Title
Cancer and fertility preservation in Puerto Rico: a qualitative study of healthcare provider perceptions
Authors
Karen E. Dyer
Gwendolyn P. Quinn
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 8/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-016-3166-6

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