Increasing access to fertility care through private foundations.

OBJECTIVE: To characterize the available support for infertility treatment and populations served by private foundations across the United States. DESIGN: Web-based cross-sectional survey. SETTING: Not applicable. PATIENT(S): Not applicable. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Geographies and populations served, dollar-amount and scope of financial assistance provided by private foundations for individuals seeking financial assistance for infertility treatment. RESULT(S): Thirty-seven private foundations were identified, 25 responded (68% response rate). More than one-half of the foundations had awarded grants to lesbian, gay, and transgender individuals, as well as single men and women. Forty percent of the foundations serve only a single state or geographic region. Foundations have provided 9,996 grants for infertility treatment, 1,740 in 2016 alone, with an average value of $8,191 per grant. The Livestrong foundation has provide more than 90% of these grants, and only to patients with a history of cancer. Twelve percent of foundations provide assistance for fertility preservation in patients with cancer, and 20% provide assistance for elective oocyte cryopreservation. CONCLUSION(S): Private foundations significantly increase access to infertility care for individuals and couples affected by cancer who could otherwise not afford treatment. Significant heterogeneity exists regarding the populations served and the services available for grant support by these foundations, and the landscape of options for patients unaffected by cancer is severely limited.

Non-Hodgkin's lymphoma survivors' fertility and sexual function-related information needs.

This population-based study assessed information needs related to fertility and sexual function in 250 non-Hodgkin's lymphoma survivors from a Los Angeles Surveillance, Epidemiology, and End Results cancer registry 2-5 years after diagnosis. Results suggest that many survivors have persistent fertility and sexual concerns 2-5 years after diagnosis, highlighting the importance of oncologists working collaboratively with reproductive endocrinologists to uniformly inform patients about these issues during routine follow-up cancer care visits.

Fertility and risk factors for elevated infertility concern in 10-year hematopoietic cell transplant survivors and case-matched controls.

PURPOSE: To describe fertility status and the prevalence of and risk factors for elevated infertility concern in 10-year adult cancer survivors who underwent myeloablative stem cell transplant (SCT). PATIENTS AND METHODS: Perceived fertility status, conception efforts, and infertility concern were reported before transplant and after 10 years by 120 cancer survivors who received myeloablative SCT and their case-matched controls. RESULTS: Respondents (including cases and controls) were predominantly white and married. Sex, age, race, ethnicity and education level were case matched. Four survivors (all males) conceived after completing cancer treatment, one with unassisted conception. Twenty-two percent of survivors compared with 9% of controls reported that they had looked into family-building options because of infertility (P = .009). Fourteen survivors (12%) compared with eight controls (7%) indicated that they had tried unsuccessfully to have children in the previous 10 years (P = not significant). One quarter of survivors had moderate to high levels of concern about infertility, compared with 7% of controls. A majority of survivors younger than age 40 years (n = 20; 54%) expressed elevated infertility concern. Survivors without children before transplant had greater risk of elevated concern after 10 years (odds ratio, 3.41; 95% CI, 1.93 to 11.30; P = .05). Although female controls were more likely to express elevated infertility concern (P = .007), sex did not discriminate concern among survivors. CONCLUSION: The prevalence of infertility and related concerns is higher among long-term SCT survivors than among age-, sex-, and education-matched controls. Younger SCT recipients and those without children have persistent fertility-related needs even 10 years after treatment.

Health disparities research--a model for conducting research on cancer disparities: characterization and reduction.

The existence of disparities in health has gained national attention. While racial disparities in health have been documented for decades, "health disparities research" has not been described or defined. Health disparities may occur in categories such as racial/ethnic, age, and in geographic categories such as rural/urban, as well as in socioeconomic status. This paper, using the documented racial disparities in cancer for blacks and whites, presents a framework and model for documenting disparities, designing and conducting health disparities research, and applying the results of this research to reduce or eliminate disproportionate rates. The model consists of four components: 1. Surveillance 2. Explanatory Research 3. Intervention Research: Development and Evaluation 4. Translation/Application of Research Results. This model is presented to assist researchers in systematically addressing health disparities through well designed, well conducted, and well applied research. The Special Populations Cancer Research Networks are an 18 member national network of grants that focus on cancer disparities research, community awareness and participatory research, increased accrual of minorities to clinical trials, and training of minority investigators. The primary objective of the University of Maryland School of Medicine's grant is to reduce cancer rate disparities in underserved communities.