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Cancer patients in Europe could be missing out on options to preserve fertility due to lack of awareness and patchy national guidelines

  • Teva Pharmaceuticals Europe surveyed over 450 global hemato-oncologists and fertility specialists from nearly 70 countries to better understand the oncofertility referral pathway.
  • Over two-thirds (68%) of oncologists either believe there are no national fertility preservation guidelines, or are not aware of any.1
  • Survey highlights need for improved education and standardised referral pathways for oncofertility.

Amsterdam / 23 November, 2017 – Results of a new survey highlight the need for improved education and standardised guidance for oncologists initiating cancer treatment in women who may want to safeguard their fertility.1 While discussing fertility preservation with newly diagnosed cancer patients is a high priority for over two-thirds (70%) of oncologists, almost one in four (24%) are still of the opinion that the success rate of fertility preservation is not yet good enough to make it an available option.1 This seems to be reflected in referral rates, with nearly one in five cancer patients, who consult IVF clinics, seeking out fertility preservation advice themselves without an oncologist referral.1

Infertility is a possible side effect of some types of cancer treatment.2 This is because chemotherapy and radiotherapy can affect the ovaries, the production of eggs in the ovaries or the womb.3 The only way to help safeguard fertility for these patients is to initiate fertility preservation prior to cancer treatment. Options include egg-freezing, a process where eggs are extracted from the ovaries and frozen for future fertilisation and implementation, and embryo-freezing, where the collected eggs are already fertilised with sperm prior to being frozen.4

Teva Pharmaceuticals Europe conducted the survey in order to better understand the oncofertility referral pathway as well as the habits of oncologists & fertility specialists when it comes to discussing this matter with their patients.1 Nearly all (97%) oncologists questioned declared they do inform their patients about the risk of infertility associated with cancer treatment, with 9 in 10 stating they immediately refer at-risk patients to fertility specialists.1 However, interestingly, the survey also revealed that nearly two thirds of fertility specialists are under the impression oncologists do not sufficiently explain and address the issue of fertility after cancer treatment with their patients.1

Another unexpected finding of the survey was that one in five oncologists did not know if there were any national guidelines on fertility preservation for cancer patients.1 Fewer than one-third of the oncologists (31%) said there were national guidelines, compared with 43% of fertility specialists1, reflecting either a lack of guidelines and/or a lack of awareness of availability of guidelines. However, nearly all healthcare professionals agreed on the need for guidelines, with 89% of oncologists and 92% of fertility specialists saying they were either useful or needed1.

“It’s critical cancer patients of child-bearing age are given the chance to preserve their fertility before starting treatment, and they should expect consistent provision of advice and care,” says Professor Zeev Shoham, Director of the IVF unit, Kaplan Medical Centre, Rehovot, Israel, whose reference portal for fertility specialists, “IVF Worldwide”, played a leading role in the survey. “Oncologists understand the importance of discussing fertility with their patients, but they’re trying to give their patients the best care with varying knowledge and, as seen in the survey, often without being aware of guidelines. These results once again highlight the key need for improved education of oncologists and standardised referral pathways.”

“Teva Pharmaceuticals is dedicated to helping women, who are faced with cancer, focus on getting well, knowing that everything possible is being done to preserve their fertility, if that is their wish,” says Rachel Levy-Toledano, Associate Medical Director Fertility, Teva Pharmaceuticals Europe.

The full results of the survey are expected to be published in the first half of 2018.

-ENDS-

Notes to editors

About cancer and fertility risk

Cancer can occur when the cells in a specific part of the body grow and reproduce uncontrollably. These cells can invade and attack surrounding healthy tissue. Cancer treatment often includes chemotherapy (medication used to stop the cancer cells reproducing)5 or radiotherapy (use of high-energy radiation).6

These cancer treatments can impact fertility temporarily or permanently. It can be difficult to know in advance what the effects of the cancer treatment will be until treatment has been completed. It often depends on individual circumstances, such as age, gender, type of treatment and the location of the cancer in the body.

In women, chemotherapy and radiotherapy can impact the ovaries and reproduction by causing fewer or no eggs to be produced, as well as potentially compromising the ovaries or the womb.4 In men, cancer can affect the production of sperm or testosterone.7

About fertility preservation treatment options

In women, there are different ways of preserving fertility, these include:

  • egg-freezing, a process by which a woman is stimulated to produce more eggs which are then collected and frozen.4 When a couple decide they are ready for a child, the eggs are removed from storage and the male’s sperm is used to fertilise the egg. 
  • embryo-freezing, where the collected eggs are fertilised with sperm and then frozen4
  • Ovarian tissue cryopreservation where prior to cancer treatment, a piece of ovarian tissue is removed using a minimally invasive procedure and transplanted back in the patient after cancer treatment. This technique can restore fertility and ovarian hormonal secretion after cancer treatment.8

About the research

The survey was conducted by IVF Worldwide on behalf of Teva Pharmaceuticals Europe. A total of 321 IVF unit medical directors from 68 countries performing 537,800 IVF cycles annually, along with 132 hemato-oncologists responded to the survey. Over two-thirds (71%) of the oncologists and 45% of the fertility specialists who responded were from Europe.

The IVF specialists were sent a 33-item web-based questionnaire that addressed practices and views of fertility preservation for cancer patients. The invitation to participate in this survey was sent via email to IVF specialists throughout the world who are registered with IVF-Worldwide. In addition, the questionnaire was posted to the IVF-Worldwide website for one month. Most of the responses came from IVF clinics that are actively performing fertility preservation procedures, which may have biased their responses.

A questionnaire of 19 questions was sent by email to all EBMT (European Society for Blood and Marrow Transplantation) members, who are mostly involved in hemato-oncology.

About IVF-Worldwide

IVF-Worldwide.com is an in-vitro fertilization (IVF)-focused website for doctors, embryologists, nurses and social workers. IVF-Worldwide.com links doctors and specialists from IVF centers in order to encourage dialogue, discuss special treatments and medications, and advance research on IVF issues. IVF-Worldwide.com also assists patients by providing information, community forums and a safe environment for them to maintain a dialogue with doctors and learn more about infertility and treatment. Founded by experts in the field, IVF-Worldwide.com has the vision of providing its members with the ability to locate IVF units anywhere in the world and communicate easily with it. For more information visit http://www.ivf-worldwide.com/

1. Teva Oncofertility Survey

2. Talking about your fertility before cancer treatment starts. Macmillan. Available at: http://www.macmillan.org.uk/information-and-support/coping/side-effects-and-symptoms/fertility-in-women/talking-about-fertility-before-cancer-treatment.html [Accessed August 2017]

3. How Treatment Can Affect Fertility (women). Macmillan. Available at: http://www.macmillan.org.uk/information-and-support/coping/side-effects-and-symptoms/fertility-in-women/how-treatment-can-affect-fertility.html [Accessed August 2017]

4. Preserving Your Fertility (women). Macmillan. Available at: http://www.macmillan.org.uk/information-and-support/coping/side-effects-and-symptoms/fertility-in-women/preserving-your-fertility.html [Accessed August 2017]

5. Chemotherapy. NHS Choices. Available at: http://www.nhs.uk/conditions/chemotherapy/Pages/Definition.aspx [Accessed August 2017]

6. Radiotherapy. NHS Choices. Available at: http://www.nhs.uk/conditions/radiotherapy/Pages/Introduction.aspx [Accessed August 2017]

7. How Treatment Can Affect Fertility (men). Macmillan. Available at: http://www.macmillan.org.uk/information-and-support/coping/side-effects-and-symptoms/fertility-in-men/how-treatment-can-affect-fertility.html#103339 [Accessed August 2017]

8. Kondapalli L.A. (2012) Ovarian Tissue Cryopreservation and Transplantation. In: Gracia C., Woodruff T. (eds) Oncofertility Medical Practice. Springer, New York, NY

About Teva

Teva is among the top 15 global pharmaceutical companies globally, delivering high-quality, patient-centric healthcare solutions used by approximately 200 million patients in 60 markets every day. Teva produces a leading innovative treatment for multiple sclerosis and has late-stage development programs for a range of disorders of the central nervous system, including movement disorders, migraine, pain and neurodegenerative conditions.

With its European headquarters in Amsterdam, the Netherlands, Teva is the world’s largest generic medicines producer, leveraging its portfolio of more than 1,800 molecules to produce a broad range of products in nearly every therapeutic area. Teva draws on its specialty and generics capabilities to seek new ways of addressing unmet patient needs by combining drug development with devices, services and technologies. Teva's net revenues in 2016 were $21.9 billion (approximately €20.8 billion). For more information, visit, http://www.tevaeurope.com/news

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