1
|
Lau LS, Allingham C, Anazodo A, Sullivan M, Peate M, Hunter S, Stern C, Ryan AL, Super L, Orme LM, McCarthy M, Gook D, Lewin J, Marino J, Ryan J, Downie P, Manudhane R, Winstanley M, Pettit T, Lantsberg D, Irving H, Reid S, Heath JA, Kabalan-Baeza P, Wanaguru D, Moore L, Gillam L, Zacharin M, Assis M, Rozen G, Hunter T, Julania S, Sharwood E, Ameratunga D, Jayasinghe Y. The Australian New Zealand Consortium in Children, Adolescents, and Young Adults Oncofertility action plan. Pediatr Blood Cancer 2024; 71:e31041. [PMID: 38715224 DOI: 10.1002/pbc.31041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 03/25/2024] [Accepted: 04/12/2024] [Indexed: 05/24/2024]
Abstract
International and national oncofertility networks, including the US-led Oncofertility Consortium, FertiProtekt, and the Danish Network, have played pivotal roles in advancing the discipline of oncofertility over the last decade. Many other countries lack a shared approach to pediatric oncofertility health service delivery. This study aims to describe baseline oncofertility practices at Australian New Zealand Children's Haematology/Oncology Group centers in 2019-2021, describe binational priorities for care, and propose a 5-year action plan for best practice to be implemented by the newly formed Australian New Zealand Consortium in Children, Adolescents, and Young Adults (CAYA) Oncofertility (ANZCO).
Collapse
Affiliation(s)
- Lei Shong Lau
- Department of Obstetrics, Gynaecology and Newborn Health, Royal Women's Hospital, University of Melbourne, Parkville, Melbourne, Victoria, Australia
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Catherine Allingham
- Department of Obstetrics, Gynaecology and Newborn Health, Royal Women's Hospital, University of Melbourne, Parkville, Melbourne, Victoria, Australia
| | - Antoinette Anazodo
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia
- School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Michael Sullivan
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Michelle Peate
- Department of Obstetrics, Gynaecology and Newborn Health, Royal Women's Hospital, University of Melbourne, Parkville, Melbourne, Victoria, Australia
| | - Sarah Hunter
- Starship Blood and Cancer Centre, Starship Hospital Te Whatu Ora-Health New Zealand, Auckland, New Zealand
| | - Catharyn Stern
- Department of Reproductive Services, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Anne Louise Ryan
- Department of Oncology and Haematology, Perth Children's Hospital, Perth, Western Australia, Australia
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Leanne Super
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, Victoria, Australia
- Children's Cancer Centre, Monash Children's Hospital, Melbourne, Victoria, Australia
- Monash University, Melbourne, Victoria, Australia
| | - Lisa M Orme
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Maria McCarthy
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Debra Gook
- Department of Obstetrics, Gynaecology and Newborn Health, Royal Women's Hospital, University of Melbourne, Parkville, Melbourne, Victoria, Australia
- Department of Reproductive Services, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Jeremy Lewin
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Victorian Adolescent & Young Adult Cancer Service, Melbourne, Victoria, Australia
| | - Jennifer Marino
- Department of Obstetrics, Gynaecology and Newborn Health, Royal Women's Hospital, University of Melbourne, Parkville, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Jessica Ryan
- Cancer Centre for Children, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Peter Downie
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, Victoria, Australia
- Children's Cancer Centre, Monash Children's Hospital, Melbourne, Victoria, Australia
- Monash University, Melbourne, Victoria, Australia
| | - Rebecca Manudhane
- Michael Rice Centre for Haematology and Oncology, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Mark Winstanley
- Starship Blood and Cancer Centre, Starship Hospital Te Whatu Ora-Health New Zealand, Auckland, New Zealand
| | - Tristan Pettit
- Children's Haematology Oncology Centre, Waipapa Hospital, Christchurch, New Zealand
| | - Daniel Lantsberg
- Department of Obstetrics, Gynaecology and Newborn Health, Royal Women's Hospital, University of Melbourne, Parkville, Melbourne, Victoria, Australia
- Department of Reproductive Services, Royal Women's Hospital, Melbourne, Victoria, Australia
- Melbourne IVF, Melbourne, Victoria, Australia
| | - Helen Irving
- Oncology Services Group, Children's Health Queensland Hospital and Health Service, University of Queensland, Brisbane, Queensland, Australia
| | - Sally Reid
- University of Adelaide, Adelaide, South Australia, Australia
| | - John A Heath
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
- Department of Pediatrics, Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Paola Kabalan-Baeza
- Hunter and Northern New South Wales Youth Cancer Service, John Hunter Children's Hospital, New Lambton Heights, New South Wales, Australia
| | - Dylan Wanaguru
- School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Department of Pediatric Surgery, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Lyndal Moore
- Hunter and Northern New South Wales Youth Cancer Service, Calvary Mater Hospital, Waratah, New South Wales, Australia
| | - Lynn Gillam
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Children's Bioethics Centre, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Margaret Zacharin
- Department of Endocrinology & Diabetes, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Michael Assis
- Department of Obstetrics, Gynaecology and Newborn Health, Royal Women's Hospital, University of Melbourne, Parkville, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Oncofertility Service, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Genia Rozen
- Department of Reproductive Services, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Tamara Hunter
- Perth Children's Hospital, Perth, Western Australia, Australia
| | - Shital Julania
- Department of Oncology and Haematology, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Erin Sharwood
- Department of Endocrinology and Diabetes, Queensland Children's Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Herston, Queensland, Australia
| | - Devini Ameratunga
- Gynaecology and Women's Service, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Yasmin Jayasinghe
- Department of Obstetrics, Gynaecology and Newborn Health, Royal Women's Hospital, University of Melbourne, Parkville, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Oncofertility Service, Royal Children's Hospital, Melbourne, Victoria, Australia
| |
Collapse
|
2
|
Takae S, Harada M, Nakamura K, Furuyama S, Ono M, Osuga Y, Suzuki N. Survey on the implementation status and reproductive outcomes of oocyte and ovarian tissue cryopreservation in Japan: Historical comparison with nationwide surveys. J Obstet Gynaecol Res 2024; 50:709-718. [PMID: 38263596 DOI: 10.1111/jog.15893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/08/2024] [Indexed: 01/25/2024]
Abstract
PURPOSE To clarify the reproductive outcomes of fertility preservation (FP) treatment. METHODS We conducted a mailed-in questionnaire survey at institutions certified by the Japan Society of Obstetrics and Gynecology to investigate the number of oocyte cryopreservations (OC) and ovarian tissue cryopreservations (OTC) performed from December 2016 to the end of 2020. And, we conducted a detailed investigation of cases in which frozen specimens were used during the investigation period, and made historical comparisons with previous nationwide studies. RESULTS Responses were received from 114 out of 150 facilities (response rate: 76.0%) for OC and 43 out of 51 for OTC (response rate: 84.3%). Breast cancer was the most common disease among patients whose FP specimens were used. During the study period, 1237 OCs and 198 OTCs were performed. In addition, 57 cycles of embryo transfer (ET) using cryopreserved oocytes and 12 cases of ovarian tissue transplantation (OTT) were performed. The mean age of patients who underwent ET using cryopreserved oocytes was 34.8 (±5.8) years, with a median age of 36 years. The pregnancy rate per ET using cryopreserved oocytes was 26.3% and the live birth rate (LBR) was 17.5%. Further, the LBR per patient was 43.3%, and the pregnancy rate following OTTs was 33.3%. Also, controlled ovarian stimulation using the random start method or the combination of aromatase inhibitors had no effect on pregnancy outcome. CONCLUSION Implementation of both OCs and OTCs have markedly increased over time in Japan, with comparable reproductive outcomes as other reports.
Collapse
Affiliation(s)
- Seido Takae
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki City, Kanagawa, Japan
| | - Miyuki Harada
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kentaro Nakamura
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki City, Kanagawa, Japan
| | - Sayako Furuyama
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki City, Kanagawa, Japan
| | - Masanori Ono
- Department of Obstetrics and Gynecology, Tokyo Medical University, Tokyo, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki City, Kanagawa, Japan
| |
Collapse
|
3
|
Takae S, Harada M, Nakamura K, Furuyama S, Ono M, Osuga Y, Suzuki N. Reproductive outcomes of embryo cryopreservation and transfer at the start-up phase of fertility preservation in Japan. Reprod Med Biol 2024; 23:e12581. [PMID: 38899000 PMCID: PMC11185938 DOI: 10.1002/rmb2.12581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 04/18/2024] [Accepted: 04/29/2024] [Indexed: 06/21/2024] Open
Abstract
Purpose To verify the effectiveness of embryo transfer (ET) using cryopreserved embryo as fertility preservation (FP). Methods This study was a questionnaire survey. The total number of embryo cryopreservation (EC) was investigated between 2014 and 2020. And for patients who underwent ET among study period, details of EC, outcome of ET, number of live births, and mortality were investigated. Results Of the 150 facilities, 114 responded (76.0%). A total of 1420 EC were performed during the study period; and ET was performed for 417 patients. Breast cancer was the most common primary disease. A total of 199 live births (including prospective) were obtained by ET; 1.7 EC and 2.2 ET were performed per patient, and live birth rate was 21.4% per ET (28.1% on 35-37-year-old patients). The number of EC and ET increased with age. The final birth rate, including pregnancies other than FP, was 51.8%. Ovarian stimulation with aromatase inhibitors was commonly used, although with no effect on live birth rates. Random start stimulation was also common, experienced by 36.3% of breast cancer patients. Conclusion Reproductive outcomes of ETs following EC as FP are acceptable. This research project was registered in the University Hospital Medical Information Network (UMIN000043664).
Collapse
Affiliation(s)
- Seido Takae
- Department of Obstetrics and GynecologySt. Marianna University School of MedicineKawasaki CityKanagawaJapan
| | - Miyuki Harada
- Department of Obstetrics and Gynecology, Faculty of MedicineThe University of TokyoBunkyo‐kuTokyoJapan
| | - Kentaro Nakamura
- Department of Obstetrics and GynecologySt. Marianna University School of MedicineKawasaki CityKanagawaJapan
| | - Sayako Furuyama
- Department of Obstetrics and GynecologySt. Marianna University School of MedicineKawasaki CityKanagawaJapan
| | - Masanori Ono
- Department of Obstetrics and GynecologyTokyo Medical UniversityShinjuku‐kuTokyoJapan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Faculty of MedicineThe University of TokyoBunkyo‐kuTokyoJapan
| | - Nao Suzuki
- Department of Obstetrics and GynecologySt. Marianna University School of MedicineKawasaki CityKanagawaJapan
| |
Collapse
|
4
|
Prades S, Jos SL, Saïas-Magnan J, Bujan L, Eustache F, Blagosklonov O, Lechevallier E, Brugnon F, Loup-Cabaniols V, Bosquet D, Prades M, Ducrocq B, Chalas C, Giscard-d'Estaing S, Mayeur A, Koscinsky I, Schmitt F, Papaxanthos-Roche A, Teletin M, Thibault E, Beauvillard D, Mirallie S, Delepine B, Benhaim A, May-Panloup P, Veau S, Frapsauce C, Fauque P, Costello R, Rives N, Metzler-Guillemain C, Perrin J. Efficient pathway for men fertility preservation in testicular cancer or lymphoma: a cross-sectional study of national 2018 data. Basic Clin Androl 2023; 33:35. [PMID: 38082221 PMCID: PMC10714657 DOI: 10.1186/s12610-023-00209-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 09/29/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND In 15-49 years-old men, the main cancers are testicular cancer (TC) and lymphomas (L): freezing of ejaculated sperm is primarily used for male fertility preservation (FP) before cancer treatment. Our objective was to analyze the French FP rate in 15-49 years-old men diagnosed with TC or L in 2018. We designed a national descriptive cross-sectional study of sperm banking rate in men with a diagnosis of TC, Hodgkin L (HL) or non-Hodgkin L (NHL). From the French National Cancer Institute (INCa) 2018 data, we extracted the estimated incidence of TC and L in metropolitan France. From the 2018 activity report of CECOS network (Centers for Study and Banking of Eggs and Sperm), we extracted the number of men with TC or L who banked ejaculated sperm. We estimated the proportion of 15-49 years-old men diagnosed with TC or L who banked sperm. RESULTS Among 15-49 years-old men, INCa estimated 38,048 new cancer diagnoses in metropolitan France in 2018: 2,630 TC and 3,913 L (943 HL and 2,970 NHL). The CECOS network provided data from 26/27 metropolitan centers (96% response rate): 1,079 sperm banking for men with TC, 375 for HL and 211 for NHL. We estimated that the 2018 sperm banking rate in France was 41% for TC, 40% for HL, and 7% for NHL. CONCLUSIONS To our knowledge, our paper is the first cross-sectional study with multicenter and national data analyzing FP rate in cancer men: it suggests an efficient pathway for men to FP before cancer treatment, compared to previously published studies. Although sperm banking rate in 15-49 years-old men could definitely be improved, further studies should evaluate the information given to patients before gonadotoxic treatments, the factors associated with the absence of sperm banking and whether this lack of referral induces a loss of chance for these men.
Collapse
Affiliation(s)
- Ségolène Prades
- CECOS/Laboratory of Reproductive Biology, La Conception University Hospital, 13385, Marseille, France
| | - Sarah-Lyne Jos
- CECOS/Laboratory of Reproductive Biology, La Conception University Hospital, 13385, Marseille, France
| | - Jacqueline Saïas-Magnan
- CECOS/Laboratory of Reproductive Biology, La Conception University Hospital, 13385, Marseille, France
| | - Louis Bujan
- DEFE (Développement Embryonnaire, Fertilité, Environnement) INSERM, Universités Montpellier Et Toulouse 3, CECOS Hôpital Paule de Viguier, CHU de Toulouse, 1202, Toulouse, France
| | - Florence Eustache
- CECOS, Site Jean Verdier, Hôpitaux Universitaires Paris Seine-Saint-Denis, Bondy, France
- Genomics, Epigenetics and Physiopathology of Reproduction, Institut Cochin, Inserm U1016, Paris, France
| | - Oxana Blagosklonov
- Service de Biologie Et Medecine de La Reproduction, Cryobiologie-CECOS, CHRU Jean Minjoz, Besançon, France
| | - Eric Lechevallier
- Service d'Urologie et Transplantation Rénale, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Florence Brugnon
- 1240 IMOST, INSERM, Clermont Ferrand, France
- Service AMP CECOS, CHU Clermont Ferrand, Clermont Ferrand, France
| | - Vanessa Loup-Cabaniols
- CECOS Languedoc Roussillon, MONTPELLIER Hôpital Arnaud de Villeneuve, Montpellier, France
| | - Dorian Bosquet
- Service de Médecine Et Biologie de la Reproduction - CECOS-CHU Amiens Picardie - Site Sud, Amiens, France
| | - Marie Prades
- Service de Biologie de La Reproduction-CECOS, Hôpital Tenon (AP-HP), Sorbonne-Université, 75020, PARIS, France
| | - Bérengère Ducrocq
- Institut de Biologie de la Reproduction - CECOS Hôpital Calmette, CHU de Lille, Lille, France
| | - Céline Chalas
- Laboratoire de Biologie de la Reproduction-CECOS, Assistance Publique-Hôpitaux de Paris.Centre Université Paris-Cité, GHU Cochin, Paris, France
| | - Sandrine Giscard-d'Estaing
- Biologie de La Reproduction, U1208, Hospices Civil de Lyon, HFME, Inserm, Bron, France
- Faculté de Médecine Lyon Sud, Université Claude Bernard, Oullins, France
| | - Anne Mayeur
- Reproductive Biology Department, CECOS, Paris-Saclay University, Antoine-Béclère Hospital, APHP, Clamart, France
| | - Isabelle Koscinsky
- NGERE (Nutrition Génétique Et Exposition Aux Risques Environnementaux) INSERM 1256 Université de Lorraine, 10 Avenue de La Forêt de Haye, 54505, Vandoeuvre Les Nancy, France
- Laboratoire de Biologie de La Reproduction, Hôpital Saint Joseph 26 Boulevard de Louvain, 13008, Marseille, France
| | - Françoise Schmitt
- CECOS ALSACE Mulhouse Groupe Hospitalier, de La Région de Mulhouse Et Sud Alsace, Mulhouse, France
| | | | - Marius Teletin
- Institut de Génétique Et de Biologie Moléculaire Et Cellulaire (IGBMC), Université́ de Strasbourg, France-LBDR-CECOS, Hôpitaux Universitaires de Strasbourg (HUS), , Strasbourg, France
| | - Emmanuelle Thibault
- Laboratoire de Biologie de la Reproduction - CECOS Hôpital L'Archet 2 - CHU de Nice, Nice, France
| | | | - Sophie Mirallie
- Service de Médecine Et Biologie de La Reproduction, CHU Nantes, France
| | - Béatrice Delepine
- Service de Biologie de La Reproduction Reims - Pôle de Biologie Médicale Et Pathologie, Reims, France
| | - Annie Benhaim
- Service de Biologie de La Reproduction Coordinatrice Clinico-Biologique du Centre d'AMP du CHU de Caen Pôle de Biologie-CHU, Caen, France
| | - Pascale May-Panloup
- Biologie de La Reproduction, Centre Hospitalier Universitaire & Univ Angers, INSERM, CNRS, MITOVASC, Equipe MitoLab, SFR ICAT, 49000, Angers, France
| | - Ségolène Veau
- Service de Biologie de La Reproduction-CECOS, CHU Rennes - Hôpital Sud, Rennes, France
| | - Cynthia Frapsauce
- Service de Médecine Et de Biologie de La Reproduction-CECOS, CHRU Bretonneau, Tours, France
| | - Patricia Fauque
- Burgundy University, INSERM 1231, Dijon, France
- Dijon University Hospital, Biology of Reproduction-CECOS Laboratory, Dijon, France
| | - Régis Costello
- Service d'Hématologie Et Thérapie Cellulaire, Hôpital La Conception, Assistance Publique Des Hôpitaux de Marseille, 147 Boulevard Baille, 13005, Marseille, France
| | - Nathalie Rives
- NorDiC UMR 1239, team "Adrenal and Gonadal Pathophysiology", Biology of Reproduction-CECOS Laboratory, Univ Rouen Normandie, Inserm, Rouen University Hospital, Rouen, France
| | - Catherine Metzler-Guillemain
- CECOS/Laboratory of Reproductive Biology, La Conception University Hospital, 13385, Marseille, France
- Aix Marseille Univ, INSERM, MMG, UMR_S1251, Marseille, France
| | - Jeanne Perrin
- CECOS/Laboratory of Reproductive Biology, La Conception University Hospital, 13385, Marseille, France.
- Aix Marseille Univ, Avignon Université, CNRS, IRD, IMBE, Marseille, France.
| |
Collapse
|
5
|
Germeyer A, Nawroth F. [Indication and implementation of fertility preservation measures in female cancer patients]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023:10.1007/s00105-023-05171-0. [PMID: 37314451 DOI: 10.1007/s00105-023-05171-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 05/04/2023] [Indexed: 06/15/2023]
Abstract
The aspects of fertility preservation in women prior to surgical, gonadotoxic or radiation therapy represent a challenging topic in many disciplines and often in an interdisciplinary setting. Within an often short period of time, individual counselling and consideration must be given as to whether fertility-protective measures are useful. The implementation is ultimately decided by the patient. A prerequisite for helpful counselling is knowledge about the potential effects of cancer treatment on ovarian function as well as the implementation and potential individual benefits of fertility-protective measures. Networks such as FertiPROTEKT Netzwerk e. V. are helpful for orientation in terms of content and timely implementation of counselling and corresponding measures.
Collapse
Affiliation(s)
- Ariane Germeyer
- Gynäkologische Endokrinologie und Fertilitätsstörungen, Universitäts-Frauenklinik Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Deutschland.
| | - Frank Nawroth
- Facharzt-Zentrum für Kinderwunsch, Pränatale Medizin, Endokrinologie und Osteologie, amedes MVZ Hamburg, Hamburg, Deutschland
| |
Collapse
|
6
|
Ozimek N, Salama M, Woodruff TK. National oncofertility registries around the globe: a pilot survey. Front Endocrinol (Lausanne) 2023; 14:1148314. [PMID: 37223027 PMCID: PMC10200897 DOI: 10.3389/fendo.2023.1148314] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/12/2023] [Indexed: 05/25/2023] Open
Abstract
Purpose Oncofertility is an emerging discipline which aims to preserve fertility of young cancer patients. As fertility preservation services have become increasingly available to cancer patients in many countries around the globe, it is crucial to establish a foundation of collaborative reporting to continuously monitor and assess oncofertility practices. This survey study investigates the current global landscape of official national oncofertility registries, a vital tool which allows for surveillance of the field. Methods An online pilot survey was conducted to give the opportunity to report official national oncofertility registries available in 2022. Survey questions covered the availability of official national registries for oncofertility as well as the official national registries for cancer and assisted reproductive technologies. Participation in the survey was voluntary, anonymous and for free. Results According to our online pilot survey, responses were collected from 20 countries including Argentina, Australia, Brazil, Canada, Chile, China, Egypt, Germany, Greece, India, Japan, Kenya, Philippines, Romania, South Africa, Thailand, Tunisia, UK, USA & Uruguay. Only 3 out of the 20 surveyed countries have well-established official national oncofertility registries; and include Australia, Germany & Japan. The Australian official national oncofertility registry is part of Australasian Oncofertility Registry that also includes New Zealand. The German official national oncofertility registry is part of FertiPROTEKT Network Registry for German speaking countries that also includes Austria & Switzerland. The Japanese official national oncofertility registry includes Japan only and called Japan Oncofertility Registry (JOFR). A supplementary internet search confirmed the aforementioned results. Therefore, the final list of countries around the globe that have official national oncofertility registries includes Australia, Austria, Germany, Japan, New Zealand, and Switzerland. Some other countries such as the USA and Denmark are on their way to establish official national registries for oncofertility care. Conclusion Although oncofertility services are expanding globally, very few countries have well-established official national oncofertility registries. By reviewing such a global landscape, we highlight the urgent need for having a well-established official national oncofertility registry in each country to monitor oncofertility services in a way that best serves patients.
Collapse
Affiliation(s)
| | - Mahmoud Salama
- Oncofertility Consortium, Michigan State University, East Lansing, MI, United States
| | - Teresa K. Woodruff
- Oncofertility Consortium, Michigan State University, East Lansing, MI, United States
| |
Collapse
|
7
|
Ligon JA, Hayashi M, Ciampa D, Kramer C, Guastella A, Fuchs RJ, Herati AS, Christianson MS, Chen AR. A multidisciplinary pediatric oncofertility team improves fertility preservation and counseling across 7 years. Cancer Rep (Hoboken) 2023; 6:e1753. [PMID: 36346013 PMCID: PMC9939996 DOI: 10.1002/cnr2.1753] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/20/2022] [Accepted: 10/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oncofertility is a developing field of increasing importance, particularly in pediatric oncology, where most patients are likely to survive long-term and have not yet had the opportunity to have children. AIMS We performed a quality improvement initiative to increase our rates of fertility preservation counseling and referral through the implementation of a pediatric oncofertility team, and we report outcomes 7 years following implementation of our initiative. METHODS AND RESULTS We compare our baseline oncofertility survey to 44 post-intervention survey respondents and electronic medical record documentation for 149 patients treated in 2019. Ninety-five percent of post-intervention survey respondents recalled fertility counseling (baseline 70%, p = .004) and 89.3% were appropriately referred for fertility preservation (baseline 50%, p = .017). Counseling was documented in 60.4% of charts; 81% of patients analyzed by chart review were appropriately referred for fertility preservation. Fertility preservation outcomes differed by sex assigned at birth. CONCLUSION Creation of an oncofertility team produced improvements in fertility counseling and fertility preservation referral across an extended period of time.
Collapse
Affiliation(s)
- John A. Ligon
- Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins University (JHU)BaltimoreMarylandUSA
- Department of Pediatrics, Division of Hematology/OncologyUniversity of FloridaGainesvilleFloridaUSA
| | - Masanori Hayashi
- Department of Pediatrics—Hematology/oncology and Bone Marrow TransplantationUniversity of ColoradoAuroraColoradoUSA
| | - Devon Ciampa
- Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins University (JHU)BaltimoreMarylandUSA
| | - Cara Kramer
- Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins University (JHU)BaltimoreMarylandUSA
| | - Alfredo Guastella
- Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins University (JHU)BaltimoreMarylandUSA
| | - Robert J. Fuchs
- Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins University (JHU)BaltimoreMarylandUSA
| | - Amin S. Herati
- James Buchanan Brady Urological Institute and Department of UrologyJHUBaltimoreMarylandUSA
| | | | - Allen R. Chen
- Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins University (JHU)BaltimoreMarylandUSA
| |
Collapse
|
8
|
Maezawa T, Takae S, Takeuchi H, Takenaka M, Ota K, Horie A, Suzuki T, Takai Y, Kimura F, Furui T, Ikeda T, Suzuki N. A Nationwide Survey Aimed at Establishing an Appropriate Long-Term Storage and Management System for Fertility Preserving Specimens in Japan. J Adolesc Young Adult Oncol 2022. [DOI: 10.1089/jayao.2021.0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Tadashi Maezawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Seido Takae
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hiroki Takeuchi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Motoki Takenaka
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Kuniaki Ota
- Department of Obstetrics and Gynecology, Tokyo Rosai Hospital, Ohta-ku, Japan
| | - Akihito Horie
- Department of Gynecology and Obstetrics, Graduate School of Medical Science, Kyoto University, Sakyo-ku, Japan
| | - Tatsuya Suzuki
- Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Japan
| | - Yasushi Takai
- Department of Obstetrics and Gynecology, Saitama Medical Center, Kawagoe, Japan
| | - Fuminori Kimura
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Japan
| | - Tatsuro Furui
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| |
Collapse
|
9
|
Wang M, Zhu L, Xiong H, Wang J, Li Z, Yang L, Jin L, Xi Q. Lack of Knowledge, the main Stumbling Block of Fertility Preservation Promotion in China. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:739-747. [PMID: 32920747 DOI: 10.1007/s13187-020-01875-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/09/2020] [Indexed: 06/11/2023]
Abstract
The aim of this study is to evaluate fertility preservation (FP) popularization in China among female cancer patients in terms of awareness of fertility, knowledge about FP, and attitudes toward FP. A questionnaire-based survey was conducted among female cancer patients in Tongji Hospital in China from March 2019 to July 2019. The 29 fertility-related issues, which were presented in either five-point Likert scales or "yes or no", in this questionnaire consisted of demographic characteristic and disease-related situation, awareness of fertility, knowledge about FP, and attitudes toward FP. Participants were required to finish the questionnaire, and data were gathered and analyzed by SPSS. Forty-five valid questionnaires without missing data remained in the final analysis. The survey discovered that a regional imbalanced limitation in knowledge of infertility risk and FP in young cancer patients acted as a major obstacle in FP promotion nationwide and FP decision-making in patients. Compared with rural patients, patients from urban areas were more eager to give birth and more likely to have a better understanding of FP with a more positive attitude. Moreover, most of the participants (62.2%) had a low level of understanding of FP, although they remained positive toward it. "Cancer treatment as the priority", "Cancer relapse caused by FP", and "Health of the next generation" were the top three factors affecting decisions on FP. The findings revealed a general FP actuality in China and specifically offered some intervention targets in the near future to improve FP service and networks, benefiting more female patients of childbearing age who are at risk of infertility.
Collapse
Affiliation(s)
- Meng Wang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lixia Zhu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hua Xiong
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiaming Wang
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, China
| | - Zhou Li
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liu Yang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Qingsong Xi
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| |
Collapse
|
10
|
Takae S, Kato K, Watanabe C, Nara K, Koizumi T, Kawai K, Ota K, Yumura Y, Yabuuchi A, Kuwahara A, Furui T, Takai Y, Irahara M, Suzuki N. A practical survey of fertility-preservation treatments in the startup phase in Japan. J Obstet Gynaecol Res 2022; 48:1061-1075. [PMID: 35274401 DOI: 10.1111/jog.15199] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/26/2022] [Accepted: 02/09/2022] [Indexed: 12/11/2022]
Abstract
AIM The actual status of fertility preservation treatments in the startup phase in Japan was investigated as a basis for discussing future directions. METHODS This study was conducted as "Research project to promote support of children and parenting 2016" which was supported by Ministry of Health in Japan with the approval of the institutional review board at St. Marianna University. Subjects of the survey were facilities registered with the Japan Society of Obstetrics and Gynecology as fertility preservation facilities, and facilities belonging to the Japan Association of Private Assisted Reproductive Technology Clinics and Laboratories. We provided questionnaires to survey both the medical care system and cases for which fertility preservation was implemented between 2006 and 2016. RESULTS Responses were obtained from 68 facilities (of the 64, 59 [92.2%] responded to the questionnaire and 9 clinics cooperated). Many facilities limited the cryopreservation of oocytes and ovaries to patients 40-41 years old and the use of eggs to patients 44-45 years old. In the patient survey, 812 cases of oocyte cryopreservation and 201 cases of ovarian tissue cryopreservation were performed during study period. Breast cancer was the most indicated disease, with oocyte cryopreservation in the late 30s and ovarian tissue cryopreservation in the early 30s. Very few babies were born from fertility preservation, and no live birth cases of ovarian tissue cryopreservation were identified. CONCLUSIONS Even from the early days, fertility preservation was implemented according to certain standards in Japan, but was characterized by a large variety of facilities.
Collapse
Affiliation(s)
- Seido Takae
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki-city, Kanagawa, Japan
| | | | - Chie Watanabe
- Faculty of Human Sciences, Sophia University, Tokyo, Japan
| | - Kazuko Nara
- Department of Clinical Psychology, Kameda Medical Center, Chiba, Japan
| | - Tomoe Koizumi
- National Research Institute for Child Health and Development, Tokyo, Japan
| | - Kiyotaka Kawai
- Department of Reproductive Medicine, Kameda Medical Center, Chiba, Japan
| | - Kuniaki Ota
- Department of Obstetrics and Gynecology, Nasu Red Cross Hospital, Tochigi, Japan
| | - Yasushi Yumura
- Reproduction Center, Yokohama City University Medical Center, Yokohama-city, Kanagawa, Japan
| | | | - Akira Kuwahara
- Department of Obstetrics and Gynecology, University of Tokushima, Tokushima, Japan
| | - Tatsuro Furui
- Department of Obstetrics and Gynecology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yasushi Takai
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama, Medical University, Saitama, Japan
| | - Minoru Irahara
- Department of Obstetrics and Gynecology, University of Tokushima, Tokushima, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki-city, Kanagawa, Japan
| |
Collapse
|
11
|
Salama M, Lambertini M, Christianson MS, Jayasinghe Y, Anazodo A, De Vos M, Amant F, Stern C, Appiah L, Woodard TL, Anderson RA, Westphal LM, Leach RE, Rodriguez-Wallberg KA, Patrizio P, Woodruff TK. Installing oncofertility programs for breast cancer in limited versus optimum resource settings: Empirical data from 39 surveyed centers in Repro-Can-OPEN Study Part I & II. J Assist Reprod Genet 2022; 39:505-516. [PMID: 35032286 PMCID: PMC8760079 DOI: 10.1007/s10815-022-02394-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/05/2022] [Indexed: 01/09/2023] Open
Abstract
PURPOSE As a further step to elucidate the actual diverse spectrum of oncofertility practices for breast cancer around the globe, we present and discuss the comparisons of oncofertility practices for breast cancer in limited versus optimum resource settings based on data collected in the Repro-Can-OPEN Study Part I & II. METHODS We surveyed 39 oncofertility centers including 14 in limited resource settings from Africa, Asia & Latin America (Repro-Can-OPEN Study Part I), and 25 in optimum resource settings from the United States, Europe, Australia and Japan (Repro-Can-OPEN Study Part II). Survey questions covered the availability of fertility preservation and restoration options offered to young female patients with breast cancer as well as the degree of utilization. RESULTS In the Repro-Can-OPEN Study Part I & II, responses for breast cancer and calculated oncofertility scores showed the following characteristics: (1) higher oncofertility scores in optimum resource settings than in limited resource settings especially for established options, (2) frequent utilization of egg freezing, embryo freezing, ovarian tissue freezing, GnRH analogs, and fractionation of chemo- and radiotherapy, (3) promising utilization of oocyte in vitro maturation (IVM), (4) rare utilization of neoadjuvant cytoprotective pharmacotherapy, artificial ovary, and stem cells reproductive technology as they are still in preclinical or early clinical research settings, (5) recognition that technical and ethical concerns should be considered when offering advanced and innovative oncofertility options. CONCLUSIONS We presented a plausible oncofertility best practice model to guide oncofertility teams in optimizing care for breast cancer patients in various resource settings.
Collapse
Affiliation(s)
- Mahmoud Salama
- Oncofertility Consortium, Michigan State University, 965 Wilson Road, Room A626B, East Lansing, MI 48824-1316 USA
| | - M. Lambertini
- Department of Medical Oncology, UOC Clinica Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - MS Christianson
- Division of Reproductive Endocrinology and Infertility, Johns Hopkins Fertility Center, Johns Hopkins University School of Medicine, 10751 Falls Road, Suite 280, Lutherville, MD 21093 USA
| | - Y. Jayasinghe
- Royal Children’s Hospital, Flemington Rd, Parkville, Melbourne, Vic 3054 Australia
- Department of Obstetrics & Gynecology, Royal Womens Hospital Melbourne, Parkville, Australia
| | - A. Anazodo
- Fertility Research Centre, Royal Hospital for Women, Barker Street, Sydney, Australia
| | - M. De Vos
- Centre for Reproductive Medicine of UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - F. Amant
- Department of Oncology, KU Leuven, Leuven, Belgium
- Department of Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - C. Stern
- Fertility Preservation Service, Reproductive Services Unit, Royal Women’s Hospital, Parkville, 3051 Australia
- Fertility Preservation Service, Melbourne IVF, East Melbourne, 3002 Australia
| | - L. Appiah
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO USA
| | - T. L. Woodard
- Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Oncofertility Program, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - R. A. Anderson
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - L. M. Westphal
- Stanford University Hospital, 300 Pasteur Drive, Stanford, CA USA
| | - R. E. Leach
- Oncofertility Consortium, Michigan State University, 965 Wilson Road, Room A626B, East Lansing, MI 48824-1316 USA
| | - K. A. Rodriguez-Wallberg
- Department of Oncology-Pathology, Karolinska University Hospital, 14186 Stockholm, Sweden
- Department of Reproductive Medicine, Division of Gynecology and Reproduction, Karolinska University Hospital, 14186 Stockholm, Sweden
| | - P. Patrizio
- Yale Fertility Center and Yale Fertility Preservation Program, 200 West Campus Dr, Orange, CT 06477 USA
| | - Teresa K. Woodruff
- Oncofertility Consortium, Michigan State University, 965 Wilson Road, Room A626B, East Lansing, MI 48824-1316 USA
| |
Collapse
|
12
|
Oktay K, Marin L, Bedoschi G, Pacheco F, Sugishita Y, Kawahara T, Taylan E, Acosta C, Bang H. Ovarian transplantation with robotic surgery and a neovascularizing human extracellular matrix scaffold: a case series in comparison to meta-analytic data. Fertil Steril 2022; 117:181-192. [PMID: 34801235 PMCID: PMC8863399 DOI: 10.1016/j.fertnstert.2021.08.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To report our experience with robot-assisted (RA) autologous cryopreserved ovarian tissue transplantation (ACOTT) with the use of a neovascularizing extracellular matrix scaffold. DESIGN Case series with meta-analytic update. SETTING Academic. PATIENT(S) Seven recipients of RA-ACOTT. INTERVENTION(S) Before or shortly after initiating chemotherapy, ovarian tissue was cryopreserved from 7 women, who then underwent RA-ACOTT 9.9 ± 1.8 years (range, 7-12 years) later. Perioperatively, they received transdermal estrogen and low-dose aspirin to enhance graft vascularization. Ovarian cortical pieces were thawed and sutured on an extracellular matrix scaffold, which was then robotically anastomosed to the bivalved remaining ovary in 6 cases and retroperitoneally (heterotopic) to the lower abdomen in 1 case. MAIN OUTCOME MEASURE(S) Ovarian function return, the number of oocytes/embryos, aneuploidy %, live births, and neonatal outcomes were recorded. Graft longevity was compared with the mean from the meta-analytic data. RESULT(S) Ovarian function returned 13.9 ± 2.7 weeks (11-16.2 weeks) after ACOTT, and oocytes were retrieved in all cases with 12.3 ± 6.9 embryos generated. In contrast to orthotopic, the heterotopic ACOTT demonstrated low embryo quality and an 80% aneuploidy rate. A recipient did not attempt to conceive and 2 needed a surrogate, whereas 4 of 4 delivered 6 healthy children, compared with 115 of 460 (25% pregnancy rate) from the meta-analytic data (n = 79). The mean graft longevity (43.2 ± 23.6/47.4 ± 22.8 months with/without sensitivity analysis) trended longer than the meta-analytic mean (29.4 ± 22.7), even after matching age at cryopreservation. CONCLUSION(S) In this series, RA-ACOTT resulted in extended graft longevity, with ovarian functions restored in all cases, even when the tissues were cryopreserved after chemotherapy exposure.
Collapse
Affiliation(s)
- Kutluk Oktay
- Laboratory of Molecular Reproduction and Fertility Preservation, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06510, USA,Innovation Institute for Fertility Preservation, New York, NY 10028, USA
| | - Loris Marin
- Laboratory of Molecular Reproduction and Fertility Preservation, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06510, USA,Department of Women’s and Children’s Health, University of Padua, Padua, PD 35100, Italy
| | - Giuliano Bedoschi
- Laboratory of Molecular Reproduction and Fertility Preservation, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06510, USA,Division of Reproductive Medicine, Department of Gynecology & Obstetrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP 14049-900, Brazil
| | - Fernanda Pacheco
- Innovation Institute for Fertility Preservation, New York, NY 10028, USA,Classiclínica, Porto Alegre, Rio Grande do Sul, 90000-000, Brazil
| | - Yodo Sugishita
- Laboratory of Molecular Reproduction and Fertility Preservation, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06510, USA,St Marianna University, Yokohama, Japan
| | - Tai Kawahara
- Laboratory of Molecular Reproduction and Fertility Preservation, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06510, USA,St Marianna University, Yokohama, Japan
| | - Enes Taylan
- Laboratory of Molecular Reproduction and Fertility Preservation, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Carlo Acosta
- Innovation Institute for Fertility Preservation, New York, NY 10028, USA
| | - Heejung Bang
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, CA 95616, USA
| |
Collapse
|
13
|
Biskup E, Xin Z, Li R, Zucal JP, Lu Y, Sun Y, Appiah LC, Lindheim SR, Zhang H. Oncofertility Knowledge and Communication: Comparison Between Medical and Surgical Oncologists and Breast Cancer Patients in Academic Chinese Centers. Front Surg 2021; 8:681614. [PMID: 34557514 PMCID: PMC8453209 DOI: 10.3389/fsurg.2021.681614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022] Open
Abstract
Background: As cancer has become a major public health issue in China, fertility preservation remains limited despite the wide application of Assisted Reproductive Technology (ART) throughout the country. Objective: This study aimed to identify gaps in knowledge and communication as well as referrals in the previous year regarding oncofertility among medical and surgical oncologists and breast cancer patients (BCPs) in Chinese academic settings to target areas of needed improvement. Materials and Methods: A WeChat online questionnaire was designed, distributed, and compared between medical and surgical oncology specialists and reproductive age BCPs in academic teaching settings in Shanghai. Results: Sixty-one medical and surgical oncologists and 125 BCPs responded to the survey. 63.3% of oncologists were familiar with the term “oncofertility” compared to 25.6% of BCPs (p < 0.001). Oncologists were more likely to correctly know the costs associated with treatment (59.0 vs. 32.0%, p < 0.001); patient did not have to be married to undergo oncofertility treatment (50.8 vs. 24.8%, p < 0.001). Both oncologists and BCPs were similarly unlikely to know when patients could utilize cryopreserved tissue in the future (37.7 vs. 22.2%, p = 0.056). While oncologists reported they discussed all oncofertility options (41.0%) and offered psychological counseling (98.4%), significantly fewer BCPs reported receiving information on all options and offered counseling (3.2%, p < 0.001 and 85.6%, p < 0.01). Knowledge of oncofertility was the most important predictor for providing and receiving counseling from oncologists [OR = 6.44 (95% CI = 1.59–26.1, p = 0.009] and BCPs (OR = 3.73 95% CI: = 1.36–10.2, p = 0.011). Overall, 57.4% of oncologists referred <10 patients and none referred more than 25 patients in the past year. Conclusion: Data suggests a significant knowledge gap and ineffective communication/comprehension exists between academic Chinese oncologists and BCPs. Continued education and raised awareness are needed to optimize utilization of oncofertility services in China.
Collapse
Affiliation(s)
- Ewelina Biskup
- Department of Medical Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Department of Basic and Clinical Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China.,International Center for Multimorbidity and Complexity in Medicine (ICMC), Universität Zürich, Zürich, Switzerland
| | - Zhaochen Xin
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Rui Li
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - John P Zucal
- Wright State University Boonshoft School of Medicine, Dayton, OH, United States
| | - Yao Lu
- Center for Reproductive Medicine, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Yun Sun
- Center for Reproductive Medicine, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Leslie Coker Appiah
- Department of Obstetrics and Gynecology, The University of Colorado, Denver, CO, United States
| | - Steven R Lindheim
- Wright State University Boonshoft School of Medicine, Dayton, OH, United States.,Center for Reproductive Medicine, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hongwei Zhang
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
14
|
Hassel JC, Livingstone E, Allam JP, Behre HM, Bojunga J, Klein HH, Landsberg J, Nawroth F, Schüring A, Susok L, Thoms KM, Kiesel L, Berking C. Fertility preservation and management of pregnancy in melanoma patients requiring systemic therapy. ESMO Open 2021; 6:100248. [PMID: 34438241 PMCID: PMC8390524 DOI: 10.1016/j.esmoop.2021.100248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/21/2021] [Accepted: 07/27/2021] [Indexed: 01/09/2023] Open
Abstract
Melanoma is one of the most common cancers in adolescents and adults at fertile age, especially in women. With novel and more effective systemic therapies that began to profoundly change the dismal outcome of melanoma by prolonging overall survival, the wish for fertility preservation or even parenthood has to be considered for a growing portion of melanoma patients-from the patients' as well as from the physicians' perspective. The dual blockade of the mitogen-activated protein kinase pathway by B-Raf proto-oncogene serine/threonine kinase and mitogen-activated protein kinase inhibitors and the immune checkpoint inhibition by anti-programmed cell death protein 1 and anti-cytotoxic T-lymphocyte-associated protein-4 monoclonal antibodies constitute the current standard systemic approaches to combat locally advanced or metastatic melanoma. Here, the preclinical data and clinical evidence of these systemic therapies are reviewed in terms of their potential gonadotoxicity, teratogenicity, embryotoxicity and fetotoxicity. Recommendations for routine fertility and contraception counseling of melanoma patients at fertile age are provided in line with interdisciplinary recommendations for the diagnostic work-up of these patients and for fertility-protective measures. Differentiated recommendations for the systemic therapy in both the adjuvant and the advanced, metastatic treatment situation are given. In addition, the challenges of pregnancy during systemic melanoma therapy are discussed.
Collapse
Affiliation(s)
- J C Hassel
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - E Livingstone
- Department of Dermatology, University Hospital Essen, Essen, Germany
| | - J P Allam
- Department of Andrology, University Hospital Bonn, Bonn, Germany
| | - H M Behre
- Center for Reproductive Medicine and Andrology, University Hospital Halle (Saale), Halle (Saale), Germany
| | - J Bojunga
- Department of Endocrinology, Diabetology and Nutrition Medicine, University Hospital Frankfurt, Frankfurt, Germany
| | - H H Klein
- Department of Internal Medicine, Endocrinology & Diabetology & Gastroenterology and Hepatology, BG University Hospital Bergmannsheil Bochum, Bochum, Germany
| | - J Landsberg
- Department of Dermatology and Allergy, University Hospital Bonn, Bonn, Germany
| | - F Nawroth
- Center for Infertility, Prenatal Medicine, Endocrinology and Osteology, Amedes Medical Center MVZ Hamburg, Hamburg, Germany
| | - A Schüring
- Fertility Center MVZ KITZ Regensburg, Regensburg, Germany
| | - L Susok
- Department of Dermatology, University Hospital Bochum, Bochum, Germany
| | - K M Thoms
- Department of Dermatology, Venereology and Allergy, University Medical Center Goettingen, Goettingen, Germany
| | - L Kiesel
- Department of Gynecology and Obstetrics, University Hospital Münster, Münster, Germany
| | - C Berking
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Comprehensive Cancer Center Erlangen EMN, Deutsches Zentrum Immuntherapie (DZI), Erlangen, Germany.
| |
Collapse
|
15
|
Khiat S, Pibarot M, Roux J, Bottin P, Saïas J, Rives N, Courbiere B. Challenging cases in oncofertility: insights from a national specialized e-meeting for fertility preservation specialists. J Assist Reprod Genet 2021; 38:2445-2453. [PMID: 34291419 PMCID: PMC8294278 DOI: 10.1007/s10815-021-02275-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 07/07/2021] [Indexed: 12/04/2022] Open
Abstract
Purpose To determine the use of a new specialized E-Meeting for Complex Cases in Oncofertility by fertility preservation specialists (FPSs) Material and methods We present 3 years of activity of the E-Meeting for Complex Cases in Oncofertility, a new tool created in September 2016 which allows national oncofertility experts to share viewpoints about challenging cases for which they do not have experience or sufficient data in order to provide them an emergency advice within 48 h. Second, a survey was conducted to evaluate the use of this e-meeting for participating FPSs. Results One hundred and four experts have joined the e-meeting since its set-up, and 109 challenging cases have been submitted. The mean age of the patients was 22.4 ± 8.9 years, and 87.0% were female. Each submitted case received on average of 1.8 ± 1.1 different strategies for FP and the opinions of 7.1 ± 3.4 experts. Among the FPSs who submitted cases, seeking opinions from other FPSs allowed them to confirm their care plan (N = 49, 84.4%), to offer different options to their patients (N = 34, 58.6%), and to compare their practices with those of other specialists (N = 23, 39.6%). All respondents reported a self-perceived improvement in their practice of oncologic FP (n = 80, 100.0%). Conclusion Specific attention should be paid to challenging cases for which the experiences of only a few individuals exist. Enhancing communication between FPSs through oncofertility networks, pooling experiences, and collecting the most complex cases is required to improve the management of these patients. Supplementary Information The online version contains supplementary material available at 10.1007/s10815-021-02275-1.
Collapse
Affiliation(s)
- Samuel Khiat
- Pôle Femmes-Parents-Enfants, Centre Clinico-biologique AMP-CECOS, Plateforme Cancer et Fertilité ONCOPACA-Corse, Assistance-Publique des Hôpitaux de Marseille (AP-HM), La Conception, 147 bd Baille, 13005, Marseille, France
| | - Michele Pibarot
- Regional Network of Cancerology ONCOPACA-Corse, hôpitaux Sud, 270, Boulevard Sainte-Marguerite, 13009, Marseille, France
| | - Jennifer Roux
- Regional Network of Cancerology ONCOPACA-Corse, hôpitaux Sud, 270, Boulevard Sainte-Marguerite, 13009, Marseille, France
| | - Pauline Bottin
- Pôle Femmes-Parents-Enfants, Centre Clinico-biologique AMP-CECOS, Plateforme Cancer et Fertilité ONCOPACA-Corse, Assistance-Publique des Hôpitaux de Marseille (AP-HM), La Conception, 147 bd Baille, 13005, Marseille, France
| | - Jacqueline Saïas
- Pôle Femmes-Parents-Enfants, Centre Clinico-biologique AMP-CECOS, Plateforme Cancer et Fertilité ONCOPACA-Corse, Assistance-Publique des Hôpitaux de Marseille (AP-HM), La Conception, 147 bd Baille, 13005, Marseille, France
| | - Nathalie Rives
- Biology of Reproduction-CECOS Laboratory, UNIROUEN, EA 4308 "Gametogenesis and Gamete Quality", Rouen University Hospital, Normandie Univ, 76031, Rouen, France
| | - Blandine Courbiere
- Pôle Femmes-Parents-Enfants, Centre Clinico-biologique AMP-CECOS, Plateforme Cancer et Fertilité ONCOPACA-Corse, Assistance-Publique des Hôpitaux de Marseille (AP-HM), La Conception, 147 bd Baille, 13005, Marseille, France. .,CNRS, IRD, Avignon Université, IMBE, Aix Marseille Univ, 13397, Marseille, France.
| |
Collapse
|
16
|
Doungkamchan C, Orwig KE. Recent advances: fertility preservation and fertility restoration options for males and females. Fac Rev 2021; 10:55. [PMID: 34195694 PMCID: PMC8204761 DOI: 10.12703/r/10-55] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Fertility preservation is the process of saving gametes, embryos, gonadal tissues and/or gonadal cells for individuals who are at risk of infertility due to disease, medical treatments, age, genetics, or other circumstances. Adult patients have the options to preserve eggs, sperm, or embryos that can be used in the future to produce biologically related offspring with assisted reproductive technologies. These options are not available to all adults or to children who are not yet producing mature eggs or sperm. Gonadal cells/tissues have been frozen for several thousands of those patients worldwide with anticipation that new reproductive technologies will be available in the future. Therefore, the fertility preservation medical and research communities are obligated to responsibly develop next-generation reproductive technologies and translate them into clinical practice. We briefly describe standard options to preserve and restore fertility, but the emphasis of this review is on experimental options, including an assessment of readiness for translation to the human fertility clinic.
Collapse
Affiliation(s)
- Chatchanan Doungkamchan
- Molecular Genetics and Developmental Biology Graduate Program, University of Pittsburgh School of Medicine, Pittsburgh, PA 15260, USA
- Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
- Department of Anatomy, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kyle E Orwig
- Molecular Genetics and Developmental Biology Graduate Program, University of Pittsburgh School of Medicine, Pittsburgh, PA 15260, USA
- Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| |
Collapse
|
17
|
Galbinski S, Kowalewski LS, Grigolo GB, da Silva LR, Jiménez MF, Krause M, Frantz N, Bös-Mikich A. Comparison between two cryopreservation techniques of human ovarian cortex: morphological aspects and the heat shock response (HSR). Cell Stress Chaperones 2021; 27:97-106. [PMID: 35043289 PMCID: PMC8943117 DOI: 10.1007/s12192-022-01252-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 11/03/2022] Open
Abstract
This study was tailored to compare the cryopreservation of the human ovarian cortex using closed metal container vitrification or the slow-freezing technique. Superficial ovarian cortical tissue biopsies were collected from 12 participants who underwent gynaecological videolaparoscopy. The fragmented samples were allocated to three experimental conditions: (a) fresh ovarian tissue, (b) slow-freezing, and (c) vitrification with a metal closed container. After thawing or rewarming, cellular morphological analyses were performed to determine tissue viability. The cellular response to thermal stress was measured by a putative increase in the immune quantification of the heat shock protein 70 kDa (heat shock protein 70 kDa response - HSR) after a heat challenge (2 h exposure at 42 °C). Both the total number of intact follicles and the frequency of primordial follicles were higher in fresh ovarian tissue than in the preserved samples, regardless of the technique employed. There was a trend towards an increase in the absolute number of intact follicles in the tissue preserved by vitrification. After cryopreservation, a higher HSR was obtained after slow-freezing. These results indicate that both cryopreservation techniques present advantages and may be used as alternatives to ovarian tissue cryopreservation.
Collapse
Affiliation(s)
- Sérgio Galbinski
- Unidade de Reprodução Humana, Hospital Fêmina, Porto Alegre, RS, Brazil
- Programa de Pós-graduação em Ginecologia e Obstetrícia da Universidade Federal do Rio Grande do Sull, Porto Alegre, RS, Brazil
| | - Lucas Stahlhöfer Kowalewski
- Laboratory of Inflammation, Metabolism and Exercise Research (LAPIMEX) and Laboratory of Cellular Physiology, Department of Physiology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Gisele Bettú Grigolo
- Laboratory of Inflammation, Metabolism and Exercise Research (LAPIMEX) and Laboratory of Cellular Physiology, Department of Physiology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Larissa Ramos da Silva
- Instituto de Ciencias Basicas da Saude, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Mirela Foresti Jiménez
- Unidade de Reprodução Humana, Hospital Fêmina, Porto Alegre, RS, Brazil
- Programa de Pós-graduação em Ginecologia e Obstetrícia da Universidade Federal do Rio Grande do Sull, Porto Alegre, RS, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Mauricio Krause
- Laboratory of Inflammation, Metabolism and Exercise Research (LAPIMEX) and Laboratory of Cellular Physiology, Department of Physiology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Nilo Frantz
- Nilo Frantz Medicina Reprodutiva, Porto Alegre, RS, Brazil
| | - Adriana Bös-Mikich
- Instituto de Ciencias Basicas da Saude, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| |
Collapse
|
18
|
Installing oncofertility programs for common cancers in optimum resource settings (Repro-Can-OPEN Study Part II): a committee opinion. J Assist Reprod Genet 2021; 38:163-176. [PMID: 33452592 PMCID: PMC7810602 DOI: 10.1007/s10815-020-02012-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 01/03/2023] Open
Abstract
PURPOSE The main objective of Repro-Can-OPEN Study Part 2 is to learn more about oncofertility practices in optimum resource settings to provide a roadmap to establish oncofertility best practice models. METHODS As an extrapolation for oncofertility best practice models in optimum resource settings, we surveyed 25 leading and well-resourced oncofertility centers and institutions from the USA, Europe, Australia, and Japan. The survey included questions on the availability and degree of utilization of fertility preservation options in case of childhood cancer, breast cancer, and blood cancer. RESULTS All surveyed centers responded to all questions. Responses and their calculated oncofertility scores showed three major characteristics of oncofertility practice in optimum resource settings: (1) strong utilization of sperm freezing, egg freezing, embryo freezing, ovarian tissue freezing, gonadal shielding, and fractionation of chemo- and radiotherapy; (2) promising utilization of GnRH analogs, oophoropexy, testicular tissue freezing, and oocyte in vitro maturation (IVM); and (3) rare utilization of neoadjuvant cytoprotective pharmacotherapy, artificial ovary, in vitro spermatogenesis, and stem cell reproductive technology as they are still in preclinical or early clinical research settings. Proper technical and ethical concerns should be considered when offering advanced and experimental oncofertility options to patients. CONCLUSIONS Our Repro-Can-OPEN Study Part 2 proposed installing specific oncofertility programs for common cancers in optimum resource settings as an extrapolation for best practice models. This will provide efficient oncofertility edification and modeling to oncofertility teams and related healthcare providers around the globe and help them offer the best care possible to their patients.
Collapse
|
19
|
Wyns C, Kanbar M, Giudice MG, Poels J. Fertility preservation for prepubertal boys: lessons learned from the past and update on remaining challenges towards clinical translation. Hum Reprod Update 2020; 27:433-459. [PMID: 33326572 DOI: 10.1093/humupd/dmaa050] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/25/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Childhood cancer incidence and survivorship are both on the rise. However, many lifesaving treatments threaten the prepubertal testis. Cryopreservation of immature testicular tissue (ITT), containing spermatogonial stem cells (SSCs), as a fertility preservation (FP) option for this population is increasingly proposed worldwide. Recent achievements notably the birth of non-human primate (NHP) progeny using sperm developed in frozen-thawed ITT autografts has given proof of principle of the reproductive potential of banked ITT. Outlining the current state of the art on FP for prepubertal boys is crucial as some of the boys who have cryopreserved ITT since the early 2000s are now in their reproductive age and are already seeking answers with regards to their fertility. OBJECTIVE AND RATIONALE In the light of past decade achievements and observations, this review aims to provide insight into relevant questions for clinicians involved in FP programmes. Have the indications for FP for prepubertal boys changed over time? What is key for patient counselling and ITT sampling based on the latest achievements in animals and research performed with human ITT? How far are we from clinical application of methods to restore reproductive capacity with cryostored ITT? SEARCH METHODS An extensive search for articles published in English or French since January 2010 to June 2020 using keywords relevant to the topic of FP for prepubertal boys was made in the MEDLINE database through PubMed. Original articles on fertility preservation with emphasis on those involving prepubertal testicular tissue, as well as comprehensive and systematic reviews were included. Papers with redundancy of information or with an absence of a relevant link for future clinical application were excluded. Papers on alternative sources of stem cells besides SSCs were excluded. OUTCOMES Preliminary follow-up data indicate that around 27% of boys who have undergone testicular sampling as an FP measure have proved azoospermic and must therefore solely rely on their cryostored ITT to ensure biologic parenthood. Auto-transplantation of ITT appears to be the first technique that could enter pilot clinical trials but should be restricted to tissue free of malignant cells. While in vitro spermatogenesis circumvents the risk linked to cancer cell contamination and has led to offspring in mice, complete spermatogenesis has not been achieved with human ITT. However, generation of haploid germ cells paves the way to further studies aimed at completing the final maturation of germ cells and increasing the efficiency of the processes. WIDER IMPLICATIONS Despite all the research done to date, FP for prepubertal boys remains a relatively young field and is often challenging to healthcare providers, patients and parents. As cryopreservation of ITT is now likely to expand further, it is important not only to acknowledge some of the research questions raised on the topic, e.g. the epigenetic and genetic integrity of gametes derived from strategies to restore fertility with banked ITT but also to provide healthcare professionals worldwide with updated knowledge to launch proper multicollaborative care pathways in the field and address clinical issues that will come-up when aiming for the child's best interest.
Collapse
Affiliation(s)
- Christine Wyns
- Andrology lab, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.,Department of Gynecology-Andrology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Marc Kanbar
- Andrology lab, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.,Department of Gynecology-Andrology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Maria Grazia Giudice
- Andrology lab, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.,Department of Gynecology-Andrology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Jonathan Poels
- Andrology lab, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.,Department of Gynecology-Andrology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| |
Collapse
|
20
|
Gonçalves V, Ferreira PL, Quinn GP. Integration of partners of young women with cancer in oncofertility evidence-based informational resources. Cancer Med 2020; 9:7375-7380. [PMID: 32864852 PMCID: PMC7571813 DOI: 10.1002/cam4.3377] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/07/2020] [Accepted: 07/25/2020] [Indexed: 12/22/2022] Open
Abstract
Oncofertility has evolved over the years, with a prodigious amount of research documenting the importance of fertility for young patients with cancer, and the potential impact that fertility impairments due to cancer treatments has on their Quality of Life (QoL). Multiple professional bodies and scientific societies have included fertility as an integral part of clinical management. Clinical guidelines advocate that health professionals have the duty to discuss the risk of infertility and fertility preservation options as early as possible and refer to fertility specialists when appropriate. Collectively, fertility decisions are regarded as difficult for both patients and providers. Since providing fertility‐related information is vital for better decision making, researchers and policy makers have concentrated their efforts in developing educational tools to aid decisions and guidelines to optimize the delivery of this information, focusing mainly on patients‐providers and largely neglecting the role and influence that partners play in this process. Here, we reflect on the importance of partners in fertility decisions, with a focus on the provision of fertility‐related information that is also geared towards partner. We highlight the need to involve partners in fertility discussions, and that their needs should be taken into account in both clinical guidelines and in the development of educational tools, for an optimal decision‐making process.
Collapse
Affiliation(s)
- Vânia Gonçalves
- Centre for Health Studies and Research of the University of Coimbra (CEISUC), Faculty of Economics, University of Coimbra, Coimbra, Portugal
| | - Pedro L Ferreira
- Centre for Health Studies and Research of the University of Coimbra (CEISUC), Faculty of Economics, University of Coimbra, Coimbra, Portugal
| | - Gwendolyn P Quinn
- Departments of Obstetrics and Gynecology and Population Health, Grossman School of Medicine, New York University, New York, NY, USA
| |
Collapse
|
21
|
von Wolff M, Nawroth F. Fertilitätsprotektion bei onkologischen und nichtonkologischen Erkrankungen. GYNAKOLOGISCHE ENDOKRINOLOGIE 2020. [DOI: 10.1007/s10304-020-00322-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
22
|
Reproductive outcomes after in vitro fertilization treatment in a cohort of Danish women transplanted with cryopreserved ovarian tissue. Fertil Steril 2020; 114:379-387. [PMID: 32624219 DOI: 10.1016/j.fertnstert.2020.03.035] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/22/2020] [Accepted: 03/25/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate ovarian stimulation regimens and reproductive outcomes in a cohort of women undergoing ovarian tissue cryopreservation (OTC) and ovarian tissue transplantation (OTT). DESIGN Retrospective cohort study. SETTING University hospital and fertility clinics. PATIENTS Twenty-eight women undergoing OTT and in vitro fertilization (IVF) from 2012 to 2017. INTERVENTION OTC, OTT, and IVF. MAIN OUTCOME MEASURES Ovarian stimulation and IVF outcomes. RESULTS In total, 99 cycles were performed in 28 patients. In 19 patients responding to stimulation, a median of 3.0 cycles per patient (range: 1-14 cycles) was performed, and 2.0 mature oocytes were retrieved per cycle. The empty follicle rate was 35.9%. Eleven women achieved 15 pregnancies, of which 60% were lost during the first or second trimester, resulting in 5 of 28 women having ≥1 live births, and seven healthy children being born. In breast cancer patients (mean age at OTC: 33.0 years), the pregnancy rates (PR) and live birth rates (LBR) were 35.0% and 5.0% per embryo transfer, respectively. Patients aged ≥34.5 years at OTC all had breast cancer and did not achieve any pregnancies. For all other diagnoses (mean age at OTC: 26.6 years), PR and LBR were 50.0% and 37.5% per embryo transfer, respectively. Collectively, 39% of patients conceived at least once, and 17.9% delivered. Frozen-thawed embryo transfer (FET) resulted in more pregnancies than did fresh embryo transfer. CONCLUSION Our results suggest that women of advanced maternal age undergoing OTC and IVF have a poor ovarian reserve, resulting in a poor reproductive outcome. Interestingly, FET appeared to be superior to fresh transfer.
Collapse
|
23
|
Salama M, Ataman-Millhouse L, Braham M, Berjeb K, Khrouf M, Rodrigues JK, Reis FM, Silva TC, Sánchez F, Romero S, Smitz J, Vásquez L, Vega M, Sobral F, Terrado G, Lombardi MG, Scarella A, Bourlon MT, Verduzco-Aguirre H, Sánchez AM, Adiga SK, Tholeti P, Udupa KS, Mahajan N, Patil M, Dalvi R, Venter C, Demetriou G, Geel J, Quintana R, Rodriguez G, Quintana T, Viale L, Fraguglia M, Coirini M, Remolina-Bonilla YA, Noguera JAR, Velásquez JC, Suarez A, Arango GD, Pineda JID, Aldecoa MDC, Javed M, Al Sufyan H, Daniels N, Oranye BC, Ogunmokun AA, Onwuzurigbo KI, Okereke CJ, Whesu TC, Woodruff TK. Installing oncofertility programs for common cancers in limited resource settings (Repro-Can-OPEN Study): An extrapolation during the global crisis of Coronavirus (COVID-19) pandemic. J Assist Reprod Genet 2020; 37:1567-1577. [PMID: 32594284 PMCID: PMC7320246 DOI: 10.1007/s10815-020-01821-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 05/10/2020] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The state of limited resource settings that Coronavirus (COVID-19) pandemic has created globally should be taken seriously into account especially in healthcare sector. In oncofertility, patients should receive their fertility preservation treatments urgently even in limited resource settings before initiation of anticancer therapy. Therefore, it is very crucial to learn more about oncofertility practice in limited resource settings such as in developing countries that suffer often from shortage of healthcare services provided to young patients with cancer. METHODS As an extrapolation during the global crisis of COVID-19 pandemic, we surveyed oncofertility centers from 14 developing countries (Egypt, Tunisia, Brazil, Peru, Panama, Mexico, Colombia, Guatemala, Argentina, Chile, Nigeria, South Africa, Saudi Arabia, and India). Survey questionnaire included questions on the availability and degree of utilization of fertility preservation options in case of childhood cancer, breast cancer, and blood cancer. RESULTS All surveyed centers responded to all questions. Responses and their calculated oncofertility scores showed different domestic standards for oncofertility practice in case of childhood cancer, breast cancer, and blood cancer in the developing countries under limited resource settings. CONCLUSIONS Medical practice in limited resource settings has become a critical topic especially after the global crisis of COVID-19 pandemic. Understanding the resources necessary to provide oncofertility treatments is important until the current COVID-19 pandemic resolves. Lessons learned will be valuable to future potential worldwide disruptions due to infectious diseases or other global crises.
Collapse
Affiliation(s)
- M. Salama
- Oncofertility Consortium, Feinberg School of Medicine, Northwestern University, Chicago, Illinois USA
| | - L. Ataman-Millhouse
- Oncofertility Consortium, Feinberg School of Medicine, Northwestern University, Chicago, Illinois USA
| | - M. Braham
- Aziza Othmana Hospital of Tunis, Tunis, Tunisia
| | - K. Berjeb
- Aziza Othmana Hospital of Tunis, Tunis, Tunisia
| | - M. Khrouf
- FERTILLA, Clinique la Rose, Tunis, Tunisia
| | - J. K. Rodrigues
- Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - F. M. Reis
- Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - T. Cury- Silva
- Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - F. Sánchez
- Laboratorio de Biología Reproductiva y Preservación de la Fertilidad, Laboratorios de Investigación y Desarrollo, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - S. Romero
- Laboratorio de Biología Reproductiva y Preservación de la Fertilidad, Laboratorios de Investigación y Desarrollo, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - J. Smitz
- Laboratorio de Biología Reproductiva y Preservación de la Fertilidad, Laboratorios de Investigación y Desarrollo, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - L. Vásquez
- Unidad de Oncología Pediátrica, Hospital Edgardo Rebagliati Martins, Lima, Peru
| | - M. Vega
- Panama Fertility, Sistema Nacional de Investigadores, Panama City, Panama
| | - F. Sobral
- Pregna Medicina Reproductiva, Buenos Aires, Argentina
| | - G. Terrado
- Pregna Medicina Reproductiva, Buenos Aires, Argentina
| | | | - A. Scarella
- Centro de Reproduccion Humana, Facultad de Medicina, Universidad de Valparaiso, Valparaiso, Chile
| | - M. T. Bourlon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - H. Verduzco-Aguirre
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - A. M. Sánchez
- Instituto Nacional de Perinatología Isidro Espinoza de los Reyes, Mexico City, Mexico
| | - S. K. Adiga
- Fertility Preservation Centre, Department of Clinical Embryology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - P. Tholeti
- Fertility Preservation Centre, Department of Clinical Embryology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - K. S. Udupa
- Department of Medical Oncology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - N. Mahajan
- Mother and Child Hospital, New Delhi, India
| | - M. Patil
- Dr. Patil’s Fertility and Endoscopy Clinic, Bangalore, India
| | - R. Dalvi
- Hospital Institute of Medical Sciences & SRCC children’s Hospital, Mumbai, India
| | - C. Venter
- Vitalab Fertility Centre, Johannesburg, South Africa
| | - G. Demetriou
- Department Medical Oncology, University of Witwatersrand, Johannesburg, South Africa
| | - J. Geel
- Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | | | | | | | - L. Viale
- Procrearte, Buenos Aires, Argentina
| | | | - M. Coirini
- Hospital de Niños Victor J. Vilela. Rosario, Santa Fe, Argentina
| | | | | | | | - A. Suarez
- Instituto Nacional de Cancerología, Bogota, Colombia
| | | | - J. I. D. Pineda
- Instituto Guatemalteco de Seguridad Social (IGSS), Guatemala City, Guatemala
| | - M. D. C. Aldecoa
- Instituto Guatemalteco de Seguridad Social (IGSS), Guatemala City, Guatemala
| | - M. Javed
- Thuriah Medical Center, Riyadh, Kingdom of Saudi Arabia
| | - H. Al Sufyan
- Thuriah Medical Center, Riyadh, Kingdom of Saudi Arabia
| | - N. Daniels
- The Oncology and Fertility Centres of Ekocorp Plc, Eko Hospitals, Lagos, Nigeria
| | - B. C. Oranye
- The Oncology and Fertility Centres of Ekocorp Plc, Eko Hospitals, Lagos, Nigeria
| | - A. A. Ogunmokun
- The Oncology and Fertility Centres of Ekocorp Plc, Eko Hospitals, Lagos, Nigeria
| | | | | | - T. C. Whesu
- Kingswill Specialist Hospital, Lagos, Nigeria
| | - T. K. Woodruff
- Oncofertility Consortium, Feinberg School of Medicine, Northwestern University, Chicago, Illinois USA
| |
Collapse
|
24
|
Sonmezer M, Ozkavukcu S, Sukur YE, Kankaya D, Arslan O. First pregnancy and live birth in Turkey following frozen-thawed ovarian tissue transplantation in a patient with acute lymphoblastic leukemia who underwent cord blood transplantation. J Assist Reprod Genet 2020; 37:2033-2043. [PMID: 32556882 DOI: 10.1007/s10815-020-01850-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/03/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To report the first live birth after frozen-thawed ovarian transplantation in Turkey and the second case for an acute lymphoblastic leukemia (ALL) survivor in the world. METHODS A 19-year-old patient underwent ovarian tissue cryopreservation (OTC) before cord blood transplantation in 2010. She was diagnosed as ALL with a bone marrow biopsy revealing 90% blast ALL-L2 type, and karyotype analyses indicated reciprocal translocation at t(9;22)(q34;q11). The patient received the Berlin-Frankfurt-Munster (BFM) protocol, and complete remission was achieved before fertility preservation. Serum AMH level was measured as 1.5 ng/ml, and 12 antral follicles were counted on ultrasound. She was informed about fertility preservation options and decided to proceed with OTC, with her signed consent before cord blood transplantation in April 2011. Ovarian tissue transplantation (OTT) was performed in 2017 when the patient was menopausal with serum FSH levels > 100 IU/ml and estradiol < 20 pg/ml and hematologically in molecular remission. Detailed molecular analysis, standard histology, and immunohistochemistry demonstrated that the thawed tissue is free of malignant cells. RESULTS Six months following OTT, she had spontaneous menstruation with serum FSH 11 IU/ml and estradiol 53 pg/ml. Two consecutive IVF cycles yielded three top-quality embryos. Following three embryo transfer cycles, one fresh and two frozen, a healthy term live birth was achieved. Frozen-thawed-transplanted tissues were extracted during caesarean delivery upon the patient's request after a total period of 25 months in vivo, and histopathological evaluation revealed that the tissue was free of leukemic infiltration. CONCLUSION The authors report the first pregnancy and live birth in Turkey and the second live birth in the world following transplantation of frozen-thawed ovarian tissue in a leukemia survivor. As the transplanted tissues were removed during caesarean delivery, histological findings prove the functionality and the malignant-free status of the transplanted tissue during the grafted period.
Collapse
Affiliation(s)
- Murat Sonmezer
- Center for Assisted Reproduction, Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine, Ankara,, 06620, Turkey.
| | - Sinan Ozkavukcu
- Center for Assisted Reproduction, Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine, Ankara,, 06620, Turkey.,Department of Histology and Embryology, Ankara University Faculty of Medicine, Ankara,, 06230, Turkey
| | - Yavuz Emre Sukur
- Center for Assisted Reproduction, Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine, Ankara,, 06620, Turkey
| | - Duygu Kankaya
- Department of Pathology, Ankara University Faculty of Medicine, Ankara., 06230, Turkey
| | - Onder Arslan
- Bone Marrow Transplantation Unit, Department of Hematology, Ankara University Faculty of Medicine, Ankara,, 06620, Turkey
| |
Collapse
|
25
|
Alviggi C, Esteves SC, Orvieto R, Conforti A, La Marca A, Fischer R, Andersen CY, Bühler K, Sunkara SK, Polyzos NP, Strina I, Carbone L, Bento FC, Galliano D, Yarali H, Vuong LN, Grynberg M, Drakopoulos P, Xavier P, Llacer J, Neuspiller F, Horton M, Roque M, Papanikolaou E, Banker M, Dahan MH, Foong S, Tournaye H, Blockeel C, Vaiarelli A, Humaidan P, Ubaldi FM. COVID-19 and assisted reproductive technology services: repercussions for patients and proposal for individualized clinical management. Reprod Biol Endocrinol 2020; 18:45. [PMID: 32404170 PMCID: PMC7218705 DOI: 10.1186/s12958-020-00605-z] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 04/28/2020] [Indexed: 02/06/2023] Open
Abstract
The prolonged lockdown of health services providing high-complexity fertility treatments -as currently recommended by many reproductive medicine entities- is detrimental for society as a whole, and infertility patients in particular. Globally, approximately 0.3% of all infants born every year are conceived using assisted reproductive technology (ART) treatments. By contrast, the total number of COVID-19 deaths reported so far represents approximately 1.0% of the total deaths expected to occur worldwide over the first three months of the current year. It seems, therefore, that the number of infants expected to be conceived and born -but who will not be so due to the lockdown of infertility services- might be as significant as the total number of deaths attributed to the COVID-19 pandemic. We herein propose remedies that include a prognostic-stratification of more vulnerable infertility cases in order to plan a progressive restart of worldwide fertility treatments. At a time when preventing complications and limiting burdens for national health systems represent relevant issues, our viewpoint might help competent authorities and health care providers to identify patients who should be prioritized for the continuation of fertility care in a safe environment.
Collapse
Affiliation(s)
- Carlo Alviggi
- grid.4691.a0000 0001 0790 385XDepartment of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Sandro C. Esteves
- grid.489976.d0000 0004 0437 566XANDROFERT, Andrology and Human Reproduction Clinic, Av. Dr. Heitor Penteado, 1463, Campinas, SP 13075-460 Brazil
- grid.411087.b0000 0001 0723 2494Department of Surgery (Division of Urology), University of Campinas (UNICAMP), Campinas, Brazil
- grid.7048.b0000 0001 1956 2722Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Raoul Orvieto
- grid.413795.d0000 0001 2107 2845Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Ramat Gan, Israel
- grid.12136.370000 0004 1937 0546The Tarnesby-Tarnowski Chair for Family Planning and Fertility Regulation, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Alessandro Conforti
- grid.4691.a0000 0001 0790 385XDepartment of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Antonio La Marca
- grid.7548.e0000000121697570Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Claus Y. Andersen
- grid.4973.90000 0004 0646 7373Laboratory of Reproductive Biology, University Hospital of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Klaus Bühler
- Center for Gynecology, Endocrinology and Reproductive Medicine, and Stuttgart, Ulm, Germany
- Scientific-Clinical Centre for Endometriosis of the University Hospitals of Saarland, Saarbrücken, Germany
| | - Sesh K. Sunkara
- grid.13097.3c0000 0001 2322 6764Department of Women’s Health, Faculty of Life Sciences, King’s College London, London, UK
| | | | - Ida Strina
- grid.4691.a0000 0001 0790 385XDepartment of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Luigi Carbone
- grid.4691.a0000 0001 0790 385XDepartment of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Fabiola C. Bento
- grid.489976.d0000 0004 0437 566XANDROFERT, Andrology and Human Reproduction Clinic, Av. Dr. Heitor Penteado, 1463, Campinas, SP 13075-460 Brazil
| | | | | | - Lan N. Vuong
- grid.413054.70000 0004 0468 9247Department of Obstetrics and Gynecology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- grid.490472.cIVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - Michael Grynberg
- grid.460789.40000 0004 4910 6535Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Antoine Béclère, Clamart, France, Université Paris Saclay, Saint-Aubin, France
| | - Panagiotis Drakopoulos
- Center for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
- grid.8127.c0000 0004 0576 3437Department of Obstetrics and Gynecology, Medical School, University of Crete, 71110, Heraklion, Crete, Greece
| | - Pedro Xavier
- Unit of Reproductive Medicine, Department of Gynecology and Obstetrics, Hospital Center São João, Porto, Portugal
| | - Joaquin Llacer
- grid.476436.40000 0001 0259 6889Instituto Bernabeu, Alicante, Spain
| | | | - Marcos Horton
- Pregna Medicina Reprodutiva, Buenos Aires, Argentina
| | | | - Evangelos Papanikolaou
- grid.492697.7Assisting Nature, Centre of Assisted Reproduction and Genetics, Thessaloniki, Greece
- grid.4793.900000001094570053rd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Michael H. Dahan
- grid.14709.3b0000 0004 1936 8649Department of Obstetrics and Gynecology, McGill University, Montreal, Canada
| | - Shu Foong
- grid.22072.350000 0004 1936 7697Department of Obstetrics & Gynecology, University of Calgary, Calgary, Canada
- Regional Fertility Program, Calgary, Canada
| | - Herman Tournaye
- Center for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Christophe Blockeel
- Center for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Peter Humaidan
- grid.7048.b0000 0001 1956 2722Faculty of Health, Aarhus University, Aarhus, Denmark
- GENERA, Center for Reproductive Medicine, Rome, Italy
| | | | | |
Collapse
|
26
|
Salama M, Anazodo A, Woodruff TK. Preserving fertility in female patients with hematological malignancies: a multidisciplinary oncofertility approach. Ann Oncol 2019; 30:1760-1775. [PMID: 31418765 DOI: 10.1093/annonc/mdz284] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Oncofertility is a new interdisciplinary field at the intersection of oncology and reproductive medicine that expands fertility options for young cancer patients. The most common forms of hematological malignancies that occur in girls and young women and therefore necessitate oncofertility care are acute lymphocytic leukemia, acute myeloid leukemia, non-Hodgkin's lymphoma, and Hodgkin's lymphoma. Aggressive gonadotoxic anticancer regimens including alkylating chemotherapy and total body irradiation are used often in treating girls and young women with hematological malignancies. The risks of gonadotoxicity and subsequent iatrogenic premature ovarian insufficiency and fertility loss depend mainly on the type and stage of the disease, dose of anticancer therapy as well as the age of the patient at the beginning of treatment. To avoid or at least mitigate the devastating complications of anticancer therapy-induced gonadotoxicity, effective and comprehensive strategies that integrate different options for preserving and restoring fertility ranging from established to experimental strategies should be offered before, during, and after chemotherapy or radiotherapy. A multidisciplinary approach that involves strong coordination and collaboration between hemato-oncologists, gynecologists, reproductive biologists, research scientists, and patient navigators is essential to guarantee high standard of care.
Collapse
Affiliation(s)
- M Salama
- Department of Obstetrics and Gynecology, Feinberg School of Medicine-Northwestern University, Chicago, USA
| | - A Anazodo
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia; Nelune Cancer Centre, Prince of Wales Hospital, Sydney, Australia; School of Women's and Children's Health, University of New South Wales, Sydney, Australia
| | - T K Woodruff
- Department of Obstetrics and Gynecology, Feinberg School of Medicine-Northwestern University, Chicago, USA.
| |
Collapse
|
27
|
Takae S, Lee JR, Mahajan N, Wiweko B, Sukcharoen N, Novero V, Anazodo AC, Gook D, Tzeng CR, Doo AK, Li W, Le CTM, Di W, Chian RC, Kim SH, Suzuki N. Fertility Preservation for Child and Adolescent Cancer Patients in Asian Countries. Front Endocrinol (Lausanne) 2019; 10:655. [PMID: 31681163 PMCID: PMC6804405 DOI: 10.3389/fendo.2019.00655] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 09/09/2019] [Indexed: 12/31/2022] Open
Abstract
Background: At present, fertility is one of the main concerns of young cancer patients. Following this trend, "fertility preservation (FP)" has been established and has become a new field of reproductive medicine. However, FP for child and adolescent (C-A) cancer patients is still developing, even in advanced countries. The aim of the present study was to assess the barriers to FP for C-A patients by investigating the current status of FP for C-A patients in Asian countries, which just have started FP activities. Method: A questionnaire survey of founding members of the Asian Society for Fertility Preservation (ASFP) was conducted in November 2018. Main findings: Of the 14 countries, 11 country representatives replied to this survey. FP for C-A patients is still developing in Asian countries, even in Australia, Japan, and Korea, which have organizations or academic societies specialized for FP. In all countries that replied to the present survey, the patients can receive embryo cryopreservation (EC), oocyte cryopreservation (OC), and sperm cryopreservation (SC) as FP. Compared with ovarian tissue cryopreservation (OTC), testicular tissue cryopreservation (TTC) is an uncommon FP treatment because of its still extremely experimental status (7 of 11 countries provide it). Most Asian countries can provide FP for C-A patients in terms of medical technology, but most have factors inhibiting to promote FP for C-A patients, due to lack of sufficient experience and an established system promoting FP for C-A patients. "Don't know how to provide FP treatment for C-A" is a major barrier. Also, low recognition in society and among medical staff is still a particularly major issue. There is also a problem with cooperative frameworks with pediatric departments. To achieve high-quality FP for C-A patients, a multidisciplinary approach is vital, but, according to the present study, few paramedical staff can participate in FP for C-A patients in Asia. Only Australia and Korea provide FP information by video and specific resources. Conclusion: The present study demonstrated the developing status of FP for C-A patients in Asian countries. More intensive consideration and discussion are needed to provide FP in Asian societies based on the local cultural and religious needs of patients.
Collapse
Affiliation(s)
- Seido Takae
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
- *Correspondence: Seido Takae
| | - Jung Ryeol Lee
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul, South Korea
| | | | - Budi Wiweko
- Division of Reproductive Endocrionolgy and Infertility, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Depok, Indonesia
| | - Nares Sukcharoen
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bankok, Thailand
| | - Virgilio Novero
- St. Luke's Medical Center, Quezon City, Philippines
- Section of Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Philippines Manila, Manila, Philippines
| | - Antoinette Catherine Anazodo
- Kids Cancer Centre and Sydney Youth Cancer Service, Sydney Children's Hospital, Randwick, NSW, Australia
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW, Australia
- School of Women's and Children's Health, University of New South Wales, Kensington, NSW, Australia
| | - Debra Gook
- Melbourne IVF, Melbourne, VIC, Australia
| | - Chii-Ruey Tzeng
- Division of Infertility, Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan
| | | | - Wen Li
- Reproductive Medicine Center, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | | | - Wen Di
- Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ri-Cheng Chian
- Center for Reproductive Medicine, Tenth People's Hospital of Tongji University, Shanghai, China
| | - Seok Hyun Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| |
Collapse
|