Table 1.
Age | Numerical value |
---|---|
Gender | Female |
Male | |
Region of the country | Northeast |
Southeast | |
Midwest | |
West | |
Southwest | |
Level of practice | Fellow |
Attending | |
Retired | |
Medical specialty | Gynecologic oncology |
Medical oncology | |
Radiation oncology | |
General gynecology | |
Other | |
Description of practice | Private |
Academic | |
Community | |
N/A | |
Years in practice caring for gynecologic oncology patients | 1–5 |
6–9 | |
10–15 | |
16–20 | |
21 + | |
Reproductive practices | |
How often do you address fertility concerns with patients prior to treatment? | Always |
Sometimes | |
Rarely | |
Never | |
How often do you address contraception with patients that maintain fertility potential? | Always |
Sometimes | |
Rarely | |
Never | |
Do you prescribe or administer contraception? | Yes |
No | |
If you address contraception with patients that maintain fertility potential, please check all that apply | Oral contraceptive pills |
Injection – DMPA Implant Intrauterine device | |
If you prescribe or administer contraception for patients that maintain fertility potential, please check all that apply | Oral contraceptive pills |
Injection – DMPA | |
Implant Intrauterine device | |
Do you make referrals to: benign gynecologist, family planning specialist, or pediatrician specifically for contraception planning? | Yes |
No | |
Do you routinely follow up on the referral for contraception planning to ensure a plan is established? | Yes |
No | |
Do you routinely offer referral to Reproductive Endocrinology and Infertility (REI) or Maternal-Fetal Medicine (MFM) for preconception, pretreatment counseling? | Yes |
No | |
Do you agree unplanned pregnancy is a potential problem among your patients who maintain fertility potential? | Yes |
No | |
Do you feel your patients understand unplanned pregnancy is possible, even in the setting of oncology treatment or surveillance? | Yes |
No | |
In the previous year, how many of your patients have experienced an unplanned pregnancy either during or after oncology treatment? | 0–5 |
6–10 | |
11–15 | |
16–20 | |
In the previous five years, how many of your patients have experienced an unplanned pregnancy either during or after oncology treatment? | 0–5 |
6–10 | |
11–15 | |
16–20 |