Impact of a Nurse Navigator Program on Referral Rates and Use of Fertility Preservation Among Female Cancer Patients: A 14‐Year Retrospective Cohort Study

ABSTRACT Introduction Given the known detrimental impact of cancer treatment on fertility, fertility preservation (FP) is recommended for reproductive age patients who are newly diagnosed with cancer. However, the rate of referral to fertility specialists remains suboptimal. The objective of this st...

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Main Authors: Mackenzie Naert, Kimia Sorouri, Andrea Lanes, Abigail M. Kempf, Lucy Chen, Randi Goldman, Ann H. Partridge, Elizabeth Ginsburg, Serene S. Srouji, Zachary Walker
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.70529
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author Mackenzie Naert
Kimia Sorouri
Andrea Lanes
Abigail M. Kempf
Lucy Chen
Randi Goldman
Ann H. Partridge
Elizabeth Ginsburg
Serene S. Srouji
Zachary Walker
author_facet Mackenzie Naert
Kimia Sorouri
Andrea Lanes
Abigail M. Kempf
Lucy Chen
Randi Goldman
Ann H. Partridge
Elizabeth Ginsburg
Serene S. Srouji
Zachary Walker
author_sort Mackenzie Naert
collection DOAJ
description ABSTRACT Introduction Given the known detrimental impact of cancer treatment on fertility, fertility preservation (FP) is recommended for reproductive age patients who are newly diagnosed with cancer. However, the rate of referral to fertility specialists remains suboptimal. The objective of this study was to determine the impact of a dedicated Nurse Navigator Program (NNP) on the rate of referrals and utilization of FP services. Methods A retrospective cohort study of all women ≥ 18 years old referred for FP consultation with a known cancer diagnosis from 2007 to 2021 at a single, large academic center was conducted. FP referrals for non‐cancer indications were excluded. Descriptive statistics were performed including comparing referrals received per 30 days and FP utilization rates pre‐NNP (October 2007–September 2013) to post‐NNP (October 2013–December 2021). Results A total of 176 patients were included pre‐NNP and 990 patients post‐NNP. Overall, the mean age at the time of referral was 31.5 ± 6.9 years. The referral rates post‐NNP were higher among those without prior exposure to chemotherapy/radiation (0.33 pre‐NNP vs. 2.75 post‐NNP per 30 days, p < 0.01) and lower among those with prior exposure to chemotherapy/radiation (1.26 pre‐NNP vs. 0.70 post‐NNP per 30 days, p < 0.01). Conclusions After the launch of a dedicated fertility preservation nurse navigation program at our institution, we observed a higher number of referrals for FP as well as greater use of FP overall. While not the only variable that changed during this period, this program has optimized patient care and clinical workflow at our institution and serves as a model for such improvement.
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spelling doaj-art-e4a7a9c4a84840c9a0bb9fb70c33bc842025-08-20T03:27:57ZengWileyCancer Medicine2045-76342025-02-01143n/an/a10.1002/cam4.70529Impact of a Nurse Navigator Program on Referral Rates and Use of Fertility Preservation Among Female Cancer Patients: A 14‐Year Retrospective Cohort StudyMackenzie Naert0Kimia Sorouri1Andrea Lanes2Abigail M. Kempf3Lucy Chen4Randi Goldman5Ann H. Partridge6Elizabeth Ginsburg7Serene S. Srouji8Zachary Walker9Brigham and Women's Hospital Boston Massachusetts USADana‐Farber Cancer Institute Boston Massachusetts USABrigham and Women's Hospital Boston Massachusetts USABrigham and Women's Hospital Boston Massachusetts USAHarvard Medical School Boston Massachusetts USANorthwell New Hyde Park New York USAHarvard Medical School Boston Massachusetts USABrigham and Women's Hospital Boston Massachusetts USABrigham and Women's Hospital Boston Massachusetts USABrigham and Women's Hospital Boston Massachusetts USAABSTRACT Introduction Given the known detrimental impact of cancer treatment on fertility, fertility preservation (FP) is recommended for reproductive age patients who are newly diagnosed with cancer. However, the rate of referral to fertility specialists remains suboptimal. The objective of this study was to determine the impact of a dedicated Nurse Navigator Program (NNP) on the rate of referrals and utilization of FP services. Methods A retrospective cohort study of all women ≥ 18 years old referred for FP consultation with a known cancer diagnosis from 2007 to 2021 at a single, large academic center was conducted. FP referrals for non‐cancer indications were excluded. Descriptive statistics were performed including comparing referrals received per 30 days and FP utilization rates pre‐NNP (October 2007–September 2013) to post‐NNP (October 2013–December 2021). Results A total of 176 patients were included pre‐NNP and 990 patients post‐NNP. Overall, the mean age at the time of referral was 31.5 ± 6.9 years. The referral rates post‐NNP were higher among those without prior exposure to chemotherapy/radiation (0.33 pre‐NNP vs. 2.75 post‐NNP per 30 days, p < 0.01) and lower among those with prior exposure to chemotherapy/radiation (1.26 pre‐NNP vs. 0.70 post‐NNP per 30 days, p < 0.01). Conclusions After the launch of a dedicated fertility preservation nurse navigation program at our institution, we observed a higher number of referrals for FP as well as greater use of FP overall. While not the only variable that changed during this period, this program has optimized patient care and clinical workflow at our institution and serves as a model for such improvement.https://doi.org/10.1002/cam4.70529fertility preservationnurse navigatoroncofertilityreferralsutilization
spellingShingle Mackenzie Naert
Kimia Sorouri
Andrea Lanes
Abigail M. Kempf
Lucy Chen
Randi Goldman
Ann H. Partridge
Elizabeth Ginsburg
Serene S. Srouji
Zachary Walker
Impact of a Nurse Navigator Program on Referral Rates and Use of Fertility Preservation Among Female Cancer Patients: A 14‐Year Retrospective Cohort Study
Cancer Medicine
fertility preservation
nurse navigator
oncofertility
referrals
utilization
title Impact of a Nurse Navigator Program on Referral Rates and Use of Fertility Preservation Among Female Cancer Patients: A 14‐Year Retrospective Cohort Study
title_full Impact of a Nurse Navigator Program on Referral Rates and Use of Fertility Preservation Among Female Cancer Patients: A 14‐Year Retrospective Cohort Study
title_fullStr Impact of a Nurse Navigator Program on Referral Rates and Use of Fertility Preservation Among Female Cancer Patients: A 14‐Year Retrospective Cohort Study
title_full_unstemmed Impact of a Nurse Navigator Program on Referral Rates and Use of Fertility Preservation Among Female Cancer Patients: A 14‐Year Retrospective Cohort Study
title_short Impact of a Nurse Navigator Program on Referral Rates and Use of Fertility Preservation Among Female Cancer Patients: A 14‐Year Retrospective Cohort Study
title_sort impact of a nurse navigator program on referral rates and use of fertility preservation among female cancer patients a 14 year retrospective cohort study
topic fertility preservation
nurse navigator
oncofertility
referrals
utilization
url https://doi.org/10.1002/cam4.70529
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