1
|
Foster KL, Lee DJ, Witchel SF, Gordon CM. Ovarian Insufficiency and Fertility Preservation During and After Childhood Cancer Treatment. J Adolesc Young Adult Oncol 2024; 13:377-388. [PMID: 38265460 DOI: 10.1089/jayao.2023.0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
Premature ovarian insufficiency (POI) is one of many potential long-term consequences of childhood cancer treatment in females. Causes of POI in this patient population can include chemotherapy, especially alkylating agents, and radiation therapy. Rarely, ovarian tumors lead to ovarian dysfunction. POI can manifest as delayed pubertal development, irregular menses or amenorrhea, and infertility. This diagnosis often negatively impacts emotional health due to the implications of impaired ovarian function after already enduring treatment for a primary malignancy. The emerging adult may be challenged by the impact on energy level, quality of life, and fertility potential. POI can also lead to low bone density and compromised skeletal strength. This review discusses the health consequences of POI in childhood cancer survivors (CCS). We also explore the role of fertility preservation for CCS, including ovarian tissue cryopreservation and other available options. Lastly, knowledge gaps are identified that will drive a future research agenda.
Collapse
Affiliation(s)
- Kayla L Foster
- Texas Children's Cancer and Hematology Center, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - Danielle J Lee
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Selma F Witchel
- Division of Pediatric Endocrinology, Department of Pediatrics, UPMC Children's Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Catherine M Gordon
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| |
Collapse
|
2
|
Kayiira A, McLaughlin S, John JN, Zaake D, Xiong S, Balagadde JK, Gomez-Lobo V, Wabinga H, Ghebre R. Future Fertility Among Pediatric Cancer Patients: Experiences and Perspectives of Health Workers in a Low-Resource Setting. J Adolesc Young Adult Oncol 2024. [PMID: 38613474 DOI: 10.1089/jayao.2024.0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2024] Open
Abstract
Purpose:Although fertility preservation for patients with childhood and adolescent cancer is considered standard of care in the high-resource settings, it is rarely offered in low-resource settings. This study explores the experiences and perspectives of oncology health care professionals in Uganda to identify contextual barriers and facilitators to addressing oncofertility in low-resource settings. Methods: Using ground theory, we conducted in-depth face-to-face interviews of health care professionals managing pediatric patients at the Uganda Cancer Institute (UCI). Using a systematic, semi-structured interview guide, participants were asked open-ended questions about their understanding of fertility preservation and their perspectives on implementing this care at their institution. Although all the eligible health care providers were interviewed, interview transcripts were uploaded into NVivo version 12 and openly coded as per theoretical requirements. Codes were refined into categories and later into structured themes. Results: Twelve health care professionals were interviewed. Most participants identified as female (n = 9). Their role in the medical team varied from nurses (n = 6), medical officers (n = 3), pediatric oncologists (n = 2), and pediatric oncology fellow (n = 1). Six themes were noted as follows: (1) importance of information, (2) importance of future fertility, (3) inadequate consideration to future fertility, (4) communication barriers, (5) inadequate knowledge, and (6) resource barriers. Conclusion: Although health care providers at the UCI face contextual barriers to addressing future fertility among patients with pediatric cancer, they value preserving fertility in this population. Future initiatives that aim to introduce oncofertility care in low-resource settings should prioritize educating providers and building capacity to meet the oncofertility needs in this setting.
Collapse
Affiliation(s)
- Anthony Kayiira
- Department of Obstetrics and Gynaecology, Uganda Martyrs University School of Medicine, Kampala, Uganda
- Department of Reproductive Endocrinology and Infertility, Mulago Specialized Women's and Neonatal Hospital, Kampala, Uganda
| | - Sarah McLaughlin
- Georgetown University School of Medicine, Washington, District of Columbia, USA
| | | | - Daniel Zaake
- Department of Obstetrics and Gynaecology, Uganda Martyrs University School of Medicine, Kampala, Uganda
| | - Serena Xiong
- University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | | | - Veronica Gomez-Lobo
- Department of Pediatric and Adolescent Gynecology, Eunice Kennedy Shriver National Institute of Child Health, and Human Development, Bethesda, Maryland, USA
| | - Henry Wabinga
- Kampala Cancer Registry, Makerere University College of Health Sciences, Kampala, Uganda
| | - Rahel Ghebre
- Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
3
|
Gupta D, Singh S, Shukla S, Shrivastava S. Oncofertility: Treatment options from bench to bedside. CANCER PATHOGENESIS AND THERAPY 2023; 1:284-289. [PMID: 38327602 PMCID: PMC10846294 DOI: 10.1016/j.cpt.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/05/2023] [Accepted: 05/10/2023] [Indexed: 02/09/2024]
Abstract
In recent years, there has been continuous improvement in the treatment and diagnosis of cancer, which has led to a significant improvement in the survival rate of cancer patients. Treatments that include chemotherapy, radiotherapy, surgery, or combined therapy have several side effects that may lead to premature ovarian insufficiency in females or substantial male germ cell loss. Reproductive biologists recommend that all patients who are diagnosed with a malignant tumor must undergo a consultation for fertility protection and preservation. In this review, we discuss the background knowledge, methods, and options for fertility preservation and how these new strategies help oncologists, surgeons, pediatricians, and hematologists, conserve fertility and be aware of the concepts, methods, and importance of fertility guards. This review may aid in the advancement of novel personalized methods for fertility preservation according to patients' conditions.
Collapse
Affiliation(s)
- Divya Gupta
- Reproductive Biology and Toxicology Lab, SOS in Zoology, Jiwaji University, Gwalior, Madhya Pradesh 474011, India
| | - Shubham Singh
- Department of Zoology, Guru Ghasidas Vishwavidyalaya, Bilaspur (C.G.) 495009, India
| | - Sangeeta Shukla
- Reproductive Biology and Toxicology Lab, SOS in Zoology, Jiwaji University, Gwalior, Madhya Pradesh 474011, India
| | - Sadhana Shrivastava
- Reproductive Biology and Toxicology Lab, SOS in Zoology, Jiwaji University, Gwalior, Madhya Pradesh 474011, India
| |
Collapse
|