Interpretation
cancer, cancer treatmentIn, infertility
CANCER
OC’s popularity for fertility preservation is increasing despite debates regarding its applications. Decision-making is challenging because of uncertainty surrounding the utilization rates of frozen oocytes and thus the effectiveness of the procedure. This knowledge gap hinders comprehensive ethical and cost-effectiveness analyses, which are otherwise powerful decision-making tools. Nevertheless, fertility preservation with OC is accepted in accordance with the ethical principles of autonomy (e.g. individual reproductive choices), beneficence (e.g. avoiding infertility), non-maleficence (e.g. acceptable health risks), and justice (i.e. fairness from a societal perspective)Previous surveys have studied attitudes towards OC for age-related concerns, although very few have compared them with attitudes towards OC when fertility is threatened by a medical condition or treatment. Planned OC receives variable support among young adult women internationallySignificant differences in attitudes towards medical versus age-related applications of OC are suggested by previous surveys. In a survey among Irish women, 72% would consider OC for fertility preservation but 25% only approved it for medical reasons as before cancer treatmentIn contrast, our results show no significant differences in attitudes toward general and personal use of OC, or in the WTP, in a medical or age-related scenario. One possible explanation concerns the timing and population of the different surveys. Awareness and acceptance for OC have likely increased through time and may be particularly high in specific populations, such as young adult university students. Another explanation is that our study investigated attitudes in relation to two scenarios that were almost identical except for the threat to fertility (medical versus purely age-related). More importantly, only one scenario was randomly delivered within each survey to counteract bias that can influence responses when different indications are evaluated side-by-side, as competing alternativesIndeed, public funding appeared less obvious than the use of OC itself in this study. Not all respondents agreed with it for medical reasons even if that is available in Sweden, and significantly less approved it in the age-related scenario. This is consistent with a previous Canadian survey where more respondents approved public funding for cancer patients (80.2%) than for women who are not “ready to have a child” (45.4%)WTP estimates in our study were not significantly predicted by reported income, regardless of the scenario. It is beyond the scope of this study to provide an empirical explanation to this finding, but its interpretation should take into account the potential influence that fairness, efficiency or sustainability considerations may have on preferences in social insurance contexts such as the Swedish/European one, which could be further explored in qualitative studies