Bridging the gap: An outlook of oncofertility care in Africa

Abstract

This article examines existing literature on oncofertility in Africa and explores the barriers to oncofertility care. Patient-level barriers include lack of awareness about fertility preservation options, financial constraints, and the heavy emotional burden of cancer diagnosis and treatment. Healthcare-provider barriers encompass lack of awareness, prioritization of prompt cancer treatment, and implicit biases. Health-system barriers include limited facilities that can provide assisted reproductive technologies, limited insurance coverage for oncofertility services, weak referral systems, and the absence of national guidelines on oncofertility care. Socio-cultural barriers include religious objections, misinformation contributing to mistrust of fertility preservation options, and ethical dilemmas related to discussing future fertility with cancer patients whose primary focus is survival or with pediatric patients. This article also explores ways of improving oncofertility care in the region. These include educational initiatives for healthcare providers, capacity building, incorporation of oncofertility services into national cancer control programs, development of a centralized referral system, telemedicine, and increasing awareness to cancer patients.