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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).
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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
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Łubik-Lejawka D, Gabriel I, Marzec A, Olejek A. Oncofertility as an Essential Part of Comprehensive Cancer Treatment in Patients of Reproductive Age, Adolescents and Children. Cancers (Basel) 2024; 16:1858. [PMID: 38791937 PMCID: PMC11119835 DOI: 10.3390/cancers16101858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
The number of children, adolescents and young adults diagnosed with cancer has been rising recently. Various oncological treatments have a detrimental effect on female fertility, and childbearing becomes a major issue during surveillance after recovery. This review discusses the impact of oncological treatments on the ovarian reserve with a thorough explanation of oncologic treatments' effects and modes of oncofertility procedures. The aim of this review is to help clinicians in making an informed decision about post-treatment fertility in their patients. Ultimately, it may lead to improved overall long-term outcomes among young populations suffering from cancer.
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Affiliation(s)
| | | | | | - Anita Olejek
- Department of Gynaecology, Obstetrics and Oncological Gynaecology in Bytom, Medical University of Silesia, 40-055 Katowice, Poland; (D.Ł.-L.); (I.G.); (A.M.)
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3
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Ruan X, Xu C, Huang H, Xu B, Du J, Cheng J, Jin F, Gu M, Kong W, Yin C, Wu Y, Tian Q, Cao Y, Wu R, Xu L, Jin J, Li Y, Dai Y, Ju R, Ma F, Wang G, Wei W, Huang X, Qin M, Lin Y, Sun Y, Liu R, Zhang W, Li X, Zou L, Hao M, Ye X, Wang F, Wang Y, Hu Z, Huang Y, Zhu T, Yang C, Wang J, Yang X, Ni R, Wang L, Luo G, Min A, Zhang S, Li P, Cheng L, Li L, Jin Q, Shi D, Li Y, Ren F, Cheng Y, Niu J, Tian Y, Mueck AO. Practice guideline on ovarian tissue cryopreservation and transplantation in the prevention and treatment of iatrogenic premature ovarian insufficiency. Maturitas 2024; 182:107922. [PMID: 38325136 DOI: 10.1016/j.maturitas.2024.107922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 02/09/2024]
Abstract
Premature ovarian insufficiency (POI) refers to the decline of ovarian function before the age of 40. POI causes a reduction in or loss of female fertility, accompanied by different degrees of menopausal symptoms, which increases the risk of chronic diseases related to early menopause and seriously affects patients' quality of life and health. It is conservatively estimated that at least one million prepubertal girls and women of reproductive age in China are at risk of iatrogenic POI caused by radiotherapy and chemotherapy every year. With the development of medical technology and the breakthrough of scientific and technological advances, preventing and treating iatrogenic POI have become possible. International and national guidelines consider cryopreserved ovarian tissue transplantation to be the most promising method of preserving the ovarian function and fertility of prepubertal girls and women of reproductive age who cannot delay radiotherapy and chemotherapy. In order to guide the clinical application of ovarian tissue cryopreservation and transplantation technology in China, the Guideline Working Group finally included 14 scientific questions and 18 recommendations through a questionnaire survey, field investigation, and consultation of a large number of Chinese and English literature databases in order to provide a reference for colleagues in clinical practice.
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Affiliation(s)
- Xiangyan Ruan
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China; Department for Women's Health, University Women's Hospital and Research Center for Women's Health, University of Tuebingen, Tuebingen, Germany.
| | - Che Xu
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China; Fuxing Hospital, Capital Medical University, Beijing, China
| | - Hefeng Huang
- Ministry of Education Key Laboratory of Reproductive Genetics, Shool of Medicine, Zhejiang University, Hangzhou, China
| | - Binghe Xu
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Juan Du
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Jiaojiao Cheng
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Fengyu Jin
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Muqing Gu
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Weimin Kong
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Chenghong Yin
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Yurui Wu
- Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Qinjie Tian
- Peking Union Medical College Hospital, Peking Union Medical College/Chinese Academy of Medical Sciences, Beijing, China
| | - Yunxia Cao
- The First Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Ruifang Wu
- Peking University Shenzhen Hospital, Shenzhen, China
| | - Liangzhi Xu
- West China Second University Hospital, Sichuan University, Chengdu, China
| | - Jing Jin
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Yanglu Li
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Yinmei Dai
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Rui Ju
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Fei Ma
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Gang Wang
- Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, China
| | - Wei Wei
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | | | - Maoquan Qin
- National Center for Children's Health, Hematology Center, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Yuan Lin
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian, China
| | - Yuan Sun
- Beijing Jingdu Children's Hospital, Beijing, China
| | - Rong Liu
- Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Wei Zhang
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xiaodong Li
- The First Hospital of Hebei Medical University, Hebei, China
| | - Lin Zou
- Affiliated Hospital of Guangdong Medical University, Guangdong, China
| | - Min Hao
- Second Hospital of Shanxi Medical University, Shanxi, China
| | - Xiyang Ye
- Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Fuling Wang
- The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yue Wang
- Henan Provincial People's Hospital, Zhengzhou, China
| | - Zhuoying Hu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yanhong Huang
- Xi'an International Medical Center Hospital, Xi'an, China
| | - Tianyuan Zhu
- Gansu Provincial Maternal and Child-care Hospital/Gansu Province Central Hospital, Lanzhou, China
| | - Caihong Yang
- The General Hospital of Ningxia Medical University, Ningxia, China
| | - Jinping Wang
- Zibo Maternal And Child Health Hospital, Zibo, China
| | - Xiaomin Yang
- Liuzhou Maternity and Child Healthcare Hospital, Liuzhou, China
| | - Rong Ni
- The Central Hospital of Enshi Tu Jia and Miao Autonomous Prefecture, Enshi, China
| | - Liqun Wang
- Jiangxi Maternal and Child Health Hospital, Jiangxi, China
| | - Guangxia Luo
- The First People's Hospital of Huaihua (Hunan University of Medicine General Hospital), Huaihua, China
| | - Aiping Min
- People's Hospital of Leshan City, Leshan, China
| | - Siyou Zhang
- The First People's Hospital of Foshan, Foshan, China
| | - Peiling Li
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Linghui Cheng
- The First Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Lianfang Li
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Huairou Maternal and Child Health Care Hospital, Huairou, China
| | - Quanfang Jin
- Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
| | - Dongmei Shi
- Maternal and Child Health Hospital of Yinchuan, Yinchuan, China
| | - Yan Li
- Luoyang Anhe Hospital, Luoyang, China
| | | | | | - Jumin Niu
- Shenyang Women's and Children's Hospital, Shenyang, China
| | - Ying Tian
- XiangXi Ninger Obstetrics and Gynecology Hospital, Xiangxi, China
| | - Alfred O Mueck
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China; Department for Women's Health, University Women's Hospital and Research Center for Women's Health, University of Tuebingen, Tuebingen, Germany
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Kayiira A, Neda John J, Zaake D, Xiong S, Kambugu Balagadde J, Gomez-Lobo V, Wabinga H, Ghebre R. Understanding Fertility Attitudes and Outcomes Among Survivors of Adolescent and Young Adult Cancers in a Low-Resource Setting: A Registry-Based Computer-Assisted Telephone Interview Survey. J Adolesc Young Adult Oncol 2023; 12:520-528. [PMID: 36579945 PMCID: PMC10457622 DOI: 10.1089/jayao.2022.0114] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Purpose: To establish the extent of self-reported reproductive failure associated with cancer treatment, and attitudes toward fertility among adolescent and young adult (AYA) cancer survivors in Uganda. Methods: A registry-based computer-assisted telephone interview survey was conducted in Uganda. The survey population were survivors of childhood, adolescent and early adulthood cancers diagnosed between 2007 and 2018. The survey explored fertility outcomes, experiences of oncofertility and fertility attitudes of AYA cancer survivors. Results: Thirty-four (female = 14 and male = 20) interviews were completed. Survivors were 18-35 years of age. The median age at cancer diagnosis was 23.5 for females and 17.5 for males. Kaposi's sarcoma contributed to 44% of primary cancer diagnoses. All the survivors had received chemotherapy alone or in combination with other modalities and 79% of survivors had not received satisfactory information about future fertility before cancer treatment. Twenty one percent of males and 46% females met the criteria for infertility and 60% of these had met this criterion after their cancer diagnosis. Eighty two percent wanted to raise a biologically related child. Forty seven percent would be dissatisfied with their lives if they were unable to have a child or additional children. Conclusion: AYA cancer survivors in this low-resource setting reported reproductive failure, despite a strong fertility desire. Information and counseling provided on therapy-related problems before cancer treatment was insufficient and reinforces the need to build capacity for oncofertility resources within the region.
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Affiliation(s)
- Anthony Kayiira
- Department of Obstetrics and Gynecology, Uganda Martyrs University School of Medicine, Kampala, Uganda
- Department of Reproductive Endocrinology and Infertility, Mulago Specialized Women's and Neonatal Hospital, Kampala, Uganda
| | | | - Daniel Zaake
- Department of Obstetrics and Gynecology, Uganda Martyrs University School of Medicine, Kampala, Uganda
| | - Serena Xiong
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis. Minnesota, USA
| | | | - Veronica Gomez-Lobo
- Department of Pediatric and Adolescent Gynecology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Henry Wabinga
- Kampala Cancer Registry, Makerere University College of Health Sciences, Kampala, Uganda
| | - Rahel Ghebre
- Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minneapolis, Minnesota, USA
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Salama M, Nahata L, Jayasinghe Y, Gomez-Lobo V, Laronda MM, Moravek MB, Meacham LR, Christianson MS, Lambertini M, Anazodo A, Quinn GP, Woodruff TK. Pediatric oncofertility care in limited versus optimum resource settings: results from 39 surveyed centers in Repro-Can-OPEN Study Part I & II. J Assist Reprod Genet 2023; 40:443-454. [PMID: 36542312 PMCID: PMC9768400 DOI: 10.1007/s10815-022-02679-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE As a secondary report to elucidate the diverse spectrum of oncofertility practices for childhood cancer around the globe, we present and discuss the comparisons of oncofertility practices for childhood 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, and Latin America (Repro-Can-OPEN Study Part I), and 25 in optimum resource settings from the USA, Europe, Australia, and Japan (Repro-Can-OPEN Study Part II). Survey questions covered the availability of fertility preservation and restoration options offered in case of childhood cancer as well as their degree of utilization. RESULTS In the Repro-Can-OPEN Study Part I & II, responses for childhood cancer and calculated oncofertility scores showed the following characteristics: (1) higher oncofertility scores in optimum resource settings than in limited resource settings for ovarian and testicular tissue cryopreservation; (2) frequent utilization of gonadal shielding, fractionation of anticancer therapy, oophoropexy, and GnRH analogs; (3) promising utilization of oocyte in vitro maturation (IVM); and (4) rare utilization of neoadjuvant cytoprotective pharmacotherapy, artificial ovary, in vitro spermatogenesis, and stem cells reproductive technology as they are still in preclinical or early clinical research settings. CONCLUSIONS Based on Repro-Can-OPEN Study Part I & II, we presented a plausible oncofertility best practice model to help optimize care for children with cancer in various resource settings. Special ethical concerns should be considered when offering advanced and innovative oncofertility options to children.
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Affiliation(s)
- M Salama
- grid.17088.360000 0001 2150 1785Oncofertility Consortium, Michigan State University, 965 Wilson Road, Room A626B, East Lansing, MI 48824-1316 USA
| | - L. Nahata
- grid.240344.50000 0004 0392 3476Endocrinology and Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205 USA
- grid.261331.40000 0001 2285 7943Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43205 USA
| | - Y. Jayasinghe
- grid.416107.50000 0004 0614 0346Royal Children’s Hospital, Flemington Rd, Parkville, Melbourne, Vic 3054 Australia
| | - V. Gomez-Lobo
- grid.239560.b0000 0004 0482 1586Children’s National Hospital, 111 Michigan Avenue NW, Washington, DC 20010 USA
- grid.420089.70000 0000 9635 8082Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda MD, Annapolis, 20892 USA
| | - MM. Laronda
- grid.413808.60000 0004 0388 2248Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 East Chicago Ave, Box 63, Chicago, IL 60611 USA
| | - MB. Moravek
- grid.412590.b0000 0000 9081 2336Center for Reproductive Medicine, Michigan Medicine, 475 Market Place, Building 1, Suite B, Ann Arbor, MI 48108 USA
| | - LR. Meacham
- grid.428158.20000 0004 0371 6071Aflac Cancer Center Children’s Healthcare of Atlanta, Atlanta, GA USA
- grid.189967.80000 0001 0941 6502Department of Pediatrics, Emory University, 2015 Uppergate Dr, Atlanta, GA 30322 USA
| | - MS. Christianson
- grid.21107.350000 0001 2171 9311Johns Hopkins Fertility Center, Division of Reproductive Endocrinology and Infertility, Johns Hopkins University School of Medicine, 10751 Falls Road, Suite 280, Lutherville, MD 21093 USA
| | - M. Lambertini
- grid.410345.70000 0004 1756 7871Department of Medical Oncology, UOC Clinica Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- grid.5606.50000 0001 2151 3065Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy
| | - A. Anazodo
- grid.414009.80000 0001 1282 788XKids Cancer Centre, Sydney Children’s Hospital, High Street Randwick, Sydney, Randwick 2031 Australia
| | - GP. Quinn
- grid.137628.90000 0004 1936 8753New York University, NYU Langone Fertility Center, 660 First Ave, 5Th Floor, New York, NY 10016 USA
| | - TK. Woodruff
- grid.17088.360000 0001 2150 1785Oncofertility Consortium, Michigan State University, 965 Wilson Road, Room A626B, East Lansing, MI 48824-1316 USA
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Mat Jin N, Ahmad SM, Mohd Faizal A, Abdul Karim AKB, Abu MA. Ovarian tissue cryopreservation in Malaysia: a case series. Horm Mol Biol Clin Investig 2022; 43:469-474. [PMID: 35545610 DOI: 10.1515/hmbci-2021-0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/25/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES We aim to discuss the hematological cancer cases that opted for ovarian tissue cryopreservation (OTC) as fertility preservation before the gonadotoxic chemotherapy agent. CASE PRESENTATION The ovarian tissue cryopreservation (OTC) was started in August 2020 in our center. Up to now, there were four cases have been performed and included in this report. The ovarian tissue cortex was cryopreserved with cryoprotectant using Kitazato™ (Tokyo, Japan) media and fit in the closed system devices. A total of four post-OTC patients were included. The mean age was 24 years old, whereas the mean serum AMH level was 30.43 pmol/L. Most of them were diagnosed with lymphoma, except one was leukemia. All of them received additional GnRH analog following OTC as a chemoprotective agent before cancer treatment. Currently, they are recovering well and on regular follow-up with the hematological department. CONCLUSIONS Although The OTC is an ultimate option for prepubertal girls, it can be proposed as a good strategy for adult cancer women who could not delay cancer therapy.
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Affiliation(s)
- Norazilah Mat Jin
- Advanced Reproductive Centre, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Teknologi MARA (UiTM), (UKM), Selangor, Malaysia
| | - Siti Maisarah Ahmad
- Advanced Reproductive Centre, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
- Department of Obstetrics & Gynecology Hospital Tuanku Azizah, 50300 Kuala Lumpur, Malaysia
| | - Ahmad Mohd Faizal
- Advanced Reproductive Centre, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
- Department of Obstetrics and Gynaecology, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Abdul Kadir Bin Abdul Karim
- Advanced Reproductive Centre, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
- Department of Obstetrics and Gynaecology, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Muhammad Azrai Abu
- Advanced Reproductive Centre, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
- Department of Obstetrics and Gynaecology, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
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7
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Factors influencing perceived communication quality for successful fertility preservation counseling for adolescent and young adult cancer patients and their caregivers in Korea. Support Care Cancer 2022; 30:9751-9762. [DOI: 10.1007/s00520-022-07425-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 10/18/2022] [Indexed: 11/11/2022]
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8
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Global uptake of fertility preservation by women undergoing cancer treatment: An unmet need in low to high-income countries. Cancer Epidemiol 2022; 79:102189. [DOI: 10.1016/j.canep.2022.102189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 11/23/2022]
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Ataman LM, Laronda MM, Gowett M, Trotter K, Anvari H, Fei F, Ingram A, Minette M, Suebthawinkul C, Taghvaei Z, Torres-Vélez M, Velez K, Adiga SK, Anazodo A, Appiah L, Bourlon MT, Daniels N, Dolmans MM, Finlayson C, Gilchrist RB, Gomez-Lobo V, Greenblatt E, Halpern JA, Hutt K, Johnson EK, Kawamura K, Khrouf M, Kimelman D, Kristensen S, Mitchell RT, Moravek MB, Nahata L, Orwig KE, Pavone ME, Pépin D, Pesce R, Quinn GP, Rosen MP, Rowell E, Smith K, Venter C, Whiteside S, Xiao S, Zelinski M, Goldman KN, Woodruff TK, Duncan FE. A synopsis of global frontiers in fertility preservation. J Assist Reprod Genet 2022; 39:1693-1712. [PMID: 35870095 PMCID: PMC9307970 DOI: 10.1007/s10815-022-02570-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/08/2022] [Indexed: 11/28/2022] Open
Abstract
Since 2007, the Oncofertility Consortium Annual Conference has brought together a diverse network of individuals from a wide range of backgrounds and professional levels to disseminate emerging basic and clinical research findings in fertility preservation. This network also developed enduring educational materials to accelerate the pace and quality of field-wide scientific communication. Between 2007 and 2019, the Oncofertility Consortium Annual Conference was held as an in-person event in Chicago, IL. The conference attracted approximately 250 attendees each year representing 20 countries around the world. In 2020, however, the COVID-19 pandemic disrupted this paradigm and precluded an in-person meeting. Nevertheless, there remained an undeniable demand for the oncofertility community to convene. To maintain the momentum of the field, the Oncofertility Consortium hosted a day-long virtual meeting on March 5, 2021, with the theme of "Oncofertility Around the Globe" to highlight the diversity of clinical care and translational research that is ongoing around the world in this discipline. This virtual meeting was hosted using the vFairs ® conference platform and allowed over 700 people to participate, many of whom were first-time conference attendees. The agenda featured concurrent sessions from presenters in six continents which provided attendees a complete overview of the field and furthered our mission to create a global community of oncofertility practice. This paper provides a synopsis of talks delivered at this event and highlights the new advances and frontiers in the fields of oncofertility and fertility preservation around the globe from clinical practice and patient-centered efforts to translational research.
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Affiliation(s)
- L M Ataman
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 303 E. Superior Street, Lurie 7-117, Chicago, IL, 60611, USA
| | - M M Laronda
- Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - M Gowett
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 303 E. Superior Street, Lurie 7-117, Chicago, IL, 60611, USA
| | - K Trotter
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 303 E. Superior Street, Lurie 7-117, Chicago, IL, 60611, USA
| | - H Anvari
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 303 E. Superior Street, Lurie 7-117, Chicago, IL, 60611, USA
| | - F Fei
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 303 E. Superior Street, Lurie 7-117, Chicago, IL, 60611, USA
| | - A Ingram
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 303 E. Superior Street, Lurie 7-117, Chicago, IL, 60611, USA
| | - M Minette
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 303 E. Superior Street, Lurie 7-117, Chicago, IL, 60611, USA
| | - C Suebthawinkul
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 303 E. Superior Street, Lurie 7-117, Chicago, IL, 60611, USA
| | - Z Taghvaei
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 303 E. Superior Street, Lurie 7-117, Chicago, IL, 60611, USA
| | - M Torres-Vélez
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 303 E. Superior Street, Lurie 7-117, Chicago, IL, 60611, USA
| | - K Velez
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 303 E. Superior Street, Lurie 7-117, Chicago, IL, 60611, USA
| | - S K Adiga
- Department of Clinical Embryology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, India
| | - A Anazodo
- Kids Cancer Centre, Sydney Children's Hospital, Nelune Comprehensive Cancer Centre, Sydney, Australia
- School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - L Appiah
- Department of Obstetrics and Gynecology, The University of Colorado School of Medicine, Aurora, CO, USA
| | - M T Bourlon
- Hemato-Oncology Department, Instituto Nacional de Ciencias Médicas Y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - N Daniels
- The Oncology and Fertility Centres of Ekocorp, Eko Hospitals, Lagos, Nigeria
| | - M M Dolmans
- Gynecology Research Unit, Institut de Recherche Expérimentale Et Clinique, Université Catholique de Louvain, Av. Mounier 52, 1200, Brussels, Belgium
- Department of Gynecology, Cliniques Universitaires Saint-Luc, Av. Hippocrate 10, 1200, Brussels, Belgium
| | - C Finlayson
- Department of Pediatrics (Endocrinology), Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - R B Gilchrist
- School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - V Gomez-Lobo
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | | | - J A Halpern
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - K Hutt
- Anatomy & Developmental Biology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Australia
| | - E K Johnson
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - K Kawamura
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - M Khrouf
- FERTILLIA, Clinique la Rose, Tunis, Tunisia
| | - D Kimelman
- Centro de Esterilidad Montevideo, Montevideo, Uruguay
| | - S Kristensen
- Department of Fertility, Copenhagen University Hospital, Copenhagen, Denmark
| | - R T Mitchell
- Department of Developmental Endocrinology, University of Edinburgh, Edinburgh, UK
| | - M B Moravek
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Michigan, Ann Arbor, MI, USA
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | - L Nahata
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Endocrinology and Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - K E Orwig
- Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - M E Pavone
- Department of Obstetrics and Gynecology, Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - D Pépin
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - R Pesce
- Reproductive Medicine Unit, Obstetrics and Gynecology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - G P Quinn
- Departments of Obstetrics and Gynecology, Center for Medical Ethics, Population Health, Grossman School of Medicine, New York University, New York, NY, USA
| | - M P Rosen
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Reproductive Endocrinology and Infertility, University of California, San Francisco, CA, USA
| | - E Rowell
- Department of Surgery (Pediatric Surgery), Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - K Smith
- Department of Obstetrics and Gynecology, Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - C Venter
- Vitalab, Johannesburg, South Africa
| | - S Whiteside
- Fertility & Reproductive Health Program, Department of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, OH, USA
| | - S Xiao
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Environmental Health Sciences Institute, Rutgers University, New Brunswick, NJ, USA
| | - M Zelinski
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR, USA
| | - K N Goldman
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 303 E. Superior Street, Lurie 7-117, Chicago, IL, 60611, USA
| | - T K Woodruff
- Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - F E Duncan
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 303 E. Superior Street, Lurie 7-117, Chicago, IL, 60611, USA.
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10
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A modified hydrostatic microfluidic pumpless device for in vitro murine ovarian tissue culture as research model for fertility preservation. Obstet Gynecol Sci 2022; 65:376-381. [PMID: 35707972 PMCID: PMC9304444 DOI: 10.5468/ogs.22012] [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: 01/03/2022] [Accepted: 03/22/2022] [Indexed: 11/30/2022] Open
Abstract
This study aimed to compare the efficacies of conventional and non-conventional (modified hydrostatic microfluidic pumpless device, MHPD) systems on ovarian tissue culture and in vitro follicle growth using a mouse model. A total of 56 ovarian cortical tissues retrieved from seven wild-type mice were divided into three groups: 1) fresh control, 2) conventional culture system (control), and 3) non-conventional system with MHPD. Ovarian tissues were cultured for 96 hours and evaluated for follicle morphology, developmental stage, intact follicle density, and relative gene expression levels (proliferating cell nuclear antigen, insulin like growth factor 1, BAX, and Bcl-2). Our major data demonstrated that the mean percentage of primary follicle development was increased by the MHPD (P<0.05). In addition, this device could maintain and support follicle development better than the conventional culture systems. However, the overall outcomes were not significantly improved by our first-design prototype. Consequently, next-generation platforms should be developed as alternative medical tools for fertility preservation research.
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11
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Levin NJ, Zhang A, Kattari S, Moravek M, Zebrack B. "Queer Insights": Considerations and Challenges for Assessing Sex, Gender Identity, and Sexual Orientation in Oncofertility Research. ANNALS OF LGBTQ PUBLIC AND POPULATION HEALTH 2022; 3:111-128. [PMID: 38078047 PMCID: PMC10704859 DOI: 10.1891/lgbtq-2021-0015] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
This article addresses issues related to clinical and research approaches to oncofertility for adolescent and young adult (AYA) sexual and gender minority (SGM) cancer patients. Limited attention has been dedicated to understanding the extent to which oncofertility services are appropriately and equitably delivered to AYAs with diverse orientations toward sexual orientation, gender identity, and future family. Unresolved challenges to conducting research with this vulnerable population perpetuate a lack of adequate knowledge about SGM AYA oncofertility needs. Therefore, the purpose of this paper is to inform considerations of sex, gender identity, and sexual orientation for investigations that include SGM AYAs. In order to improve the knowledge base and clinical services for this population, we discuss (1) challenges to sampling this population; (2) categorization and survey logic (e.g., skip patterns) in light of fluid sexual orientation and gender identities; and (3) clinical implications of accurately assessing sex and gender for oncofertility research and practice. We also recommend strategies for producing inclusive and accurate assessments of sexual and gender identity categories in both research and clinical encounters with SGM AYAs. Incorporating "queer insights" into empirical research - that is, positioning queer theory at the center of oncofertility study design - is suggested as a future direction for oncofertility research and practice.
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Affiliation(s)
- Nina Jackson Levin
- University of Michigan, School of Social Work and Department of Anthropology
| | - Anao Zhang
- University of Michigan, School of Social Work
| | - Shanna Kattari
- University of Michigan, School of Social Work and Department of Women’s and Gender Studies
| | - Molly Moravek
- University of Michigan, Department of Obstetrics and Gynecology and Department of Urology, Ann Arbor, MI, USA
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12
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Jiménez-Trejo F, Arriaga-Canon C, Herrera LA, Lisboa-Nascimento T, Diaz D. Insights of Oncofertility in Mexico and Latin America. Front Oncol 2022; 12:811464. [PMID: 35600375 PMCID: PMC9120766 DOI: 10.3389/fonc.2022.811464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Francisco Jiménez-Trejo
- Instituto Nacional de Pediatría, Ciudad de México, Mexico
- *Correspondence: Francisco Jiménez-Trejo,
| | | | - Luis A. Herrera
- Instituto Nacional de Medicina Genómica, Ciudad de México, Mexico
| | | | - Daniel Diaz
- Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
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13
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Huang SM, Tseng LM, Yang MJ, Chang A, Lien PJ, Hsiung Y. Developing a web-based oncofertility tool for reproductive-age women with breast cancer based on social support framework. Support Care Cancer 2022; 30:6195-6204. [PMID: 35438338 DOI: 10.1007/s00520-022-07046-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 04/05/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To develop electronic systems for oncofertility support, and to examine the comprehensibility, feasibility, usability, and effects on social support and preparation for decision-making. METHODS The study steps were guided, tested, and utilized to (a) identify the requirements of a patient, (b) guide the development of support interventions, and (c) evaluate the quality of web-based oncofertility support. Alpha testing and beta testing were used to ensure the quality of the web-based oncofertility support tool. The effectiveness was evaluated using the Preparation for Decision-Making Scale and Social Support Questionnaire. RESULTS At the alpha testing phase, the mean (± standard deviation) values of the comprehensibility and usability for reproductive-age women with breast cancer were 4.24 (± 0.47) and 4.42 (± 0.57); and the mean values of the acceptability and usability for healthcare providers were 4.04 (± 0.67) and 3.99 (± 0.66), respectively. At the beta testing phase, the mean values of the feasibility for patients and healthcare providers were 3.93 (± 0.67) and 4.17 (± 0.78), respectively. The corresponding mean Preparation for Decision-Making Scale scores were 3.78 ± 0.82 and 4.11 ± 0.93, respectively. The results of the Wilcoxon signed-rank test revealed that the informational and instrumental support scores improved significantly compared with the pre-test data (informational support: 8.94 ± 3.28 vs. 10.06 ± 1.91, p < 0.01; instrumental support: 7.44 ± 2.90 vs. 8.75 ± 2.57, p < 0.01). CONCLUSIONS The oncofertility support website demonstrated acceptable comprehensibility, feasibility, and usability, in addition to informational and instrumental support. TRIAL REGISTRATION Clinicaltrials.gov NCT05100498, https://clinicaltrials.gov/ct2/show/NCT05100498.
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Affiliation(s)
- Sheng-Miauh Huang
- Department of Nursing, Mackay Medical College, No. 46, Section 3, Zhongzheng Road, New Taipei City 252, Sanzhi District, Taiwan.
| | - Ling-Ming Tseng
- Department of Surgery, Comprehensive Breast Health Center, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
| | - Ming-Jeng Yang
- Institute of Geriatric Welfare Technology & Science, Mackay Medical College, New Taipei City, Taiwan
| | - Aria Chang
- Institute of Geriatric Welfare Technology & Science, Mackay Medical College, New Taipei City, Taiwan
| | - Pei-Ju Lien
- Department of Surgery, Comprehensive Breast Health Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yvonne Hsiung
- Department of Nursing, Mackay Medical College, No. 46, Section 3, Zhongzheng Road, New Taipei City 252, Sanzhi District, Taiwan
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14
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Barriers to Oncofertility Care among Female Adolescent Cancer Patients in Canada. Curr Oncol 2022; 29:1583-1593. [PMID: 35323333 PMCID: PMC8947634 DOI: 10.3390/curroncol29030133] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/26/2022] [Accepted: 02/28/2022] [Indexed: 11/23/2022] Open
Abstract
High survival rates in adolescent cancer patients have shifted the medical focus to the long-term outcomes of cancer treatments. Surgery, chemotherapy, and radiation increase the risk of infertility and infertility-related distress in adolescent cancer patients and survivors. The aims of this narrative review were to (1) describe the psychosocial impacts of cancer-related infertility in adolescents, (2) identify multilevel barriers to fertility preservation (FP) conversations and referrals, and (3) conclude with evidence-based clinical solutions for improving the oncofertility support available to Canadian adolescents. The results of this review revealed that FP decisions occur within the patient, parent, and health care provider (HCP) triad, and are influenced by factors such as parent attitudes, patient maturity, and HCP knowledge. Decision tools and HCP education can promote the occurrence of developmentally appropriate fertility discussions. At the systems level, cost and resource barriers prevent patients from receiving sufficient fertility information and referrals. Clinical models of care (MOCs) can define interdisciplinary roles and referral pathways to improve the integration of oncofertility services into adolescent cancer care. The continued integration of oncofertility care will ensure that all Canadian adolescents receive the exemplary medical and psychological support necessary to make empowered decisions about their own fertility.
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15
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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.
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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
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16
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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.
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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
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17
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Schermerhorn SMV, Rosen MP, Blevins EM, Byrd KA, Rabban JT, Marsh P, Lucas DJ. Regional air transportation of ovarian tissue for cryopreservation in a prepubertal female with cancer. Pediatr Blood Cancer 2021; 68:e29107. [PMID: 34105898 DOI: 10.1002/pbc.29107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 11/11/2022]
Abstract
Ovarian tissue cryopreservation is the only fertility preservation (FP) option available to prepubescent females receiving gonadotoxic therapy, but it has limited availability. A 6-year-old female was diagnosed with high-risk rhabdomyosarcoma, and the planned treatment carried an 80% risk of ovarian failure. Her parents desired FP, but the nearest center was 500 miles away. The patient underwent oophorectomy at the cancer center with air transport of the tissue to the oncofertility center, where it was successfully cryopreserved. Formation of networks between full-service and limited oncofertility centers in a hub-and-spoke model would increase access to FP services, particularly in children.
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Affiliation(s)
- Sophia M V Schermerhorn
- Division of Pediatric Surgery, Department of General Surgery, Naval Medical Center San Diego, San Diego, California, USA
| | - Mitchell P Rosen
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California, USA
| | - Erin M Blevins
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Naval Medical Center San Diego, San Diego, California, USA.,School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Kevin A Byrd
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Naval Medical Center San Diego, San Diego, California, USA
| | - Joseph T Rabban
- Department of Pathology, University of California, San Francisco, California, USA
| | - Philip Marsh
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California, USA
| | - Donald J Lucas
- Division of Pediatric Surgery, Department of General Surgery, Naval Medical Center San Diego, San Diego, California, USA.,School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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18
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Bourlon MT, Anazodo A, Woodruff TK, Segelov E. Oncofertility as a Universal Right and a Global Oncology Priority. JCO Glob Oncol 2021; 6:314-316. [PMID: 32119579 PMCID: PMC7113082 DOI: 10.1200/go.19.00337] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Maria T Bourlon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | | | - Eva Segelov
- Monash Health and Monash University, Clayton, Victoria, Australia
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19
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Lambertini M, Blondeaux E, Bruzzone M, Perachino M, Anderson RA, de Azambuja E, Poorvu PD, Kim HJ, Villarreal-Garza C, Pistilli B, Vaz-Luis I, Saura C, Ruddy KJ, Franzoi MA, Sertoli C, Ceppi M, Azim HA, Amant F, Demeestere I, Del Mastro L, Partridge AH, Pagani O, Peccatori FA. Pregnancy After Breast Cancer: A Systematic Review and Meta-Analysis. J Clin Oncol 2021; 39:3293-3305. [PMID: 34197218 DOI: 10.1200/jco.21.00535] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Many patients and physicians remain concerned about the potential detrimental effects of pregnancy after breast cancer (BC) in terms of reproductive outcomes and maternal safety. This systematic review and meta-analysis aimed at providing updated evidence on these topics. METHODS A systematic literature review was conducted to identify studies including patients with a pregnancy after BC (PROSPERO number CRD42020158324). Likelihood of pregnancy after BC, their reproductive outcomes, and maternal safety were assessed. Pooled relative risks, odds ratios (ORs), and hazard ratios (HRs) with 95% CIs were calculated using random effects models. RESULTS Of 6,462 identified records, 39 were included involving 8,093,401 women from the general population and 112,840 patients with BC of whom 7,505 had a pregnancy after diagnosis. BC survivors were significantly less likely to have a subsequent pregnancy compared with the general population (relative risk, 0.40; 95% CI, 0.32 to 0.49). Risks of caesarean section (OR, 1.14; 95% CI, 1.04 to 1.25), low birth weight (OR, 1.50; 95% CI, 1.31 to 1.73), preterm birth (OR, 1.45; 95% CI, 1.11 to 1.88), and small for gestational age (OR, 1.16; 95% CI, 1.01 to 1.33) were significantly higher in BC survivors, particularly in those with previous chemotherapy exposure, compared with the general population. No significantly increased risk of congenital abnormalities or other reproductive complications were observed. Compared to patients with BC without subsequent pregnancy, those with a pregnancy had better disease-free survival (HR, 0.66; 95% CI, 0.49 to 0.89) and overall survival (HR, 0.56; 95% CI, 0.45 to 0.68). Similar results were observed after correcting for potential confounders and irrespective of patient, tumor, and treatment characteristics, pregnancy outcome, and timing of pregnancy. CONCLUSION These results provide reassuring evidence on the safety of conceiving in BC survivors. Patients' pregnancy desire should be considered a crucial component of their survivorship care plan.
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Affiliation(s)
- Matteo Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy.,Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Eva Blondeaux
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy.,Breast Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Marco Bruzzone
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Marta Perachino
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy.,Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Richard A Anderson
- MRC Centre for Reproductive Health, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Evandro de Azambuja
- Department of Medicine, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Philip D Poorvu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston MA
| | - Hee Jeong Kim
- Department of Surgical Oncology, Asan Medical Center, Seoul, Korea
| | - Cynthia Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico.,Department of Breast Tumors, Instituo Nacional de Cancerologia, Mexico City, Mexico
| | - Barbara Pistilli
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
| | - Ines Vaz-Luis
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
| | - Cristina Saura
- Department of Medical Oncology, Vall d'Hebron University Hospital (HUVH), Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | - Chiara Sertoli
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Marcello Ceppi
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Hatem A Azim
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | - Frederic Amant
- Netherlands Cancer Institute and Amsterdam University Medical Centers, Amsterdam, the Netherlands.,Department of Oncology, KU Leuven, Leuven, Belgium
| | - Isabelle Demeestere
- Fertility Clinic, CUB-Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Lucia Del Mastro
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy.,Breast Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Ann H Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston MA
| | - Olivia Pagani
- Geneva University Hospitals, European School of Oncology, Geneva, Switzerland
| | - Fedro A Peccatori
- Fertility and Procreation Unit, Gynecologic Oncology Department, European Institute of Oncology IRCCS, Milan, Italy
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20
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Woodruff TK, Ataman-Millhouse L, Acharya KS, Almeida-Santos T, Anazodo A, Anderson RA, Appiah L, Bader J, Becktell K, Brannigan RE, Breech L, Bourlon MT, Bumbuliene Ž, Burns K, Campo-Engelstein L, Campos JR, Centola GM, Chehin MB, Chen D, De Vos M, Duncan FE, El-Damen A, Fair D, Famuyiwa Y, Fechner PY, Fontoura P, Frias O, Gerkowicz SA, Ginsberg J, Gracia CR, Goldman K, Gomez-Lobo V, Hazelrigg B, Hsieh MH, Hoyos LR, Hoyos-Martinez A, Jach R, Jassem J, Javed M, Jayasinghe Y, Jeelani R, Jeruss JS, Kaul-Mahajan N, Keim-Malpass J, Ketterl TG, Khrouf M, Kimelman D, Kusuhara A, Kutteh WH, Laronda MM, Lee JR, Lehmann V, Letourneau JM, McGinnis LK, McMahon E, Meacham LR, Mijangos MFV, Moravek M, Nahata L, Ogweno GM, Orwig KE, Pavone ME, Peccatori FA, Pesce RI, Pulaski H, Quinn G, Quintana R, Quintana T, de Carvalho BR, Ramsey-Goldman R, Reinecke J, Reis FM, Rios J, Rhoton-Vlasak AS, Rodriguez-Wallberg KA, Roeca C, Rotz SJ, Rowell E, Salama M, Saraf AJ, Scarella A, Schafer-Kalkhoff T, Schmidt D, Senapati S, Shah D, Shikanov A, Shnorhavorian M, Skiles JL, Smith JF, Smith K, Sobral F, Stimpert K, Su HI, Sugimoto K, Suzuki N, Thakur M, Victorson D, Viale L, Vitek W, Wallace WH, Wartella EA, Westphal LM, Whiteside S, Wilcox LH, Wyns C, Xiao S, Xu J, Zelinski M. A View from the past into our collective future: the oncofertility consortium vision statement. J Assist Reprod Genet 2021; 38:3-15. [PMID: 33405006 PMCID: PMC7786868 DOI: 10.1007/s10815-020-01983-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/14/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose Today, male and female adult and pediatric cancer patients, individuals transitioning between gender identities, and other individuals facing health extending but fertility limiting treatments can look forward to a fertile future. This is, in part, due to the work of members associated with the Oncofertility Consortium. Methods The Oncofertility Consortium is an international, interdisciplinary initiative originally designed to explore the urgent unmet need associated with the reproductive future of cancer survivors. As the strategies for fertility management were invented, developed or applied, the individuals for who the program offered hope, similarly expanded. As a community of practice, Consortium participants share information in an open and rapid manner to addresses the complex health care and quality-of-life issues of cancer, transgender and other patients. To ensure that the organization remains contemporary to the needs of the community, the field designed a fully inclusive mechanism for strategic planning and here present the findings of this process. Results This interprofessional network of medical specialists, scientists, and scholars in the law, medical ethics, religious studies and other disciplines associated with human interventions, explore the relationships between health, disease, survivorship, treatment, gender and reproductive longevity. Conclusion The goals are to continually integrate the best science in the service of the needs of patients and build a community of care that is ready for the challenges of the field in the future.
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Affiliation(s)
- Teresa K Woodruff
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | - Lauren Ataman-Millhouse
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Kelly S Acharya
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Duke Fertility Center, Durham, NC, USA
| | - Teresa Almeida-Santos
- Reproductive Medicine Unit, Coimbra Hospital and University Centre, Coimbra, Portugal.,Clinical Academic Center of Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Antoinette Anazodo
- Kids Cancer Centre, Sydney Children's Hospital, Nelune Comprehensive Cancer Centre, Sydney, Australia.,Prince of Wales Hospital, Sydney, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, Australia
| | - Richard A Anderson
- Centre for Reproductive Health, University of Edinburgh, Edinburgh, Scotland, UK
| | - Leslie Appiah
- Department of Obstetrics and Gynecology, The University of Colorado School of Medicine, Aurora, CO, USA
| | - Joy Bader
- ReproTech, Ltd., Saint Paul, MN, USA
| | | | - Robert E Brannigan
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Lesley Breech
- Department of Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Maria T Bourlon
- Hemato-Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Žana Bumbuliene
- Clinic of Obstetrics and Gynecology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Karen Burns
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Lisa Campo-Engelstein
- Institute for the Medical Humanities, Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Grace M Centola
- Dadi, Inc., Brooklyn, NY, USA.,Phoenix Sperm Bank of Seattle Sperm Bank, Phoenix, AZ, USA.,New England Cryogenic Center/New England Cord Blood Bank, Marlborough, MA, USA
| | | | - Diane Chen
- Potocsnak Family Division of Adolescent and Young Adult Medicine and Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Departments of Psychiatry and Behavioral Sciences, and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Michel De Vos
- Centre for Reproductive Medicine, UZ Brussel, Brussels, Belgium.,Follicle Biology Laboratory (FOBI), Vrije Universiteit Brussel, Brussels, Belgium.,Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Professional Education, Sechenov University, Moscow, Russia
| | - Francesca E Duncan
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ahmed El-Damen
- IVIRMA Middle East Fertility Clinic, Abu Dhabi, United Arab Emirates.,Division of Embryology and Comparative Anatomy, Faculty of Science, Cairo University, Giza, Egypt
| | - Douglas Fair
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Utah, Primary Children's Hospital, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Yemi Famuyiwa
- Montgomery Fertility Center, Rockville, MD, USA.,Department of Obstetrics and Gynecology, George Washington University School of Medicine, Washington, DC, USA
| | - Patricia Y Fechner
- Department of Pediatrics, Division of Endocrinology, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | | | - Olivia Frias
- Department of Obstetrics and Gynecology, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | | | - Jill Ginsberg
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Clarisa R Gracia
- Division of Reproductive Endocrinology & Infertility, University of Pennsylvania, Philadelphia, PA, USA
| | - Kara Goldman
- Department of Obstetrics and Gynecology, Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Veronica Gomez-Lobo
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | | | - Michael H Hsieh
- Department of Urology, George Washington University, Washington, DC, USA
| | - Luis R Hoyos
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of California, Los Angeles, CA, USA
| | - Alfonso Hoyos-Martinez
- Department of Pediatrics, Section of Pediatric Diabetes and Endocrinology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Robert Jach
- Department of Obstetrics and Gynecology, Medical College Jagiellonian University, Krakow, Poland
| | - Jacek Jassem
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
| | - Murid Javed
- OriginElle Fertility Clinic and Women's Health Centre, Ottawa, ON, Canada
| | - Yasmin Jayasinghe
- Department of Obstetrics & Gynaecology Royal Women's Hospital, University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - Roohi Jeelani
- Vios Fertility Institute, Chicago, IL, USA.,Department of Obstetrics and Gynecology, Wayne State School of Medicine, Detroit, MI, USA
| | - Jacqueline S Jeruss
- Departments of Surgery, Pathology, and Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Nalini Kaul-Mahajan
- Mother & Child Hospital, New Delhi, India.,Ferticity Fertility Clinics, New Delhi, India
| | - Jessica Keim-Malpass
- School of Nursing, University of Virginia, Charlottesville, VA, USA.,Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Tyler G Ketterl
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Washington, Seattle, WA, USA.,Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, WA, USA
| | | | - Dana Kimelman
- Centro de Esterilidad Montevideo, Montevideo, Uruguay
| | - Atsuko Kusuhara
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
| | - William H Kutteh
- Department of Reproductive Endocrinology, Vanderbilt University School of Medicine, Nashville, TN, USA.,Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Monica M Laronda
- Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Jung Ryeol Lee
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Fertility Preservation and Enhancement Research Laboratory, Seongnam, Korea
| | - Vicky Lehmann
- Department of Medical Psychology, Amsterdam University Medical Centers, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Joseph M Letourneau
- University of Utah Center for Reproductive Medicine, Salt Lake City, UT, USA
| | - Lynda K McGinnis
- Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Eileen McMahon
- Sinai Health System, Mount Sinai Fertility, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| | - Lillian R Meacham
- Department of Pediatrics, Aflac Cancer Center of Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA
| | - Monserrat Fabiola Velez Mijangos
- Biology of Human Reproduction Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Molly Moravek
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.,Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | - Leena Nahata
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - George Moses Ogweno
- Reproductive Endocrinology and Fertility, Department of Obstetrics and Gynecology, The Nairobi Hospital, Nairobi, Kenya.,Esis Health Services (EHS), Nairobi, Kenya
| | - Kyle E Orwig
- Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mary Ellen Pavone
- Department of Obstetrics and Gynecology, Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Fedro Alessandro Peccatori
- Fertility & Procreation Unit, Division of Gynecologic Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Romina Ileana Pesce
- Reproductive Medicine Unit, Obstetrics and Gynecology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Hanna Pulaski
- Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Gwendolyn Quinn
- Departments of Obstetrics and Gynecology, Center for Medical Ethics, Population Health, Grossman School of Medicine, New York University, New York, NY, USA
| | | | | | | | - Rosalind Ramsey-Goldman
- Department of Medicine/Division of Rheumatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Fernando M Reis
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Julie Rios
- Department of Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Obstetrics and Gynecology, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Alice S Rhoton-Vlasak
- Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Kenny A Rodriguez-Wallberg
- Department of Reproductive Medicine, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - Cassandra Roeca
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Seth J Rotz
- Department of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, OH, USA
| | - Erin Rowell
- Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Mahmoud Salama
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Amanda J Saraf
- Riley Hospital for Children at Indiana University, Indianapolis, IN, USA
| | - Anibal Scarella
- Centro de Reproducción Humana, Facultad Medicina, Universidad de Valparaíso, Valparaíso, Chile.,Departamento de Obstetricia y Ginecología, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile
| | | | - Deb Schmidt
- Children's Hospital of Wisconsin, Milwaukee, WI, USA
| | - Suneeta Senapati
- Division of Reproductive Endocrinology & Infertility, University of Pennsylvania, Philadelphia, PA, USA
| | - Divya Shah
- Division of Reproductive Endocrinology & Infertility, University of Pennsylvania, Philadelphia, PA, USA
| | - Ariella Shikanov
- Department of Biomedical Engineering, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Margarett Shnorhavorian
- Department of Urology, Division of Pediatric Urology, Seattle Children's Hospital, Seattle, University of Washington, Seattle, WA, USA
| | - Jodi L Skiles
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - James F Smith
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA
| | - Kristin Smith
- Department of Obstetrics and Gynecology, Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Fabio Sobral
- Pregna Medicina Reproductiva, Buenos Aires, Argentina
| | - Kyle Stimpert
- Department of Hematology/Oncology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - H Irene Su
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, CA, USA
| | - Kouhei Sugimoto
- International Center for Reproductive Medicine, Dokkyo Medical University, Saitama Medical Center, Saitama, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Mili Thakur
- Reproductive Genomics Program, The Fertility Center, Grand Rapids, MI, USA.,Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - David Victorson
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Wendy Vitek
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA.,Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
| | - W Hamish Wallace
- Paediatric Oncology, University of Edinburgh & Royal Hospital for Sick Children, Edinburgh, Scotland, UK
| | - Ellen A Wartella
- Center on Media and Human Development, School of Communication, Northwestern University, Evanston, IL, USA
| | - Lynn M Westphal
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Stacy Whiteside
- Fertility & Reproductive Health Program, Department of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, OH, USA
| | | | - Christine Wyns
- Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Shuo Xiao
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Environmental Health Sciences Institute, Rutgers University, New Brunswick, NJ, USA
| | - Jing Xu
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR, USA.,Department of Obstetrics & Gynecology, School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Mary Zelinski
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR, USA.,Department of Obstetrics & Gynecology, School of Medicine, Oregon Health & Science University, Portland, OR, USA
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21
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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.
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22
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Salama M, Ataman L, Taha T, Azmy O, Braham M, Douik F, Khrouf M, Rodrigues JK, Reis FM, Sánchez F, Romero S, Vega M, Woodruff TK. Building Oncofertility Core Competency in Developing Countries: Experience From Egypt, Tunisia, Brazil, Peru, and Panama. JCO Glob Oncol 2020; 6:360-368. [PMID: 35275746 PMCID: PMC9812447 DOI: 10.1200/go.22.00006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2017] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Little is known about oncofertility practice in developing countries that usually suffer from a shortage of health services, especially those related to cancer care. MATERIALS AND METHODS To learn more about oncofertility practice in developing countries, we generated a survey to explore the barriers and opportunities associated with oncofertility practice in five developing countries from Africa and Latin America within our Oncofertility Consortium Global Partners Network. Responses from Egypt, Tunisia, Brazil, Peru, and Panama were collected, reviewed, and discussed. RESULTS Common barriers were identified by each country, including financial barriers (lack of insurance coverage and high out-of-pocket costs for patients), lack of awareness among providers and patients, cultural and religious constraints, and lack of funding to help to support oncofertility programs. CONCLUSION Despite barriers to care, many opportunities exist to grow the field of oncofertility in these five developing countries. It is important to continue to engage stakeholders in developing countries and use powerful networks in the United States and other developed countries to aid in the acceptance of oncofertility on a global level.
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Affiliation(s)
| | | | | | | | | | | | | | - Jhenifer Kliemchen Rodrigues
- In Vitro Consultoria–Research and
Development/Clinical Embriology, Gerais, Brazil
- Universidade Federal de Minas Gerais, Belo Horizonte,
Minas Gerais, Brazil
| | - Fernando M. Reis
- Universidade Federal de Minas Gerais, Belo Horizonte,
Minas Gerais, Brazil
| | - Flor Sánchez
- Centro de Estudiose Investigaciones en
Biología y Medicina Reproductiva, Lima, Peru
| | - Sergio Romero
- Centro de Estudiose Investigaciones en
Biología y Medicina Reproductiva, Lima, Peru
| | - Mario Vega
- Consultorios Hospital Punta Pacific, Panama City,
Panama
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23
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Rozen G, Rogers P, Chander S, Anderson R, McNally O, Umstad M, Winship A, Hutt K, Teh WT, Dobrotwir A, Hart R, Ledger W, Stern K. Clinical summary guide: reproduction in women with previous abdominopelvic radiotherapy or total body irradiation. Hum Reprod Open 2020; 2020:hoaa045. [PMID: 33134561 PMCID: PMC7585646 DOI: 10.1093/hropen/hoaa045] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/13/2020] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION What is the evidence to guide the management of women who wish to conceive following abdominopelvic radiotherapy (AP RT) or total body irradiation (TBI)? SUMMARY ANSWER Pregnancy is possible, even following higher doses of post-pubertal uterine radiation exposure; however, it is associated with adverse reproductive sequelae and pregnancies must be managed in a high-risk obstetric unit. WHAT IS KNOWN ALREADY In addition to primary ovarian insufficiency, female survivors who are treated with AP RT and TBI are at risk of damage to the uterus. This may impact on its function and manifest as adverse reproductive sequelae. STUDY DESIGN SIZE DURATION A review of the literature was carried out and a multidisciplinary working group provided expert opinion regarding assessment of the uterus and obstetric management. PARTICIPANTS/MATERIALS SETTING METHODS Reproductive outcomes for postpubertal women with uterine radiation exposure in the form of AP RT or TBI were reviewed. This included Pubmed listed peer-reviewed publications from 1990 to 2019, and limited to English language.. MAIN RESULTS AND THE ROLE OF CHANCE The prepubertal uterus is much more vulnerable to the effects of radiation than after puberty. Almost all available information about the impact of radiation on the uterus comes from studies of radiation exposure during childhood or adolescence.An uncomplicated pregnancy is possible, even with doses as high as 54 Gy. Therefore, tumour treatment doses alone cannot at present be used to accurately predict uterine damage. LIMITATIONS REASONS FOR CAUTION Much of the data cannot be readily extrapolated to adult women who have had uterine radiation and the publications concerning adult women treated with AP RT are largely limited to case reports. WIDER IMPLICATIONS OF THE FINDINGS This analysis offers clinical guidance and assists with patient counselling. It is important to include patients who have undergone AP RT or TBI in prospective studies to provide further evidence regarding uterine function, pregnancy outcomes and correlation of imaging with clinical outcomes. STUDY FUNDING/COMPETING INTERESTS This study received no funding and there are no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- G Rozen
- Reproductive Services, Royal Women's Hospital, Parkville, VIC, Australia.,Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne and Gynaecology Research Centre, Parkville, VIC, Australia.,Melbourne IVF, East Melbourne, VIC, Australia
| | - P Rogers
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne and Gynaecology Research Centre, Parkville, VIC, Australia
| | - S Chander
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - R Anderson
- University of Edinburgh, MRC Centre for Reproductive Health Queens Medical Research Institute, Edinburgh, UK
| | - O McNally
- Royal Women's Hospital, Gynae-Oncology Unit, Parkville, VIC, Australia
| | - M Umstad
- Department of Maternal Fetal Medicine, Royal Women's Hospital, Parkville, VIC, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne School of BioSciences, Melbourne, VIC, Australia
| | - A Winship
- Development and Stem Cells Program, Monash University Monash Biomedicine Discovery Institute, Clayton, VIC, Australia.,Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC, Australia
| | - K Hutt
- Development and Stem Cells Program, Monash University Monash Biomedicine Discovery Institute, Clayton, VIC, Australia
| | - W T Teh
- Reproductive Services, Royal Women's Hospital, Parkville, VIC, Australia.,Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne and Gynaecology Research Centre, Parkville, VIC, Australia.,Melbourne IVF, East Melbourne, VIC, Australia
| | - A Dobrotwir
- Royal Women's Hospital, Radiology, Parkville, VIC, Australia
| | - R Hart
- University of Western Australia, School of Womens and Infants Health University of Western Australia King Edward Memorial Hospital Subiaco, Perth, WA, Australia
| | - W Ledger
- University of New South Wales, School of Womens and Childrens Health Level 1, Royal Hospital for Women, Sydney, NSW, Australia
| | - K Stern
- Reproductive Services, Royal Women's Hospital, Parkville, VIC, Australia.,Melbourne IVF, East Melbourne, VIC, Australia
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24
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Cho HW, Lee S, Min KJ, Hong JH, Song JY, Lee JK, Lee NW, Kim T. Advances in the Treatment and Prevention of Chemotherapy-Induced Ovarian Toxicity. Int J Mol Sci 2020; 21:ijms21207792. [PMID: 33096794 PMCID: PMC7589665 DOI: 10.3390/ijms21207792] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 10/20/2020] [Indexed: 12/24/2022] Open
Abstract
Due to improvements in chemotherapeutic agents, cancer treatment efficacy and cancer patient survival rates have greatly improved, but unfortunately gonadal damage remains a major complication. Gonadotoxic chemotherapy, including alkylating agents during reproductive age, can lead to iatrogenic premature ovarian insufficiency (POI), and loss of fertility. In recent years, the demand for fertility preservation has increased dramatically among female cancer patients. Currently, embryo and oocyte cryopreservation are the only established options for fertility preservation in women. However, there is growing evidence for other experimental techniques including ovarian tissue cryopreservation, oocyte in vitro maturation, artificial ovaries, stem cell technologies, and ovarian suppression. To prevent fertility loss in women with cancer, individualized fertility preservation options including established and experimental techniques that take into consideration the patient’s age, marital status, chemotherapy regimen, and the possibility of treatment delay should be provided. In addition, effective multidisciplinary oncofertility strategies that involve a highly skilled and experienced oncofertility team consisting of medical oncologists, gynecologists, reproductive biologists, surgical oncologists, patient care coordinators, and research scientists are necessary to provide cancer patients with high-quality care.
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25
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Nahata L, Gomez-Lobo V, Meacham L, Appiah L, Childress K, Hoefgen H, Dwiggins M, Whiteside S, Bjornard K, Rios J, Anazodo A, Finlayson C, Frias O, Woodruff T, Moravek M. 2019 Pediatric Initiative Network: Progress, Proceedings, and Plans. J Adolesc Young Adult Oncol 2020; 9:457-463. [PMID: 32460662 PMCID: PMC7415883 DOI: 10.1089/jayao.2020.0020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Impairment of fertility and sexual/reproductive health are common after oncologic therapy, and are known to have negative impacts on romantic relationships and psychosocial well-being among childhood cancer survivors. The Pediatric Initiative Network (PIN) is an international, multidisciplinary group of providers within the Oncofertility Consortium dedicated to preserving and protecting the fertility of children and adolescents at risk for infertility due to medical conditions or treatments. The PIN and its Best Practices and Research committees meet virtually throughout the year, with one annual in-person meeting. The purpose of this "proceedings" is to highlight key discussion points from the annual PIN meeting which took place on November 11, 2019, to 1) provide a context for pediatric groups across the country on what oncofertility programs are currently doing and why, and 2) inform stakeholders of past, present and future initiatives that may be of value to them and the patient populations they serve.
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Affiliation(s)
- Leena Nahata
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
- Division of Endocrinology, Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Veronica Gomez-Lobo
- Division of Pediatric and Adolescent Gynecology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Lillian Meacham
- Aflac Cancer Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- Division of Hematology/Oncology and Endocrinology, Department of Pediatrics, Emory University, Atlanta, Georgia, USA
| | - Leslie Appiah
- Department of Obstetrics and Gynecology, The University of Colorado School of Medicine Anschutz Medical Campus, Denver, Colorado, USA
- Children's Hospital Colorado, Denver, Colorado, USA
| | - Krista Childress
- Division of Gynecologic Specialties, Department of Gynecology and Obstetrics, Emory University, Atlanta, Georgia, USA
- Division of Pediatric Surgery, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Holly Hoefgen
- Department of Obstetrics and Gynecology, Division of Pediatric and Adolescent Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Maggie Dwiggins
- Medstar Washington Hospital Center, Washington, District of Columbia, USA
| | - Stacy Whiteside
- Division of Hematology/Oncology, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Kari Bjornard
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Julie Rios
- Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, Ohio, USA
- Comprehensive Fertility Care and Preservation Program, Division of Pediatric and Adolescent Gynecology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Antoinette Anazodo
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, Australia
| | - Courtney Finlayson
- Division of Pediatric Endocrinology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Olivia Frias
- Comprehensive Fertility Care and Preservation Program, Division of Pediatric and Adolescent Gynecology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Teresa Woodruff
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Molly Moravek
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA
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26
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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.
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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
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27
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Tholeti P, Uppangala S, Bhat V, Udupa KS, Kumar V, Patted S, Natarajan P, Spears N, Kalthur G, Woodruff TK, Adiga SK. Oncofertility: Knowledge, Attitudes, and Barriers Among Indian Oncologists and Gynecologists. J Adolesc Young Adult Oncol 2020; 10:71-77. [PMID: 32456519 DOI: 10.1089/jayao.2020.0034] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Recommendations from the American Society of Clinical Oncology (ASCO) emphasize the critical need to understand current trends in fertility preservation (FP) among the two sets of primary health care providers involved in oncofertility: the oncologists and the gynecologists. This study is aimed at understanding the health care providers' knowledge, attitudes, and barriers in oncofertility across India. Methods: An 18-item oncofertility survey was designed and directed to 77 oncologists and 214 gynecologists across India. The responses were analyzed by using descriptive statistical methods, and the oncofertility trends between the two groups were studied. Results: The total response rate was 34%, with 49 of 214 oncologists (23%) and 49 of 77 gynecologists (64%) participating in the survey. The awareness of ASCO FP guidelines among oncologists and gynecologists was 53% and 59.5%, respectively. About 48% of oncologists felt knowledgeable about sperm banking, whereas 52% knew about oocyte freezing but not about other options. On the other hand, among gynecologists, 38% reported inadequate knowledge of testicular or ovarian tissue cryopreservation. About 85% of oncologists reported routine referral of cancer diagnosed patients for FP, whereas 75% of gynecologists reported routine FP discussion with patients. Health care providers from both groups perceived the major barriers in oncofertility to be, "financial burden on the patient" (73%-86%) and, "lack of patient awareness" (71%-79.5%). Conclusion: Effective collaboration between oncologists and gynecologists is essential to establish a successful FP program. Economic burden on the patient and lack of patient and physician awareness are limiting factors that need to be overcome.
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Affiliation(s)
- Prathima Tholeti
- Department of Clinical Embryology, Centre for Fertility Preservation, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Shubhashree Uppangala
- Department of Clinical Embryology, Centre for Fertility Preservation, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Vasudeva Bhat
- Division of Pediatric Hematology and Oncology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Karthik S Udupa
- Department of Medical Oncology and Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Vijay Kumar
- Department of Pediatric Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Shobhana Patted
- Department of Obstetrics & Gynecology, Jawaharlal Nehru Medical College, Belgaum, India
| | - Pandiyan Natarajan
- Department of Andrology and Reproductive Medicine, Chettinad Super Speciality Hospital, Chennai, India
| | - Norah Spears
- Biomedical Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Guruprasad Kalthur
- Department of Clinical Embryology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Teresa K Woodruff
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Satish Kumar Adiga
- Department of Clinical Embryology, Centre for Fertility Preservation, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
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28
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Ahmad MF, Sugishita Y, Suzuki-Takahashi Y, Sawada S, Iwahata H, Shiraishi E, Takae S, Horage-Okutsu Y, Suzuki N. Oncofertility Treatment Among Breast Cancer Women: A Paradigm Shift of Practice After a Decade of Service. J Adolesc Young Adult Oncol 2020; 9:496-501. [PMID: 32283045 DOI: 10.1089/jayao.2019.0177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Our center is known as a pioneer center initiating oncofertility service since 2010 in Japan. We demonstrate our transition of this service in regional university hospitals ingenuously. Methods: We compared two phases of service: initial phase (2011 and 2012) and current phase (2019). The comparison included the number of women attending the oncofertility unit, diversity of breast cancer cases, the acceptability of preservation service, and the type of fertility preservation (FP) option offered in between these phases. Results: A total of 58 women were seen during the initial phase as compared with 41 women in the later phase. The mean age at diagnosis was not significantly different between the two periods. The majority of them were married and diagnosed with stage II luminar type. The current phase had a tendency to have a higher anti-Müllerian hormone level although not reaching significance. At least 50% of them declined FP and 84.5% never received ovarian control stimulation in the initial phase. Otherwise, 61% used aromatase inhibitor in the current phase. Only 15.5% in the initial phase received control ovarian stimulation whereas 63.4% in the current phase received it. The ovarian tissue cryopreservation was highly chosen during the initial phase (25.9%), whereas embryo cryopreservation (39%) was highly opted for during the current phase. All of our parameters are comparable between these two phases (p > 0.05). Conclusion: The significant changes of oncofertility practice were observed mainly due to the understanding of the oncofertility concept among reproductive physicians and the acceptance environment, including standard guidelines, supportive society, as well as advancements in cryobiology technique.
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Affiliation(s)
- Mohd Faizal Ahmad
- Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Yodo Sugishita
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan.,Department of Frontier Medicine, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yuki Suzuki-Takahashi
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Shino Sawada
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hideyuki Iwahata
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Eriko Shiraishi
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan.,Department of Obstetrics and Gynecology, Jikei University School of Medicine, Tokyo, Japan
| | - Seido Takae
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yuki Horage-Okutsu
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
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29
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Rashedi AS, de Roo SF, Ataman LM, Edmonds ME, Silva AA, Scarella A, Horbaczewska A, Anazodo A, Arvas A, Ramalho de Carvalho B, Sartorio C, Beerendonk CCM, Diaz-Garcia C, Suh CS, Melo C, Yding Andersen C, Motta E, Greenblatt EM, Van Moer E, Zand E, Reis FM, Sánchez F, Terrado G, Rodrigues JK, de Meneses E Silva JM, Smitz J, Medrano J, Lee JR, Winkler-Crepaz K, Smith K, Ferreira Melo E Silva LH, Wildt L, Salama M, Del Mar Andrés M, Bourlon MT, Vega M, Chehin MB, De Vos M, Khrouf M, Suzuki N, Azmy O, Fontoura P, Campos-Junior PHA, Mallmann P, Azambuja R, Marinho RM, Anderson RA, Jach R, Antunes RDA, Mitchell R, Fathi R, Adiga SK, Takae S, Kim SH, Romero S, Chedid Grieco S, Shaulov T, Furui T, Almeida-Santos T, Nelen W, Jayasinghe Y, Sugishita Y, Woodruff TK. Survey of Fertility Preservation Options Available to Patients With Cancer Around the Globe. JCO Glob Oncol 2020; 6:008144. [PMID: 32259160 PMCID: PMC7853877 DOI: 10.1200/jgo.2016.008144] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2017] [Indexed: 11/20/2022] Open
Abstract
Oncofertility focuses on providing fertility and endocrine-sparing options to patients who undergo life-preserving but gonadotoxic cancer treatment. The resources needed to meet patient demand often are fragmented along disciplinary lines. We quantify assets and gaps in oncofertility care on a global scale.
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Affiliation(s)
| | - Saskia F de Roo
- Radboud University Medical Centre, Nijmegen, the Netherlands
| | | | | | | | | | | | | | | | | | | | | | | | - Chang Suk Suh
- Seoul National University Hospital College of Medicine, Seoul, South Korea
| | | | | | | | | | | | - Elnaz Zand
- Royan Institute for Reproductive Biomedicine, Tehran, Iran
| | | | - Flor Sánchez
- Centro de Estudios e Investigaciones en Biología y Medicina Reproductiva, Lima, Peru
| | | | | | | | - Johan Smitz
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Jose Medrano
- Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Jung Ryeol Lee
- Seoul National University Hospital College of Medicine, Seoul, South Korea
| | | | | | | | - Ludwig Wildt
- Medical University of Innsbruck, Innsbruck, Austria
| | | | | | - Maria T Bourlon
- Instituto Nacional de Ciencias Médicas y Nutricíon Salvador Zubirán, Mexico City, Mexico
| | - Mario Vega
- IVF Centro de Reproducción, Panama City, Panama
| | | | | | | | - Nao Suzuki
- St Marianna University School of Medicine, Kawasaki, Japan
| | | | - Paula Fontoura
- Banco de Sêmen do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | - Ricardo M Marinho
- Pró-Criar Medicina Reprodutiva, Minas Gerais, Belo Horizonte, Brazil
| | | | - Robert Jach
- Jagiellonian University Medical College, Kraków, Poland
| | | | - Rod Mitchell
- University of Edinburgh, Edinburgh, United Kingdom
| | | | | | - Seido Takae
- St Marianna University School of Medicine, Kawasaki, Japan
| | - Seok Hyun Kim
- Seoul National University Hospital College of Medicine, Seoul, South Korea
| | - Sergio Romero
- Centro de Estudios e Investigaciones en Biología y Medicina Reproductiva, Lima, Peru
| | | | - Talya Shaulov
- University of Montreal Hospital Centre, Montreal, Quebec, Canada
| | | | | | - Willianne Nelen
- Radboud University Medical Centre, Nijmegen, the Netherlands
| | | | - Yodo Sugishita
- St Marianna University School of Medicine, Kawasaki, Japan
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Salama M, Ataman-Millhouse L, Sobral F, Terrado G, Scarella A, Bourlon MT, Adiga SK, Udupa KS, Mahajan N, Patil M, Venter C, Demetriou G, Quintana R, Rodriguez G, Quintana T, Viale L, Bonilla YAR, Noguera JAR, Velásquez JCV, Pineda JID, Aldecoa MDC, Javed M, Al Sufyan H, Daniels N, Ogunmokun AA, Woodruff TK. Barriers and Opportunities of Oncofertility Practice in Nine Developing Countries and the Emerging Oncofertility Professional Engagement Network. JCO Glob Oncol 2020; 6:1800180. [PMID: 32259158 PMCID: PMC7853876 DOI: 10.1200/jgo.18.00180] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2018] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Oncofertility practice continues to grow in developing countries despite the lack of health care services, especially those related to cancer care. The purpose of this study is to further explore oncofertility practice in these countries and identify opportunities for field-wide coalescence. METHODS We generated a survey to learn more about oncofertility practice in nine developing countries within our Oncofertility Consortium Global Partners Network—Mexico, Colombia, Guatemala, Argentina, Chile, Nigeria, South Africa, Saudi Arabia, and India. Their responses were collected, reviewed, and discussed. RESULTS Surveyed centers from the nine developing countries continue to experience a similar set of common challenges, including a lack of awareness among providers and patients, cultural and religious constraints, lack of insurance coverage and funding to help to support oncofertility programs, and high out-of-pocket costs for patients. Despite these barriers, many opportunities exist and there is great potential for the future. CONCLUSION The current need is to unify the new technologies and best practices that emerge from rural communities and developing countries with those in large metropolitan cities, both domestically (US based) and abroad, into a functional unit: the Oncofertility Professional Engagement Network. The Oncofertility Professional Engagement Network will bridge the gap between domestic and international programs to establish a strong global network in which members share resources, methodologies and experiences and further build cultural competency.
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Affiliation(s)
- Mahmoud Salama
- Northwestern University, Chicago, IL.,National Research Center, Cairo, Egypt
| | | | - Fabio Sobral
- Pregna Medicina Reproductiva, Buenos Aires, Argentina
| | | | | | - Maria T Bourlon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | | | | | - Madhuri Patil
- Private Fertility and Endoscopy Clinic, Bangalore, India
| | - Chris Venter
- Vitalab Fertility Centre, Johannesburg, South Africa
| | | | | | | | | | | | - Yuly Andrea Remolina Bonilla
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.,Instituto Nacional de Cancerología, Bogota, Colombia
| | | | | | | | | | - Murid Javed
- Thuriah Medical Center, Riyadh, Saudi Arabia
| | | | - Nonso Daniels
- The Oncology and Fertility Centres of Ekocorp, Eko Hospitals, Lagos, Nigeria
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Melo ASD, Paula CTVD, Rufato MAF, Rufato MCAC, Rodrigues JK, Ferriani RA, Barreto J. Fertility optimization in women with cancer: from preservation to contraception. JBRA Assist Reprod 2019; 23:418-429. [PMID: 30969739 PMCID: PMC6798590 DOI: 10.5935/1518-0557.20190011] [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] [Indexed: 11/20/2022] Open
Abstract
Advances in the early diagnosis and treatment of cancer have reduced mortality
rates and improved patient survival. For this reason, professionals from
different areas have strived to implement actions to increase patient
quality-of-life during and after cancer treatment. Among these measures,
integral attention in reproductive health is one of the main points for the
inclusion, safety, and autonomy of female patients. The approach to fertility in
these cases should include counseling on fertility preservation and
contraceptive options. Oocyte/embryo freezing is an effective technique that
does not delay the start of cancer treatment, since controlled ovarian
stimulation can be initiated at any stage of the menstrual cycle. At the same
time, contraceptive counseling should be conducted based on the eligibility
criteria established by the World Health Organization and the Centers for
Disease Control and Prevention. However, there is still a lack of studies on (i)
the suitability of contraceptives to patients of reproductive age with
relatively frequent tumors (lymphoma, leukemia, bone cancer), and (ii) the use
of contraceptive concurrently with chemotherapeutic agents. Therefore, the
choice of contraceptive method should consider other factors such as tumor type,
thrombogenic risk factors linked to cancer/chemotherapy, immunosuppression,
blood disorders (thrombocytopenia/anemia), bone mass reduction,
metabolic/cardiovascular effects, and drug interaction.
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Affiliation(s)
- Anderson Sanches de Melo
- Fertility Center of Ribeirão Preto (CEFERP) - Ribeirão Preto - São Paulo - Brasil.,Member of Latin America Oncofertility Network, Oncofertility Consortium.,Centro Universitário Estácio - Ribeirão Preto - São Paulo - Brasil
| | - Camilla Teles Vidal de Paula
- Fertility Center of Ribeirão Preto (CEFERP) - Ribeirão Preto - São Paulo - Brasil.,Centro Universitário Estácio - Ribeirão Preto - São Paulo - Brasil.,Department of Obstetrics and Gynecology, Ribeirão Preto Medical School, University of São Paulo. Ribeirão Preto - São Paulo - Brasil
| | - Marcelo Augusto Feres Rufato
- Fertility Center of Ribeirão Preto (CEFERP) - Ribeirão Preto - São Paulo - Brasil.,Member of Latin America Oncofertility Network, Oncofertility Consortium
| | - Mariana Carvalho Assad Carneiro Rufato
- Fertility Center of Ribeirão Preto (CEFERP) - Ribeirão Preto - São Paulo - Brasil.,Member of Latin America Oncofertility Network, Oncofertility Consortium
| | - Jhenifer Kliemchen Rodrigues
- Member of Latin America Oncofertility Network, Oncofertility Consortium.,In Vitro Embriologia Clínica e Consultoria - Nova Lima - Minas Gerais - Brasil; Universidade Federal de Minas Gerais - Belo Horizonte - Minas Gerais - Brasil
| | - Rui Alberto Ferriani
- Member of Latin America Oncofertility Network, Oncofertility Consortium.,Department of Obstetrics and Gynecology, Ribeirão Preto Medical School, University of São Paulo. Ribeirão Preto - São Paulo - Brasil
| | - Jorge Barreto
- Fertility Center of Ribeirão Preto (CEFERP) - Ribeirão Preto - São Paulo - Brasil.,Member of Latin America Oncofertility Network, Oncofertility Consortium
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32
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von Wolff M, Andersen CY, Woodruff TK, Nawroth F. FertiPROTEKT, Oncofertility Consortium and the Danish Fertility-Preservation Networks - What Can We Learn From Their Experiences? CLINICAL MEDICINE INSIGHTS. REPRODUCTIVE HEALTH 2019; 13:1179558119845865. [PMID: 31068758 PMCID: PMC6495450 DOI: 10.1177/1179558119845865] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 02/27/2019] [Indexed: 01/18/2023]
Abstract
Fertility preservation is an increasingly important discipline. It requires close coordination between reproductive medicine specialists, reproductive biologists, and oncologists in various disciplines. In addition, it represents a particular health policy challenge, since fertility-protection measures are to be understood as a treatment for side effects of gonadotoxic treatments and would therefore normally have to be reimbursed by health insurance companies. Therefore, it is inevitable that fertility-preservation activities should organise themselves into a network structure both as a medical-logistic network and as a professional medical society. The necessary network structures can differ significantly at regional, national, and international level, as the size of the regions to be integrated and the local cultural and geographical conditions, as well as the political conditions are very different. To address these issues, the current review aims to point out the basic importance and the chances but also the difficulties of fertility-protection networks and give practical guidance for the development of such network structures. We will not only discuss network structures theoretically but also present them based on three established, different sized networks, such as the Danish Network (www.rigshospitalet.dk), representing a centralised network in a small country; the German-Austrian-Swiss network FertiPROTEKT® (www.fertiprotekt.com), representing a centralised as well as decentralised network in a large country; and the Oncofertility® Consortium (www.oncofertility.northwestern.edu), representing a decentralised, internationally oriented network, primarily serving the transfer of knowledge among its members.
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Affiliation(s)
- Michael von Wolff
- University Women’s Hospital, Division of Gynaecological Endocrinology and Reproductive Medicine, Inselspital, University Hospital, Bern, Switzerland
| | - Claus Yding Andersen
- Laboratory of Reproductive Biology, Faculty of Health Science, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Teresa K Woodruff
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, USA
| | - Frank Nawroth
- Centre for Infertility, Prenatal Medicine, Endocrinology and Osteology, Amedes group, Hamburg, Germany
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Utilization and Outcomes of Fertility Preservation Techniques in Women Undergoing Allogeneic Hematopoietic Cell Transplant. Biol Blood Marrow Transplant 2019; 25:1232-1239. [PMID: 30772513 DOI: 10.1016/j.bbmt.2019.02.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/09/2019] [Indexed: 12/24/2022]
Abstract
Iatrogenic menopause with consequent infertility is a major complication in reproductive-age women undergoing hematopoietic cell transplantation (HCT). Recent guidelines recommend a discussion of the possibility of infertility and the options for fertility preservation as part of informed consent before initiation of any cancer-directed therapy, including HCT. Women age 15 to 49 years at the time of allogeneic HCT, between the years 2001 and 2017, were identified from the Mayo Clinic Rochester institutional HCT database. One hundred seventy-seven women were eligible, of whom 49 (28%) were excluded due to documented postmenopausal state or prior hysterectomy. The median age of the cohort was 31 years (range, 15 to 49 years) with median gravidity and parity being G1P1 (range, G0 to G8, P0 to P6). Fifty-four (42%) women were nulligravid at the time of HCT. Eighty-two percent underwent myeloablative conditioning (MAC), whereas 18% underwent reduced-intensity conditioning (RIC). Only 34 women (27%) had documented fertility counseling within 72 hours of diagnosis, and a total of 61 (48%) received fertility counseling prior to HCT. Thirty-eight women (30%) were referred to a reproductive endocrinologist, of whom 13 (10%) underwent assisted reproductive technologies (ART; nine oocyte cryopreservation, four embryo cryopreservation). Of these, nine procedures yielded successful cryopreserved tissue (two completed at outside institutions). The median time to completion of the seven successful ART procedures at Mayo Clinic was 13 days (range, 9 to 15 days). The remainder of women referred to reproductive endocrinology did not undergo ART due to disease severity (68%), financial barriers (20%), and/or low antral follicle count (12%). Ninety-three women (73%) received leuprolide for ovarian suppression prior to conditioning. Three (4%) of 75 women who underwent MAC and were alive >365 days after HCT had spontaneous menstrual recovery after HCT (median time, 14 months; range, 6 to 21 months), in comparison to 10 (50%) of 20 women who underwent RIC and were alive >365 days after HCT (P < .01) (median, 21.5 months; range, 5 to 83 months). In the latter cohort, there were two spontaneous pregnancies, occurring at 71 and 72 months after HCT, respectively. Oncofertility is an emerging field due to an increasing number of young cancer survivors. Herein, we document that even at a large tertiary HCT center, the rate of documented fertility counseling and reproductive endocrinology referrals was low and the rate of ART was even lower. Spontaneous menstrual recovery was rare but more likely in the setting of nonmalignant disease and RIC HCT. A concerted multidisciplinary effort is needed to understand parenthood goals and to explore the impact of HCT on decision making about fertility preservation and parenthood. These efforts could improve oncofertility referral, ART utilization, and reproductive outcomes.
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Furui T, Takai Y, Kimura F, Kitajima M, Nakatsuka M, Morishige K, Higuchi A, Shimizu C, Ozawa M, Ohara A, Tatara R, Nakamura T, Horibe K, Suzuki N. Fertility preservation in adolescent and young adult cancer patients: From a part of a national survey on oncofertility in Japan. Reprod Med Biol 2019; 18:97-104. [PMID: 30655727 PMCID: PMC6332751 DOI: 10.1002/rmb2.12256] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 10/10/2018] [Accepted: 10/15/2018] [Indexed: 11/11/2022] Open
Abstract
PURPOSE This study evaluated the current status of reproductive disorders and provision of information on oncofertility to female adolescent and young adult (AYA) cancer patients in Japan. METHODS A national survey of AYA cancer survivors was conducted. Children were <15 years old, and AYAs were 15-39 years old. Results from the survivors of other than gynecological disease who underwent chemotherapy were analyzed. RESULTS Among the survivors, 41.4% were concerned about their reproductive function and infertility, and 36.2% were aware of menstrual cycle abnormalities. Among them, 15.5% (n = 20) of all and 21.2% (n = 17) of the AYA-onset survivors suffered infertility due to chemo- or radiotherapy and gave up childbearing. These rates were significantly higher than those of healthy AYAs. Although 80.8% of AYA-onset survivors answered that they had received information on reproductive function and infertility, only 55.8% had received information on fertility preservation methods. Furthermore, only 22.4% of all and 42.3% of AYA-onset survivors had received pretreatment information on fertility preservation methods. CONCLUSIONS Not a few AYA cancer survivors reported reproductive dysfunction. These findings indicate that information provided on therapy-related problems before cancer treatment in Japan was insufficient and highlight the need to improve patient decision-making and support systems for fertility preservation.
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Affiliation(s)
- Tatsuro Furui
- Department of Obstetrics and GynecologyGifu University Graduate School of MedicineGifuJapan
| | - Yasushi Takai
- Department of Obstetrics and Gynecology, Saitama Medical CenterSaitama Medical UniversityKawagoeJapan
| | - Fuminori Kimura
- Department of Obstetrics and GynecologyShiga University of Medical ScienceOtsuJapan
| | - Michio Kitajima
- Department of Obstetrics and GynecologyNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Mikiya Nakatsuka
- Assisted Reproductive Technology CenterOkayama UniversityOkayama CityJapan
- Graduate School of Health SciencesOkayama UniversityOkayama CityJapan
| | - Ken‐ichiro Morishige
- Department of Obstetrics and GynecologyGifu University Graduate School of MedicineGifuJapan
| | | | - Chikako Shimizu
- Department of OncologyNational Center for Global Health and Medicine HospitalTokyoJapan
| | - Miwa Ozawa
- Department of PediatricsSt. Luke’s International HospitalTokyoJapan
| | - Akira Ohara
- Department of PediatricsToho UniversityTokyoJapan
| | - Ryohei Tatara
- Department of Palliative MedicineOsaka City General HospitalOsakaJapan
| | - Terukazu Nakamura
- Department of Urology, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Keizo Horibe
- Clinical Research CenterNational Hospital Organization Nagoya Medical CenterNagoyaJapan
| | - Nao Suzuki
- Department of Obstetrics and GynecologySt. Marianna University School of MedicineKawasakiJapan
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35
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Smith BM, Duncan FE, Ataman L, Smith K, Quinn GP, Chang RJ, Finlayson C, Orwig K, Valli-Pulaski H, Moravek MB, Zelinski MB, Irene Su H, Vitek W, Smith JF, Jeruss JS, Gracia C, Coutifaris C, Shah D, Nahata L, Gomez-Lobo V, Appiah LC, Brannigan RE, Gillis V, Gradishar W, Javed A, Rhoton-Vlasak AS, Kondapalli LA, Neuber E, Ginsberg JP, Muller CH, Hirshfeld-Cytron J, Kutteh WH, Lindheim SR, Cherven B, Meacham LR, Rao P, Torno L, Sender LS, Vadaparampil ST, Skiles JL, Schafer-Kalkhoff T, Frias OJ, Byrne J, Westphal LM, Schust DJ, Klosky JL, McCracken KA, Ting A, Khan Z, Granberg C, Lockart B, Scoccia B, Laronda MM, Mersereau JE, Marsh C, Pavone ME, Woodruff TK. The National Physicians Cooperative: transforming fertility management in the cancer setting and beyond. Future Oncol 2018; 14:3059-3072. [PMID: 30474429 PMCID: PMC6331694 DOI: 10.2217/fon-2018-0278] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Once unimaginable, fertility management is now a nationally established part of cancer care in institutions, from academic centers to community hospitals to private practices. Over the last two decades, advances in medicine and reproductive science have made it possible for men, women and children to be connected with an oncofertility specialist or offered fertility preservation soon after a cancer diagnosis. The Oncofertility Consortium's National Physicians Cooperative is a large-scale effort to engage physicians across disciplines – oncology, urology, obstetrics and gynecology, reproductive endocrinology, and behavioral health – in clinical and research activities to enable significant progress in providing fertility preservation options to children and adults. Here, we review the structure and function of the National Physicians Cooperative and identify next steps.
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Affiliation(s)
- Brigid M Smith
- Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Francesca E Duncan
- Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Lauren Ataman
- Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Kristin Smith
- Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.,Department of Obstetrics & Gynecology, Division of Reproductive Endocrinology & Infertility, Feinberg School of Medicine, Northwestern Medicine, Chicago, IL 60611, USA
| | - Gwendolyn P Quinn
- Department of Obstetrics & Gynecology, New York University School of Medicine, New York, NY 10016, USA
| | - R Jeffrey Chang
- Department of OB/GYN & Reproductive Sciences, Division of Reproductive Endocrinology & Infertility, University of California San Diego, La Jolla, CA 92093, USA
| | - Courtney Finlayson
- Division of Endocrinology, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL 60611 USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Kyle Orwig
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.,Magee-Womens Research Institute, Pittsburgh, PA 15213, USA
| | - Hanna Valli-Pulaski
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.,Magee-Womens Research Institute, Pittsburgh, PA 15213, USA
| | - Molly B Moravek
- Department of Obstetrics & Gynecology, Division of Reproductive Endocrinology & Infertility, University of Michigan, Ann Arbor, MI 48109, USA
| | - Mary B Zelinski
- Division of Reproductive & Developmental Science, Oregon National Primate Research Center, Beaverton, OR 97006, USA.,Department of Obstetrics & Gynecology, Oregon Health & Sciences University, Portland, OR 97239, USA
| | - H Irene Su
- Department of Reproductive Medicine & Moores Cancer Center, University of California San Diego, La Jolla, CA 92093, USA
| | - Wendy Vitek
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine & Dentistry, Rochester, NY 14642, USA
| | - James F Smith
- Department of Urology, University of California San Francisco, San Francisco, CA 94110, USA
| | - Jacqueline S Jeruss
- Department of Surgery, University of Michigan, Ann Arbor, MI 48109, USA.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
| | - Clarisa Gracia
- Department of Obstetrics & Gynecology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Christos Coutifaris
- Department of Obstetrics & Gynecology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Divya Shah
- Department of Obstetrics & Gynecology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Leena Nahata
- Department of Pediatrics, Division of Endocrinology, The Ohio State University College of Medicine/Nationwide Children's Hospital, Columbus, OH 43210, USA.,Center for Behavioral Health, the Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA
| | - Veronica Gomez-Lobo
- Division of Pediatric & Adolescent Gynecology, MedStar Washington Hospital Center, Children's National Health System, Washington, DC 20010, USA
| | - Leslie Coker Appiah
- The James Cancer Center, Nationwide Children's Hospital, The Ohio State University, Columbus, OH 43210, USA
| | - Robert E Brannigan
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Valerie Gillis
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - William Gradishar
- Department of Medicine, Division of Hematology/Oncology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Asma Javed
- Department of Pediatric & Adolescent Medicine, Division of Pediatric & Adolescent Gynecology, Mayo Clinic, Rochester, MN 55905, USA
| | - Alice S Rhoton-Vlasak
- Department of Obstetrics & Gynecology, Division of Reproductive Endocrinology & Infertility, University of Florida, Gainesville, FL 32608, USA
| | | | - Evelyn Neuber
- Center for Advanced Reproductive Services, University of Connecticut, Farmington, CT 06032, USA
| | - Jill P Ginsberg
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Charles H Muller
- Department of Urology, University of Washington School of Medicine, Seattle, WA 98195, USA
| | | | - William H Kutteh
- Division of Reproductive Endocrinology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.,Department of Surgery, St Jude Children's Research Hospital, Memphis, TN 38105, USA.,Fertility Associates of Memphis, Memphis, TN 38120, USA
| | - Steven R Lindheim
- Department of Obstetrics & Gynecology, Wright State University, Boonshoft School of Medicine, Dayton, OH 45435, USA
| | - Brooke Cherven
- Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA 30342, USA
| | - Lillian R Meacham
- Aflac Cancer & Blood Disorders Center & Department of Pediatrics, Division of Hematology/Oncology & Division of Endocrinology, Emory University, Atlanta, GA 30322, USA
| | - Pooja Rao
- Division of Pediatric Hematology/Oncology, Penn State Health Children's Hospital, Hershey, PA 17033, USA
| | - Lilibeth Torno
- Division of Oncology, CHOC Children's Hospital, Orange, CA 92868, USA
| | - Leonard S Sender
- Division of Oncology, CHOC Children's Hospital, Orange, CA 92868, USA
| | - Susan T Vadaparampil
- Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.,Department of Health Outcomes and Behaviors, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Jodi L Skiles
- Department of Pediatrics, Division of Hematology and Oncology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.,Riley Hospital for Children at IU Health, Indianapolis, IN 46202, USA
| | - Tara Schafer-Kalkhoff
- Division of Pediatric & Adolescent Gynecology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Oliva J Frias
- Division of Pediatric & Adolescent Gynecology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Julia Byrne
- Children's Research Center, Mayo Clinic, Rochester, MN 55905, USA
| | - Lynn M Westphal
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Danny J Schust
- Department of Obstetrics, Gynecology & Women's Health, University of Missouri School of Medicine, Columbia, MO 65212, USA
| | - James L Klosky
- Aflac Cancer & Blood Disorders Center & Department of Pediatrics, Division of Hematology/Oncology & Division of Endocrinology, Emory University, Atlanta, GA 30322, USA.,Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30307, USA
| | - Kate A McCracken
- Section of Pediatric & Adolescent Gynecology, Nationwide Children's Hospital, Columbus, OH 43205, USA.,Department of Obstetrics & Gynecology, The Ohio State University, Columbus, OH 43210, USA
| | - Alison Ting
- Division of Reproductive & Developmental Science, Oregon National Primate Research Center, Beaverton, OR 97006, USA.,21st Century Medicine, Inc., Fontana, CA 92336, USA
| | - Zaraq Khan
- Division of Reproductive Endocrinology & Infertility, Mayo Clinic, Rochester, MN 55905, USA.,Division of Minimally Invasive Gynecologic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Barbara Lockart
- Division of Hematology, Oncology & Stem Cell Transplant, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA.,Division of General Pediatric Surgery, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA
| | - Bert Scoccia
- Department of Obstetrics & Gynecology, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Monica M Laronda
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.,Stanley Manne Children's Research Institute, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA
| | - Jennifer E Mersereau
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & Infertility, University of North Carolina, Raleigh, NC 27599, USA
| | - Courtney Marsh
- Department of Obstetrics & Gynecology, University of Kansas Health System, Kansas City, KS 66160, USA
| | - Mary Ellen Pavone
- Department of Obstetrics & Gynecology, Division of Reproductive Endocrinology & Infertility, Feinberg School of Medicine, Northwestern Medicine, Chicago, IL 60611, USA
| | - Teresa K Woodruff
- Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
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Anazodo A, Ataman-Millhouse L, Jayasinghe Y, Woodruff TK. Oncofertility-An emerging discipline rather than a special consideration. Pediatr Blood Cancer 2018; 65:e27297. [PMID: 29972282 PMCID: PMC6150802 DOI: 10.1002/pbc.27297] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 05/16/2018] [Accepted: 05/22/2018] [Indexed: 01/09/2023]
Abstract
Originally absent from the oncologist's consult, then placed in a 'quality of life' rubric, oncofertility should now be an essential part of a comprehensive cancer treatment plan in patients of reproductive age, including adolescents and young adults (AYAs). Oncofertility encompasses the endocrine health of the patient, as well as fertility management options. Thus, pubertal transitions in males and females, bone health, and menstrual health are all part of this discipline, enabling practitioners to work in interdisciplinary teams to solve problems in reproductive health. This review provides a summary of the essential considerations required for the assessement of reproductive risk and choice of fertility preservation options as well as considerations for developing oncofertility services for AYAs.
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Affiliation(s)
- Antoinette Anazodo
- Kids Cancer Centre, Sydney Children’s Hospital, Sydney, Australia
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, Australia
- School of Women’s and Children’s Hospital, University of New South Wales, Sydney
| | - Lauren Ataman-Millhouse
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Yasmin Jayasinghe
- Department of Obstetrics & Gynaecology University of Melbourne Royal Women’s Hospital, Melbourne, Victoria, Australia
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne
| | - Teresa K. Woodruff
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Ju K, Kopp M, Wang Y, Yuan G, Zheng W, Ataman LM, Woodruff TK, Chen Q, Xiao S. A Survey Study of Attitude and Knowledge Regarding Female Fertility Preservation Among Reproductive Health Professionals in Fujian, China. J Adolesc Young Adult Oncol 2018; 8:67-73. [PMID: 30312134 DOI: 10.1089/jayao.2018.0065] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Oncofertility is a newly developed medical field dedicated to preserving adolescent and young adult-aged cancer patients' fertility. For female cancer patients who desire to have children, fertility preservation has become an important concern before the cancer therapy. This study for the first time aimed to investigate attitude and knowledge regarding female fertility preservation among reproductive health professionals in China. METHODS An online questionnaire assessing participants' demographics, experience, attitude, and basic knowledge regarding oncofertility was designed and distributed to reproductive health professionals in Fujian, one of the major regions for cancer and reproductive care in southeast China. RESULTS The majority of participants (96.6%) who were familiar with fertility preservation were willing to collaborate with oncologists on preserving patients' fertility. However, ∼20% of participants were not familiar with the term fertility preservation, and 30.4% and 52.2% of them were never consulted by a cancer patient or an oncologist about the infertility risk from cancer therapy, respectively. Years of working experience, but not gender, educational background, and marital status, was significantly associated with participants' oncofertility experience and attitude. A majority of participants (79.3%) had a middle or low level of oncofertility knowledge, which was significantly linked to their educational background. CONCLUSION Most of the surveyed reproductive health professionals held a positive attitude toward interdisciplinary collaboration with oncologists during oncofertility practice. However, the lack of their oncofertility knowledge highlighted the need of standard oncofertility education and training in China.
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Affiliation(s)
- Ke Ju
- 1 Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.,2 Department of Preventive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Megan Kopp
- 1 Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Yuqing Wang
- 1 Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.,2 Department of Preventive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Gehui Yuan
- 1 Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.,2 Department of Preventive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Weiwei Zheng
- 3 Key Laboratory of Public Health Safety, Ministry of Education, Institution for Water Pollution and Health Research, Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Lauren M Ataman
- 4 Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Teresa K Woodruff
- 4 Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Qionghua Chen
- 5 Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Shuo Xiao
- 1 Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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38
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Fertility status perception, fertility preservation and desire to have children in cancer survivors: French VICAN survey. Future Sci OA 2018; 4:FSO343. [PMID: 30450230 PMCID: PMC6234464 DOI: 10.4155/fsoa-2018-0018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 07/27/2018] [Indexed: 01/23/2023] Open
Abstract
Aim To report fertility status perception, fertility preservation and desire to have children in French cancer survivors 2 and 5 years after diagnosis. Methods A total of 427 women and 115 men self-reported treatment-induced infertility, fertility status, access to gamete conservation, desire to have children and pregnancy/live births. Results A total of 96.5% of men and 92.9% of women were thought to be fertile at diagnosis and 38% desired to have children. A total of 57.8% of men and 67.4% of women declared that no fertility preservation had been discussed before treatment. After 2 years, 26.8% of patients still desired to have children. After 5 years, 18 live births have been reported. Conclusion Despite a legal obligation and technical progress, there is a lack of information given to patients.
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de Man AM, Rashedi A, Nelen W, Anazodo A, Rademaker A, de Roo S, Beerendonk C, Woodruff TK. Female fertility in the cancer setting: availability and quality of online health information. HUM FERTIL 2018; 23:170-178. [DOI: 10.1080/14647273.2018.1506891] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Anne Marie de Man
- Department of Obstetrics and Gynecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Alexandra Rashedi
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, USA
| | - Willianne Nelen
- Department of Obstetrics and Gynecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Antoinette Anazodo
- School of Women and Children’s Health Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Alfred Rademaker
- Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Saskia de Roo
- Department of Obstetrics and Gynecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Catharina Beerendonk
- Department of Obstetrics and Gynecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Teresa K. Woodruff
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, USA
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Gonçalves V, Hudson J, Canavarro MC, Morris J, Lee MC, Donovan KA, Sutton SK, Vadaparampil ST, Quinn GP. Childbearing across borders: Fertility and parenthood attitudes and decisions among breast cancer survivors in USA and Portugal. Breast 2018; 40:16-22. [PMID: 29674220 DOI: 10.1016/j.breast.2018.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/25/2018] [Accepted: 04/02/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To compare fertility and childbearing attitudes and decisions of Portuguese and American female reproductive aged breast cancer survivors. METHODS This was a cross-sectional study of 102 young breast cancer survivors (59 from Portugal and 43 from USA). Demographic, clinical and reproductive information were collected. Fertility and parenthood attitudes and decisions were assessed through a self-report questionnaire devised specifically for the study. RESULTS Fertility issues became very important after the diagnosis for most of the women (51%). Few differences existed between USA and Portuguese participants. USA participants were more likely to undergo FP (23% USA vs Portugal 5%, p = 0.01). Portuguese women were more dissatisfied with their physician's explanations about fertility (Portugal: 23% vs USA: 3%; p = 0.01). Overall, women relied on their oncologist for fertility information (70%); only Portuguese women discussed fertility with their family medicine physician (11%). Overall, women showed positive attitudes towards motherhood. Portuguese women were more likely to report their partners placed more value on the family after their illness (Portuguese agree: 55% vs USA agree: 14%; p < 0.001). CONCLUSIONS Fertility and childbearing after breast cancer are important issues regardless of culture, background or country's heath care system. Overall, few differences across the USA and Portuguese samples were found on fertility and childbearing attitudes and decisions.
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Affiliation(s)
- Vânia Gonçalves
- Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802, Coimbra, Portugal.
| | - Janella Hudson
- Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
| | - Maria Cristina Canavarro
- Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802, Coimbra, Portugal
| | - Julie Morris
- University Hospital of South Manchester, Wythenshawe Hospital, 1st Floor, Education and Research Centre, Southmoor Road, Manchester, UK
| | - M Catherine Lee
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Kristine A Donovan
- Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA; Department of Oncologic Science, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Steven K Sutton
- Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA; Department of Oncologic Science, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Susan T Vadaparampil
- Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA; Department of Oncologic Science, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Gwendolyn P Quinn
- Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA; Department of Ob-Gyn, NYU Langone Medical Center, NY, NY 10016, USA
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41
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Salama M, Ataman L, Taha T, Azmy O, Braham M, Douik F, Khrouf M, Rodrigues JK, Reis FM, Sánchez F, Romero S, Vega M, Woodruff TK. Building Oncofertility Core Competency in Developing Countries: Experience From Egypt, Tunisia, Brazil, Peru, and Panama. J Glob Oncol 2018; 6:1700121. [PMID: 32259156 PMCID: PMC7853873 DOI: 10.1200/jgo.17.00121] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2017] [Indexed: 12/01/2022] Open
Abstract
Purpose Little is known about oncofertility practice in developing countries that usually suffer from a shortage of health services, especially those related to cancer care. Materials and Methods To learn more about oncofertility practice in developing countries, we generated a survey to explore the barriers and opportunities associated with oncofertility practice in five developing countries from Africa and Latin America within our Oncofertility Consortium Global Partners Network. Responses from Egypt, Tunisia, Brazil, Peru, and Panama were collected, reviewed, and discussed. Results Common barriers were identified by each country, including financial barriers (lack of insurance coverage and high out-of-pocket costs for patients), lack of awareness among providers and patients, cultural and religious constraints, and lack of funding to help to support oncofertility programs. Conclusion Despite barriers to care, many opportunities exist to grow the field of oncofertility in these five developing countries. It is important to continue to engage stakeholders in developing countries and use powerful networks in the United States and other developed countries to aid in the acceptance of oncofertility on a global level.
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Affiliation(s)
| | | | | | | | | | | | | | - Jhenifer Kliemchen Rodrigues
- In Vitro Consultoria–Research and Development/Clinical Embriology, Gerais, Brazil,Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fernando M. Reis
- Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Flor Sánchez
- Centro de Estudiose Investigaciones en Biología y Medicina Reproductiva, Lima, Peru
| | - Sergio Romero
- Centro de Estudiose Investigaciones en Biología y Medicina Reproductiva, Lima, Peru
| | - Mario Vega
- Consultorios Hospital Punta Pacific, Panama City, Panama
| | - Teresa K. Woodruff
- Northwestern University, Chicago, IL,Teresa K. Woodruff, PhD, Feinberg School of Medicine, Northwestern University, 303 E Superior St, Room 10-119, Chicago, IL 60611; Twitter: @oncofertility and @teresawoodruff; e-mail:
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Armstrong AG, Kimler BF, Smith BM, Woodruff TK, Pavone ME, Duncan FE. Ovarian tissue cryopreservation in young females through the Oncofertility Consortium's National Physicians Cooperative. Future Oncol 2018; 14:363-378. [PMID: 29345507 DOI: 10.2217/fon-2017-0410] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
AIM To characterize the clinical indications of females (<15 years old) undergoing ovarian tissue cryopreservation (OTC) through the Oncofertility Consortium's National Physicians Cooperative (OC-NPC). PATIENTS & METHODS The clinical indications of 114 females who underwent OTC were classified, and their incidence was compared with childhood cancer databases. RESULTS Leukemias/myeloproliferative diseases/myelodysplastic diseases and hemoglobinopathies were the most prevalent oncologic and nononcologic indications for OTC, respectively. The frequencies of malignant bone tumors and soft tissue and other extraosseous sarcomas were higher in the OC-NPC cohort relative to the general population, while CNS/intracranial/intraspinal neoplasms, retinoblastoma and hepatic tumors were lower. CONCLUSION Those opting for OTC through the OC-NPC are at highest fertility risk, indicating that the appropriate patient populations are being identified. [Formula: see text].
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Affiliation(s)
| | - Bruce F Kimler
- Radiation Oncology, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Brigid M Smith
- Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Teresa K Woodruff
- Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Mary Ellen Pavone
- Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Francesca E Duncan
- Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
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Komatsu H, Yagasaki K, Yamauchi H. Fertility decision-making under certainty and uncertainty in cancer patients. SEXUAL & REPRODUCTIVE HEALTHCARE 2017; 15:40-45. [PMID: 29389500 DOI: 10.1016/j.srhc.2017.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/20/2017] [Accepted: 12/06/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study was to understand how reproductive-age women with breast cancer make fertility-related decisions. METHODS Using grounded theory methodology, we collected data from 11 reproductive-age women with breast cancer between March and August 2016. Verbatim transcriptions were analyzed using constant comparative analysis and open, axial, and selective coding. RESULTS "Fertility Decision-Making under Certainty and Uncertainty" emerged as a core category. Fertility decision-making started with the participants' "values and preferences" about having a child. In making a decision, there were certainty ("Information" and "Emotional support") and uncertainty ("Time constraints," "Recurrent risk," "Labeling," and "Unmet needs") factors. Participants had more uncertainty factors than certainty factors, and healthcare professionals' services accounted for one of the uncertainty factors. CONCLUSIONS After fertility preservation counseling, women with cancer made difficult decisions in stressful situations without sufficient healthcare information and support. Tailored information should be provided to individual women in collaboration between oncology and reproductive health professionals.
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Affiliation(s)
- Hiroko Komatsu
- Faculty of Nursing and Medical Care, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Kaori Yagasaki
- Faculty of Nursing and Medical Care, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Hideko Yamauchi
- Department of Breast Surgery, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan.
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Stouffer RL, Woodruff TK. Nonhuman Primates: A Vital Model for Basic and Applied Research on Female Reproduction, Prenatal Development, and Women's Health. ILAR J 2017; 58:281-294. [PMID: 28985318 PMCID: PMC5886348 DOI: 10.1093/ilar/ilx027] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 06/30/2017] [Indexed: 12/20/2022] Open
Abstract
The comparative biology of reproduction and development in mammalian species is remarkable. Hence, because of similarities in environmental and neuroendocrine control of the reproductive axis, the cyclic function of the ovary and reproductive tract, establishment and control of the maternal-fetal-placental unit during pregnancy, and reproductive aging from puberty through menopause, nonhuman primates (NHPs) are valuable models for research related to women's reproductive health and its disorders. This chapter provides examples of research over the past 10+ years using Old World monkeys (notably macaque species), baboons, and to a lesser extent New World monkeys (especially marmosets) that contributed to our understanding of the etiology and therapies or prevention of: (1) ovarian disorders, e.g., polycystic ovary syndrome, mitochondrial DNA-based diseases from the oocyte; (2) uterine disorders, for example, endometriosis and uterine transplantation; and (3) pregnancy disorders, for example, preterm labor and delivery, environmental factors. Also, emerging opportunities such as viral (e.g., Zika) induced fetal defects and germline genomic editing to generate valuable primate models of human diseases (e.g., Huntington and muscular dystrophy) are addressed. Although the high costs, specialized resources, and ethical debate challenge the use of primates in biomedical research, their inclusion in fertility and infertility research is vital for continued improvements in women's reproductive health.
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Affiliation(s)
- Richard L Stouffer
- Richard L. Stouffer, Ph.D., is Professor in the Division of Reproductive and Developmental Sciences at the Oregon National Primate Research Center in Beaverton, Oregon and Professor in the Department of Obstetrics and Gynecology at Oregon Health & Sciences University in Portland, Oregon. Teresa K. Woodruff, Ph.D., is Thomas J. Watkins Professor of Obstetrics and Gynecology, Vice Chair of Research (OB/GYN), and Chief of the Division of Reproductive Science in Medicine at the Feinberg School of Medicine, and Professor of Molecular Biosciences at Weinberg College of Arts and Sciences, Northwestern University in Chicago, Illinois.
| | - Teresa K Woodruff
- Richard L. Stouffer, Ph.D., is Professor in the Division of Reproductive and Developmental Sciences at the Oregon National Primate Research Center in Beaverton, Oregon and Professor in the Department of Obstetrics and Gynecology at Oregon Health & Sciences University in Portland, Oregon. Teresa K. Woodruff, Ph.D., is Thomas J. Watkins Professor of Obstetrics and Gynecology, Vice Chair of Research (OB/GYN), and Chief of the Division of Reproductive Science in Medicine at the Feinberg School of Medicine, and Professor of Molecular Biosciences at Weinberg College of Arts and Sciences, Northwestern University in Chicago, Illinois.
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45
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Contributions of the Japanese Gynecologic Oncology Group (JGOG) in Improving the Quality of Life in Women With Gynecological Malignancies. Curr Oncol Rep 2017; 19:25. [PMID: 28303492 DOI: 10.1007/s11912-017-0580-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The Japanese Gynecologic Oncology Group (JGOG) is leading Japan in the treatment of gynecological malignancies. The JGOG consists of three treatment committees focusing on uterine cervical cancer, endometrial cancer, and ovarian cancer. Each committee makes efforts to improve treatment and diagnosis. In addition, the Supportive and Palliative Care Committee was established in 2015. Novel studies of supportive care and palliative care have been initiated by this committee. Furthermore, surveys about not only treatment results such as overall survival rates but also quality of life (QOL) and cost-effectiveness assessments are performed by the ovarian cancer committee. Improvements of patients' QOL in the treatment of gynecological malignancies were divided into three concepts as follows: QOL associated with cancer treatment, health care after cancer therapy, and progression of cancer. In this review, we report the contributions and future plans for the improvement of QOL in patients with gynecological malignancies.
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Ho WLC, Bourne H, Gook D, Clarke G, Kemertzis M, Stern K, Agresta F, Heloury Y, Clark H, Orme L, Jayasinghe Y, Zacharin MR. A short report on current fertility preservation strategies for boys. Clin Endocrinol (Oxf) 2017; 87:279-285. [PMID: 28504866 DOI: 10.1111/cen.13377] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 05/02/2017] [Accepted: 05/10/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND Advances in cancer treatment have led to improved long-term survival after childhood cancer, but often at a price of impaired future fertility. Fertility preservation (FP) in male children and early adolescents poses unique challenges as efficacy is unproven. OBJECTIVES To describe characteristics of testicular tissue cryopreservation (TTCP) specimens taken from paediatric and adolescent patients, stratified by age, and prior chemotherapy, if any, and to demonstrate evidence for germ cells. MATERIALS AND METHODS Retrospective review of gonadal biopsies and clinical records of patients consented into the Royal Children's Hospital FP programme between 1987 and 2015. Tissue was sliced into blocks, with one section sent for histopathology prior to cryopreservation. In boys ≥12 years where spermatogenesis could be expected, a portion of tissue was disaggregated completely to look for mature sperm and if found, additional tissue was dissected and the resulting suspension frozen. RESULTS Testicular tissue cryopreservation specimens in 44 males (0.3-16.8 years) provided an average of 7.8 slices per patient. All the specimens were taken at the same time as another necessary surgical procedure, under one general anaesthesic. There was only one complication of scrotal wound dehiscence. Seven of the forty-four (15.9%) patients had chemotherapy prior to testicular biopsy, while the rest were chemotherapy naïve. Five of these were prepubertal, and two were pubertal patients. Eleven subjects had tissue dissected with mature sperm found in eight. Of these eight patients where sperm were found, all were pubertal with testicular size of more than 10 mL and showing histological evidence of spermatogenesis. No histologic specimen demonstrated any malignant cells. CONCLUSIONS Testicular tissue cryopreservation can be performed in young patients without delay, preferably prior to cancer treatment. As testicular tissue contains germ cells from which haploid spermatozoa are ultimately derived, future technologies may allow their utilization for fertility in humans. This may be the only hope for biological offspring in some patients undergoing fertility compromising treatment. Retrieval of mature sperm from some pubertal patients, however, offers realistic hope to these patients of future fertility.
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Affiliation(s)
- Wei Li Cindy Ho
- Royal Children's Hospital, Melbourne, Vic., Australia
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
- Murdoch Children's Research Institute, Parkville, Vic., Australia
| | - Harold Bourne
- Melbourne IVF, East Melbourne, Vic., Australia
- Reproductive Services, Royal Women's Hospital, Melbourne, Vic., Australia
| | - Debra Gook
- Melbourne IVF, East Melbourne, Vic., Australia
- Reproductive Services, Royal Women's Hospital, Melbourne, Vic., Australia
| | - Gary Clarke
- Andrology Unit, Laboratory Services Department, Royal Children's and Royal Women's Hospital, Melbourne, Vic., Australia
| | - Matthew Kemertzis
- Department of Obstetrics & Gynaecology, Royal Women's Hospital, University of Melbourne, Melbourne, Vic., Australia
| | - Kate Stern
- Melbourne IVF, East Melbourne, Vic., Australia
- Reproductive Services, Royal Women's Hospital, Melbourne, Vic., Australia
| | | | - Yves Heloury
- Royal Children's Hospital, Melbourne, Vic., Australia
| | | | - Lisa Orme
- Royal Children's Hospital, Melbourne, Vic., Australia
| | - Yasmin Jayasinghe
- Royal Children's Hospital, Melbourne, Vic., Australia
- Department of Obstetrics & Gynaecology, Royal Women's Hospital, University of Melbourne, Melbourne, Vic., Australia
| | - Margaret R Zacharin
- Royal Children's Hospital, Melbourne, Vic., Australia
- Murdoch Children's Research Institute, Parkville, Vic., Australia
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Fathi R, Rezazadeh Valojerdi M, Ebrahimi B, Eivazkhani F, Akbarpour M, Tahaei LS, Abtahi NS. Fertility Preservation in Cancer Patients: In Vivo and In Vitro Options. CELL JOURNAL 2017; 19:173-183. [PMID: 28670510 PMCID: PMC5412777 DOI: 10.22074/cellj.2016.4880] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 07/25/2016] [Indexed: 12/29/2022]
Abstract
Oocyte, embryo and ovarian tissue cryopreservation are being increasingly proposed for fertility preservation among cancer patients undergoing therapy to enable them to have babies after the cancer is cured. Embryo cryopreservation is not appropriate for single girls without any sperm partner and also because oocyte retrieval is an extended procedure, it is impossible in cases requiring immediate cancer cure. Thus ovarian tissue cryopreservation has been suggested for fertility preservation especial in cancer patients. The main goal of ovarian cryopreservation is re-implanting the tissue into the body to restore fertility and the hormonal cycle. Different cryopreservation protocols have been examined and established for vitrification of biological samples. We have used Cryopin to plunge ovarian tissue into the liquid nitrogen and promising results have been observed. Ovarian tissue re-implantation after cancer cure has one problem- the possibility of recurrence of malignancy in the reimplanted tissue is high. Xenografting-implantation of the preserved tissue in another species- also has its drawbacks such as molecular signaling from the recipient. In vitro follicle culturing is a safer method to obtain mature oocytes for fertilization and the various studies that have been carried out in this area are reviewed in this paper.
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Affiliation(s)
- Rouhollah Fathi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mojtaba Rezazadeh Valojerdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Anatomy, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Bita Ebrahimi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Farideh Eivazkhani
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mahzad Akbarpour
- Department of Pediatrics, Pritzker School of Medicine, University of Chicago, Chicago, USA
| | - Leila Sadat Tahaei
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Naeimeh Sadat Abtahi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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Salama M, Woodruff TK. Anticancer treatments and female fertility: clinical concerns and role of oncologists in oncofertility practice. Expert Rev Anticancer Ther 2017; 17:687-692. [PMID: 28537815 DOI: 10.1080/14737140.2017.1335199] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Anticancer treatments such as aggressive chemotherapy and radiotherapy have deleterious gonadotoxic side effects and are considered the most common causes of pathological and iatrogenic fertility loss in women. Areas covered: In order to preserve fertility of young women and girls with cancer, several established, experimental, and debatable options can be offered in the emerging field of oncofertility. This article reviews the effects of anticancer treatments on female fertility and discusses the current challenges and future directions of fertility preservation options that can be offered to the female patients with cancer. Expert commentary: Although promising, several medical, economic, social and legal barriers face oncofertility practice around the globe especially in underserved areas. To overcome such barriers, more effective solutions should be provided to spread awareness and enhance communication between patients, oncologists and gynecologists. Early referral by oncologists before initiation of chemotherapy and radiotherapy is an important key factor for success in female fertility preservation strategies.
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Affiliation(s)
- Mahmoud Salama
- a Department of Obstetrics and Gynecology, Medical Faculty , University of Cologne , Cologne , Germany
| | - Teresa K Woodruff
- b Department of Obstetrics and Gynecology, Feinberg School of Medicine , Northwestern University , Chicago , Illinois , USA
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Li N, Jayasinghe Y, Kemertzis MA, Moore P, Peate M. Fertility Preservation in Pediatric and Adolescent Oncology Patients: The Decision-Making Process of Parents. J Adolesc Young Adult Oncol 2017; 6:213-222. [DOI: 10.1089/jayao.2016.0061] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Nancy Li
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Department of Gynaecology, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Yasmin Jayasinghe
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Department of Gynaecology, Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Obstetrics & Gynaecology, Royal Women's Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Matthew A. Kemertzis
- Department of Gynaecology, Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Obstetrics & Gynaecology, Royal Women's Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Paddy Moore
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Department of Gynaecology, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Michelle Peate
- Department of Obstetrics & Gynaecology, Royal Women's Hospital, University of Melbourne, Melbourne, Victoria, Australia
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Chehin MB, Bonetti TC, Serafini PC, Motta ELA. Knowledge regarding fertility preservation in cancer patients: a population-based survey among Brazilian people during the Pink October awareness event. JBRA Assist Reprod 2017; 21:84-88. [PMID: 28609273 PMCID: PMC5473699 DOI: 10.5935/1518-0557.20170021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective The aim of this study was to assess the knowledge about the risk of
infertility in cancer patients after treatment, and the options for
fertility preservation based on a survey carried out during the 2013 Pink
October campaign. Methods This survey was carried out during the 2013 Pink October event in the most
important public park of São Paulo, Brazil. Approximately 900 people
expressed interest in learning about breast cancer prevention and fertility
preservation by participating in workshops, and 242 people filled out a
questionnaire. Results Most of the respondents (78.5%) were women, and one-fourth (25%) had at least
one relative with gynecological cancer. Among women over 40 years of age,
86.3% had been screened for breast cancer at some point. However, few
participants (34.0%) were aware that cancer treatment can lead to
infertility or had heard about fertility preservation options (22.0%).
Having a relative with cancer did not influence their knowledge about
fertility preservation (22.4% versus 21.3%; p=0.864).
However, a higher educational level was significantly associated with more
knowledge about the effects of cancer on fertility and options for fertility
preservation. Conclusions The majority of participants did not have knowledge about the impact of
oncologic treatment on fertility and did not know that there are options to
preserve fertility in cancer patients. Awareness of infertility risk factors
is an essential first step to safeguard future fertility, and therefore,
more educational initiatives are needed to spread knowledge about
oncofertility.
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Affiliation(s)
- Mauricio B Chehin
- Huntington - Medicina Reprodutiva. Sao Paulo, SP, Brasil.,Disciplina de Ginecologia Endocrinológica, Departamento de Ginecologia, Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP-EPM). Sao Paulo, SP, Brasil
| | - Tatiana Cs Bonetti
- Huntington - Medicina Reprodutiva. Sao Paulo, SP, Brasil.,Disciplina de Ginecologia Endocrinológica, Departamento de Ginecologia, Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP-EPM). Sao Paulo, SP, Brasil
| | - Paulo C Serafini
- Huntington - Medicina Reprodutiva. Sao Paulo, SP, Brasil.,Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de Sao Paulo (FMUSP). Sao Paulo, SP, Brasil
| | - Eduardo LA Motta
- Huntington - Medicina Reprodutiva. Sao Paulo, SP, Brasil.,Disciplina de Ginecologia Endocrinológica, Departamento de Ginecologia, Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP-EPM). Sao Paulo, SP, Brasil
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