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‘It’s not just about having babies’

 

‘It’s not just about having babies’:

Older women’s experiences of making fertility preservation decisions in Britain.

Dr Alexis Paton

Research Associate, The SAPPHIRE Group, University of Leicester.

1800 Thursday the 8th of March 2018.

Edgar Graham Room (MST/02/002). The School of Law, Queen’s University Belfast.

Flyer [.pdf]

Cancer treatment and fertility preservation are two areas of medicine that while they overlap, they are often at odds with each other. Decisions made about cancer treatments in the here and now can have long-lasting and devastating effects on the future fertility of patients once they are cancer-free. Fertility preservation through sperm freezing is a routine part of the male cancer patient’s experience, however egg and embryo freezing for women is not routinely offered, and sometimes is not possible due to the nature of their cancer. One group of women who are particularly interested in fertility preservation, but often ignored, are older premenopausal women (aged 35-50), who attach importance to their fertility preservation for non-childbearing reasons. In particular this group are concerned with preserving their fertility because of what that fertility means to their identity as a woman and a survivor, and to maintain ovarian function and avoid early menopause. In a three year study examining the experiences of premenopausal women making fertility preservation decisions, participants of this particular group felt that their health care professionals made erroneous assumptions about the patients’ fertility/ovarian preservation needs, which kept them from making fully informed and autonomous decisions about their cancer treatments. In this seminar I will outline the findings from this group, and further argue that these experiences of older oncofertility patients can be used to highlight the need to address the persistent lack of effective communication between healthcare professionals and patients about oncofertility options, in order to better support autonomous, informed decision-making in the clinical context. By using these findings, and others, it is possible to reflect back on the efficacy of those theories of decision-making that inform current practice. Using this sociological approach to bioethical inquiry provides real-world and real-time examples of how current theories that inform policy and practice around decision-making in the clinical context no longer reflect how patients actually experience making these difficult decisions.