Table 2.

Dimensions of patient-centered fertility preservation: the special needs of women patients undergoing medical egg freezing

Dimensions	Special needs of MEF patients
System factors
Information	• Providing detailed information on both fertility risks and MEF, provided face to face and in a timely fashion • Setting realistic expectations for MEF outcomes based on single cycles
Coordination and integration	• Timely referrals from oncology to MEF services • Support for integrated oncofertility services, with team-based approach to cancer treatment and fertility preservation • Coordination with pharmacies offering online discounts and/or free donations of hormonal medications • Provision of information on cancer charities, including those that provide services and financial help to patients undergoing MEF • Coordination of medication donation and sharing within IVF clinics
Accessibility	• Accessibility to IVF clinics from community and pediatric hospitals • Emergency accessibility to IVF clinics for cancer patients on strict treatment timelines
Physical comfort	• Assistance with hormone injections • Private areas within IVF clinics devoted exclusively to young (and often single) MEF patients, apart from couple-oriented infertility patient waiting areas
Cost	• Compassionate care discounts for patients with cancer and other fertility-threatening conditions • Income-based discounts for low-income cancer patients • Access to MEF financing, including loans and monthly payment plans • Acceptance of credit card payments for MEF services • Discounts or waivers of annual storage fees for MEF patients (who are often young and out of work)
Human factors
Adolescent issues	• Addressing fear of needles and injections and providing injection assistance • Explaining MEF physical discomforts, including transvaginal procedures • Providing extra emotional and medical support for adolescent patients
Male partner involvement	• Asking whether patient has a male partner and whether she would like to include the partner in fertility discussions • Discussing both MEF and embryo freezing, including pros and cons • Providing extra emotional support for patients whose partners have left them in the midst of a medical crisis
Family involvement	• Asking whether patient has family members, especially parents, and whether she would like to include them in MEF discussions and decisions • Incorporating parental involvement in MEF discussions and decisions with young patients • Recognizing MEF as parents’ hope for future grandchildren and attempting to alleviate pressures this might place on patients
Egg disposition decisions	• Explaining egg disposition options to sick patients, especially those with advanced cancer • Counseling patients on disposition of frozen eggs to parents, sisters, or other family members, including the pros and cons • Clearly defining guidelines on posthumous egg disposition
Emotional support	• Incorporating psychologists and social workers within IVF clinic settings who specialize in oncofertility and MEF • Providing information on oncofertility support groups, especially in IVF clinics serving many cancer patients