Giving more women with cancer an opportunity for fertility preservation
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“Do you want me to save your life, or do you want to be a mother?” Marie Ennis-O’Conner was stunned to hear her doctor ask this question and thought to herself, “Can’t I have both?”

As a young woman who was engaged to be married, starting a family was top-of-mind and it hadn’t occurred to Marie that treatment for her breast cancer would stand in the way. In fact, she hadn’t seen any information about treatment and fertility, and no one had brought it up until now - weeks after her diagnosis. Marie was left feeling shocked, confused and alone.

“My trust in the healthcare team and medical system broke down. I felt like there was nobody to support me and that I had no options.”
Marie Ennis-O’Connor

Although there have been significant advances in fertility preservation techniques, not every woman with cancer is given the opportunity to access them. Like Marie, many women with cancer aren’t aware that fertility can be impacted by treatment. “Doctors are short on time and often don’t have a discussion about the potential effects of cancer treatment on fertility, ” explains Professor Teresa Almeida Santos, Assistant Professor, Faculty of Medicine, University of Coimbra, Portugal, Coordinator of the Oncofertility center at Coimbra University and Hospital Centre. “There’s an urgency to start treatment and misperceptions about the topic that overshadow the short window of time where fertility preservation should be discussed.”

Marie wishes that her healthcare team was more proactive in bringing up fertility, since she was focused on managing all the other aspects that a cancer diagnosis involves. “Things happen really fast and you have to make decisions very quickly. You don’t always have the information needed and you’re too distracted to understand what to ask about,” recalls Marie.

More information and awareness is needed to help physicians initiate fertility preservation conversations as early as possible.

“Ensuring that the topic is familiar, accessible and included as part of the standard conversation about side effects can help empower women with the information they need to make decisions with their healthcare team.”
Professor Teresa Almeida Santos
Assistant Professor, Faculty of Medicine, University of Coimbra, Portugal, Coordinator of the Oncofertility center at Coimbra University and Hospital Centre

While a lack of information presents barriers to decision making, additional challenges exist within the healthcare system. Women aren’t referred to fertility specialists and sometimes when they are, it’s too late, due to suboptimal referral pathways and missing connections between the healthcare team. According to Professor Almeida Santos, a closer relationship between oncologists and fertility specialists could improve collaboration and help close the gap.

To tackle these barriers, Roche, in partnership and co-creation with a panel of healthcare professionals and patients, offered an education program for oncologists about fertility topics and how to maximize collaboration with fertility specialists. The goal was to enable and enhance conversations between oncologists and women, and lay the groundwork for improving referral pathways.

Professor Almeida Santos was part of the panel and believes the program will increase awareness about fertility preservation among doctors, and help them understand the importance of addressing the issue as soon as a woman receives a cancer diagnosis.

Every woman with cancer interested in or considering fertility preservation should have access to timely and appropriate counselling and treatment. Marie never had the family she dreamed of, but she is hopeful that more information and meaningful changes in the healthcare system can open doors for others.

“Women want to work, date, form meaningful relationships and to have a family. Of course it’s about saving their lives, but shouldn't it also be about supporting them to live the best life that they possibly can?”
Marie Ennis-O’Connor

Professor Almeida Santos agrees. “I do believe there is hope for women who want to have children. But I also believe that even if a woman chooses not to undergo fertility preservation, the ability to discuss their options empowers them and better prepares them to manage the future.”

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