Key recommendations for high-quality female oncofertility care based on international clinical practice guidelines

Published:December 04, 2019DOI:


      Research question

      Which guideline-based key recommendations can be selected for high-quality female oncofertility care?


      The Delphi method was used to select a set of key recommendations for female oncofertility care. First, recommendations from (inter)national clinical practice guidelines were selected in four domains: risk communication, referral, counselling and decision-making. Thereafter, they were scored, per domain, on their importance for high-quality oncofertility care by a multidisciplinary, oncofertility expert panel, consisting of patients, referrers and counsellors, in two Delphi rounds. Finally, the selected key recommendations were presented for approval in a third round. Differences in perspectives between subgroups of the expert panel were analysed.


      A panel of 86 experts was asked to select key recommendations for high-quality oncofertility care. Eleven key recommendations were selected. Key recommendations in the domains risk communication and referral focused on information provision and offering referral to a reproductive specialist to female cancer patients. With the counselling domain, key recommendations focused on all aspects of counselling, including different methods, safety, pros and cons. In the decision-making domain, key recommendations focused on shared decision-making and supporting the decision with written information. The final set of key recommendations was approved by 91% of the experts. Differences in perspectives were found between subgroups. Patients found recommendations on decision-making and information provision more important.


      A set of 11 key recommendations for high-quality female oncofertility care was selected by a multidisciplinary expert panel. The involvement of the perspectives of patients, referrers and counsellors led to this valid, acceptable and credible set of key recommendations.


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      Özlem Baysal received her medical degree in 2013 after graduating from the Radboud University in Nijmegen, the Netherlands. She started her PhD programme in the same year at the Department of Obstetrics and Gynaecology at the Radboud University Medical Center on the topic of fertility preservation care in adult women.
      Key message
      Eleven key recommendations were selected for high-quality female oncofertility care by a multidisciplinary oncofertility expert panel. This set of key recommendations is the first step towards establishing a measuring tool for identifying problems, improving the quality of female oncofertility care and eventually improving the quality of life of survivors internationally.