Oncofertility care in South Africa
Dr Chris Venter updates us on the current standing of oncofertility care in South Africa.
At the start of a new year, it seems reasonable to take a “surgical pause” and reflect on the past year. What challenges were achieved and what challenges still lie ahead?
Eighteen months back when I was tasked to co-ordinate a national collaborate attempt between fertility clinics unified under the South African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG), I was made aware by my overseas mentor, Teresa Woodruff, that this would be a long-term mission, and that the challenges we’re facing in oncofertility care are universal in nature.
The field of oncofertility is very small compared to the fields of oncology and reproductive medicine. The high number of patients certainly underscore the importance of offering this treatment modality to young oncology patients.
Embarking on such a mission, we need to ask ourselves, if such a cause is needed and justified?
Evidence has shown that although the young cancer patient is faced with the inherent stress of a new cancer diagnosis, that future fertility also contributes to their current concerns.
Several studies have indicated that cancer survivors who are infertile due to cancer treatments are more likely to suffer from emotional distress. Evidence has also shown that fertility preservation improves emotional well-being.
Establishing a national network
To establish a rapid consult in fertility preservation, a network of clinics is needed to accommodate newly diagnosed patients. During late 2018, a South African fertility unit entered a collaboration with the Oncofertility Consortium, in Chicago, and became the first unit in Africa to join.
Since then, another four South African units have joined this collaboration, making oncofertility care more accessible to the South African public.
We encourage more clinics to take up this challenge and expand this network. By joining the consortium, units are now part of a global network of clinics who share their experiences and constantly strive to improve their outcomes in fertility preservation.
Engaging with a multi-disciplinary team
Communication between disciplines remains the key to effective oncofertility care. There should be no delays in referrals or treatment.
During 2019, speakers from both disciplines were invited to speak at conferences to raise awareness and create better understanding of the challenges faced in oncofertility care. When reviewing the forthcoming 2020 conferences, it seems that oncofertility care is finding its rightful place in the scientific programmes.
The psychological aspects of oncofertility care in South Africa have been poorly researched. There are currently two ongoing research projects regarding the psychosocial impact of oncofertility care in cancer patients who had undergone fertility preservation treatment. We’re looking forward to these outcomes. Disciplines such a haematology, endocrinology and breast cancer surgery will be focused on in the coming year.
Need for data recording
Individual clinics, like mentioned before, have been performing fertility preservation procedures since 2012. Up until now, there has being no recording of the number of fertility preservation procedures performed countrywide and their outcomes.
We are excited to announce that from 2019, the South African based-registry, African Network and Registry for Assisted Reproductive Technology (ANARA) will be recording fertility preservation procedures. Through this registry, we can now record all procedures and use the data to approach other stakeholders, such as the healthcare funders for financial support.
Funding always seems to be the elephant in the room. Currently patients need to fund fertility preservation out of their own pocket. This seems to be one of the major limitations to accessible fertility preservation treatment.
Engaged fertility units have adopted a principle that costs for fertility preservation options in cancer patients should be limited or close to baseline costs. Initial talks with healthcare funders seems promising, and we hope to continue with these altruistic intentions in 2020.
What to look forward to in 2020
In April 2020, during the Fertility Africa Meeting, in Cape Town, African countries have been invited to share their experience and to build on an African fertility preservation network.
Kristin Smith, a patient navigator from the Chicago Oncofertility Consortium, has been invited to share her experience in counselling and risk assessment of young cancer patients.
Various conferences, such as SASGO, SASOG and SASMO will be having fertility preservation lectures during their programmes throughout the year.
I conclude by thanking all role players: oncologist, counselling nurses, surgeons, reproductive specialist, haematologists, the pharmaceutical trade, fertility lawyers, and publications, such as Oncology Buddies, for all contributing to such a noble cause. May we all strive to make oncofertility care a standard in South Africa.[/vc_column_text]
MEET OUR EXPERT – Dr Chris Venter
Dr Chris Venter works as a reproductive medical specialist in Johannesburg. He has a keen interest in treating couples with reproductive failure and raising awareness amongst cancer patients about the importance of fertility preservation. Through collaboration with the Oncofertility Consortium Network, his goal is to unify oncofertility care in South Africa.
This article is sponsored by Ferring Pharmaceuticals in collaboration with SASREG. The content and opinions expressed are entirely the medical expert’s own work and not influenced by Ferring in any way. 2019/105