Awareness and attitudes toward fertility preservation among healthcare providers: a scoping review of quantitative evidence.

Abstract

Background: The number of people who could benefit from fertility preservation is increasing. However, access to fertility preservation services has been hampered by a lack of awareness and misconceptions among healthcare providers (HCPs). There is a need for multifaceted educational programs that consider the perceptions and needs of HCPs. Systematic knowledge of the factors influencing the awareness and attitudes of HCPs toward the use of fertility preservation can help to identify the topics to be included in curricula and the specialties where these programs are most needed.

Objective and rationale: This comprehensive scoping review aims to synthesize quantitative evidence on the factors influencing the awareness and attitudes of HCPs toward fertility preservation, identifying the segments of HCPs (i.e. occupation groups and specialties) that are considered and the fertility preservation indications and topics assessed.

Search methods: The protocol and the scoping review were conducted according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Literature searches were conducted in three databases: PubMed®, Web of Science™, and PsycINFO®. Original empirical, peer-reviewed, and full-length quantitative or mixed-methods articles concerning the awareness and attitudes of HCPs toward fertility preservation were included. Studies involving undergraduate students, interns, residents, and fellows were not considered, nor was qualitative data. The variables of interest were extracted using an individualized data charting tool, and an MS Excel spreadsheet was used to chart the data.

Outcomes: The studies reviewed, comprising 54 quantitative studies and 6 mixed-methods studies, were primarily sourced from the USA, Asian countries (China, Japan, Turkey, India, Iran), and European countries (Netherlands, France, UK). The study participants were predominantly composed of specialist medical practitioners and/or nursing professionals with expertise in the fields of oncology, obstetrics and gynecology, and pediatrics. Almost all studies assessed the awareness and attitudes of HCPs toward fertility preservation in the context of oncologic diseases and oocyte freezing. The primary topics addressed in the literature are information needs and provision and the organization of care and practice. Additional topics include legal aspects, access and coverage, as well as fertility preservation interventions. The results suggested that awareness and attitudes of HCPs toward fertility preservation tended to be influenced by factors related to their professional trajectories (level of involvement in fertility preservation issues with peers and patients, number of patients treated, and advanced training), rather than their sociodemographic characteristics or perceptions of patient's characteristics.

Wider implications: Further empirical research is required, including studies involving HCPs working in primary healthcare institutions and those specializing in psychosocial care, as well as studies into fertility preservation for reproductive aging and gender-transitioning reasons. It is necessary to invest in the provision of education regarding fertility preservation to a diverse range of HCPs, extending beyond specialist medical practitioners involved in oncology. The implementation of educational programs encompassing the legal aspects, access, coverage, and fertility preservation interventions could enhance awareness and attitudes of HCPs toward fertility preservation. Changes in policy and advocacy are needed to support better integration of fertility preservation as a tool for patients in their reproductive health journey.

Registration number: osf.io/h56ds.