Making decisions

Sunday 1 May, 2016

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After a cancer diagnosis, you will probably need to make several decisions about your fertility. This can be a confusing and complex process, particularly if you have several options to consider. You may feel that everything is happening too fast.

Gather information

Generally, people make better decisions – and have fewer regrets later – if they gather information and think about the possible consequences. Understanding your fertility options and considering the pros and cons of each option may help you make a well-informed decision.

Get expert advice

Ask your health professionals to explain your treatment options and the benefits and side effects of each.

Use a decision aid

A decision aid is designed to help you make choices about different treatment options by focusing on what matters most to you. Breast Cancer Network Australia has developed a resource called fertility-related choices to help younger women with breast cancer make fertility-related decisions.

Talk it over

Discuss the options with those close to you, like your partner or a close friend. As most decisions will affect others in your life, it’s also important to consider their opinions.

Expect to experience doubts

It’s common to feel unsure when making tough decisions. Keeping a journal or blog about your experience may help you come to a decision and review and reflect on your feelings later.

The main costs for fertility treatment

Fertility treatments can be expensive, and this may be a factor in your decision. Costs vary across Australia and between organisations. Ask your doctor about Medicare rebates and talk to your provider if you have private health insurance.

Initial fertility specialist consultation and pre-treatment tests

You need a referral from your GP or a specialist obstetrician/ gynaecologist or cancer specialist to be eligible for Medicare rebates. A referral should list both you and your partner to enable you to claim the maximum benefit.

Ask the fertility specialist if they have special fees for people diagnosed with cancer, as sometimes this is the case.

The procedure (e.g. IVF cycle/day surgery)

The fees will depend on the procedure and whether you are a public or private patient.

There may be Medicare rebates for various IVF or ICSI procedures, including blood tests, fertility specialist consultations and medicines. Although there is no Medicare rebate for private day surgery procedures, some rebates exist for anaesthetist services.

If procedures occur in a public hospital fertility unit, there will be no fees for either day surgery or anaesthetist services. You may, however, experience lengthy delays waiting for treatment.

Egg, sperm and embryo storage/cryopreservation

These may be called advanced science costs. Storage costs vary for reproductive tissue.

It may be useful to ask about up-front payments, instalment payments and annual fees.

Reviewers: Prof Roger Hart, Medical Director of Fertility Specialists of Western Australia and Professor of Reproductive Medicine, School of Women’s and Infant Health, University of Western Australia, WA; Dr Antoinette Anazodo, Paediatric and Adolescent Oncologist, Sydney Children’s and Prince of Wales Hospitals, Director of the Sydney Youth Cancer Service, NSW; Brenda Kirkwood, 13 11 20 Consultant, Cancer Council Queensland, QLD; Dr Michael McEvoy, Director of Clinical Services, Flinders Fertility, SA; Eden Robertson, Research Officer, Behavioural Sciences Unit, Sydney Children’s Hospital, NSW; Kayla Schmidt, Consumer; A/Prof Kate Stern, Head of Fertility Preservation Service, The Royal Women’s Hospital and Melbourne IVF, Head Endocrine and Metabolic Service, Royal Women’s Hospital and Clinical Director, Melbourne IVF, VIC; and Prof Jane Ussher, Centre for Health Research, Western Sydney University, NSW.

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