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Rashidian P. An update on oncofertility in prepubertal females. J Gynecol Obstet Hum Reprod 2024; 53:102742. [PMID: 38341083 DOI: 10.1016/j.jogoh.2024.102742] [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: 09/25/2023] [Revised: 02/02/2024] [Accepted: 02/08/2024] [Indexed: 02/12/2024]
Abstract
Cancer is a life-threatening event for pediatric patients. Treatment advancements in pediatric cancer have improved prognosis, but some of these treatments have gonadotoxic potential and may affect fertility in different ways. Due to the growing interest of the research community in the life prospects of young cancer survivors, there has been a demand to intersect reproductive medicine and oncology, which is referred to as "oncofertility". There are various fertility preservation options according to gender and pubertal status, and shared decisions must take place at the time of diagnosis. This study aims to provide a critical review of current and emerging strategies for preserving and restoring fertility in prepubertal females, ranging from established methods to experimental approaches that can be offered before, during, and after anticancer therapies. Additionally, the author aims to review how clinicians' awareness of oncofertility options and the latest advancements in this field, timely referral, and proper consultations with patients and their families are vital in addressing their concerns, providing emotional support, and guiding them through the decision-making process, as well as potential barriers that may hinder the fertility preservation process.
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Affiliation(s)
- Pegah Rashidian
- Reproductive Health Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
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2
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Klijn NF, ter Kuile MM, Lashley EELO. Patient-Reported Outcomes (PROs) and Patient Experiences in Fertility Preservation: A Systematic Review of the Literature on Adolescents and Young Adults (AYAs) with Cancer. Cancers (Basel) 2023; 15:5828. [PMID: 38136372 PMCID: PMC10741741 DOI: 10.3390/cancers15245828] [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: 11/06/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
With better survival rates for patients diagnosed with cancer, more attention has been focused on future risks, like fertility decline due to gonadotoxic treatment. In this regard, the emphasis during counselling regarding possible preservation options is often on the treatment itself, meaning that the medical and emotional needs of patients regarding counselling, treatment, and future fertility are often overlooked. This review focuses on patient-reported outcomes (PROs) and patient experiences regarding fertility preservation (FP)-among adolescents and young adults (AYAs) with cancer. A systematic review of the literature, with a systematic search of online databases, was performed, resulting in 61 selected articles. A quality assessment was performed by a mixed methods appraisal tool (MMAT). Based on this search, three important topics emerged: initiating discussion about the risk of fertility decline, acknowledging the importance of future fertility, and recognizing the need for more verbal and written patient-specific information. In addition, patients value follow-up care and the opportunity to rediscuss FP and their concerns about future fertility and use of stored material. A clear FP healthcare pathway can prevent delays in receiving a referral to a fertility specialist to discuss FP options and initiating FP treatment. This patient-centered approach will optimize FP experiences and help to establish a process to achieve long-term follow up after FP treatment.
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Affiliation(s)
- Nicole F. Klijn
- Department of Gynecology and Obstetrics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
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3
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Pavlick AC, Ariyan CE, Buchbinder EI, Davar D, Gibney GT, Hamid O, Hieken TJ, Izar B, Johnson DB, Kulkarni RP, Luke JJ, Mitchell TC, Mooradian MJ, Rubin KM, Salama AK, Shirai K, Taube JM, Tawbi HA, Tolley JK, Valdueza C, Weiss SA, Wong MK, Sullivan RJ. Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of melanoma, version 3.0. J Immunother Cancer 2023; 11:e006947. [PMID: 37852736 PMCID: PMC10603365 DOI: 10.1136/jitc-2023-006947] [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] [Accepted: 07/16/2023] [Indexed: 10/20/2023] Open
Abstract
Since the first approval for immune checkpoint inhibitors (ICIs) for the treatment of cutaneous melanoma more than a decade ago, immunotherapy has completely transformed the treatment landscape of this chemotherapy-resistant disease. Combination regimens including ICIs directed against programmed cell death protein 1 (PD-1) with anti-cytotoxic T lymphocyte antigen-4 (CTLA-4) agents or, more recently, anti-lymphocyte-activation gene 3 (LAG-3) agents, have gained regulatory approvals for the treatment of metastatic cutaneous melanoma, with long-term follow-up data suggesting the possibility of cure for some patients with advanced disease. In the resectable setting, adjuvant ICIs prolong recurrence-free survival, and neoadjuvant strategies are an active area of investigation. Other immunotherapy strategies, such as oncolytic virotherapy for injectable cutaneous melanoma and bispecific T-cell engager therapy for HLA-A*02:01 genotype-positive uveal melanoma, are also available to patients. Despite the remarkable efficacy of these regimens for many patients with cutaneous melanoma, traditional immunotherapy biomarkers (ie, programmed death-ligand 1 expression, tumor mutational burden, T-cell infiltrate and/or microsatellite stability) have failed to reliably predict response. Furthermore, ICIs are associated with unique toxicity profiles, particularly for the highly active combination of anti-PD-1 plus anti-CTLA-4 agents. The Society for Immunotherapy of Cancer (SITC) convened a panel of experts to develop this clinical practice guideline on immunotherapy for the treatment of melanoma, including rare subtypes of the disease (eg, uveal, mucosal), with the goal of improving patient care by providing guidance to the oncology community. Drawing from published data and clinical experience, the Expert Panel developed evidence- and consensus-based recommendations for healthcare professionals using immunotherapy to treat melanoma, with topics including therapy selection in the advanced and perioperative settings, intratumoral immunotherapy, when to use immunotherapy for patients with BRAFV600-mutated disease, management of patients with brain metastases, evaluation of treatment response, special patient populations, patient education, quality of life, and survivorship, among others.
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Affiliation(s)
| | - Charlotte E Ariyan
- Department of Surgery Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Diwakar Davar
- Hillman Cancer Center, University of Pittsburg Medical Center, Pittsburgh, Pennsylvania, USA
| | - Geoffrey T Gibney
- Lombardi Comprehensive Cancer Center, MedStar Georgetown University Hospital, Washington, District of Columbia, USA
| | - Omid Hamid
- The Angeles Clinic and Research Institute, A Cedars-Sinai Affiliate, Los Angeles, California, USA
| | - Tina J Hieken
- Department of Surgery and Comprehensive Cancer Center, Mayo Clinic, Rochester, Minnesota, USA
| | - Benjamin Izar
- Department of Medicine, Division of Hematology/Oncology, Columbia University Medical Center, New York, New York, USA
| | - Douglas B Johnson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Rajan P Kulkarni
- Departments of Dermatology, Oncological Sciences, Biomedical Engineering, and Center for Cancer Early Detection Advanced Research, Knight Cancer Institute, OHSU, Portland, Oregon, USA
- Operative Care Division, VA Portland Health Care System (VAPORHCS), Portland, Oregon, USA
| | - Jason J Luke
- Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Tara C Mitchell
- Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Meghan J Mooradian
- Cancer Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Krista M Rubin
- Cancer Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - April Ks Salama
- Department of Medicine, Division of Medical Oncology, Duke University, Durham, Carolina, USA
| | - Keisuke Shirai
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Janis M Taube
- Department of Dermatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hussein A Tawbi
- Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - J Keith Tolley
- Patient Advocate, Melanoma Research Alliance, Washington, DC, USA
| | - Caressa Valdueza
- Cutaneous Oncology Program, Weill Cornell Medicine, New York, New York, USA
| | - Sarah A Weiss
- Department of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Michael K Wong
- Patient Advocate, Melanoma Research Alliance, Washington, DC, USA
| | - Ryan J Sullivan
- Cancer Center, Massachusetts General Hospital, Boston, Massachusetts, USA
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Tholeti P, Uppangala S, Jayaram RK, Udupa KS, Kalthur G, Spears N, Woodruff T, Adiga SK. Oncofertility awareness among primary care physicians in India. F1000Res 2023; 12:153. [PMID: 37767024 PMCID: PMC10521121 DOI: 10.12688/f1000research.126232.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Primary care physicians not only coordinate referrals to oncology services but can play a crucial role in successful fertility preservation referrals in cancer-diagnosed patients. Hence, it is important to assess their knowledge and attitudes towards fertility preservation. METHODS An eighteen-item oncofertility survey was administered to primary care physicians between May 2019 to September 2020. Results: A total of forty-six responses were received and analysed. About 60% of primary care physicians did not have adequate knowledge about available fertility preservation options and only 26-32% were aware of international guidelines recommending fertility preservation in cancer patients. Conclusions: Imparting awareness and knowledge of fertility preservation and its options to primary care physicians could enable an integrated cancer care model while also facilitating successful oncofertility referrals in countries like India.
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Affiliation(s)
- Prathima Tholeti
- Centre for Fertility Preservation, Division of Clinical Embryology, Department of Reproductive Science, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576 104, India
| | - Shubhashree Uppangala
- Division of Reproductive Genetics, Department of Reproductive Science, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576 104, India
| | | | - Karthik S Udupa
- Department of Medical Oncology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576 104, India
| | - Guruprasad Kalthur
- Division of Reproductive Biology, Department of Reproductive Science, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576 104, India
| | - Norah Spears
- Department of Biomedical Sciences, University of Edinburgh, Edinburgh, EH8 9XD, UK
| | - Teresa Woodruff
- Oncofertility Consortium, Room A626B, Michigan State University, East Lansing, Michigan, 48824-1316, USA
| | - Satish K Adiga
- Centre for Fertility Preservation, Division of Clinical Embryology, Department of Reproductive Science, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576 104, India
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Wytiaz V, Levin NJ, Tan CY, Stelmak D, Iannarino N, Zhang A, Ellman E, Herrel L, Moravek M, Walling E, Chugh R, Zebrack B. Body image disturbances in adolescent and young adult cancer patients confronting infertility risk and fertility preservation decisions. J Psychosoc Oncol 2023; 42:208-222. [PMID: 37452662 PMCID: PMC10788379 DOI: 10.1080/07347332.2023.2235607] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
PURPOSE Body image is a major psychosocial concern for all cancer patients but can affect the adolescent and young adult (AYA) population in distinct ways. Similarly, the prospect of infertility and the fertility preservation process can create additional stress during cancer treatment. Discussions regarding infertility inherently implicate the body and its reproductive function, but downstream effects on self-perception have not been previously described. The aim of this study was to explore the experiences of AYAs as they considered their risk of infertility and options for fertility preservation (FP), specifically the ways in which this impacted body image and FP decision-making. METHODS AYA cancer patients (n = 27) aged 12-25 years whose cancer and treatment conferred risk of infertility were recruited through electronic health record query at an NCI-Designated Comprehensive Cancer Center. Participants completed semi-structured interviews, which were recorded, transcribed, and deductively coded for themes related to information needs, knowledge of treatment effects on fertility, and reproductive concerns after cancer. Emergent, inductive themes related to body image were identified. RESULTS Body image concerns, related to both physical appearance and body functioning emerged. Common concerns included anticipating change as it pertains to the body and its functions, physical discomfort, fear of judgment, and meeting expectations of the body. While these themes are broad in nature, they have been previously explored in relation to body image in general and their emergence in the oncofertility space provides guidance for further optimization of infertility and fertility preservation discussions. CONCLUSIONS AYA cancer patients experience a multitude of body image related disturbances when faced with the possibility of infertility and fertility preservation. In identifying and exploring these themes, future opportunities for improving oncofertility practice and discussions among AYAs with a focus on body image positivity are called upon.
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Affiliation(s)
- Victoria Wytiaz
- Department of Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Nina Jackson Levin
- Department of Anthropology, University of Michigan School of Social Work, Ann Arbor, Michigan, USA
| | - Chiu Yi Tan
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Daria Stelmak
- University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Nick Iannarino
- Department of Language, Culture and Communication, University of Michigan-Dearborn, Dearborn, Michigan, USA
| | - Anao Zhang
- Univsersity of Michigan School of Social Work, Ann Arbor, Michigan, USA
| | - Erin Ellman
- Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Lindsey Herrel
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Molly Moravek
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA
| | - Emily Walling
- Department of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rashmi Chugh
- Department of Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Brad Zebrack
- Univsersity of Michigan School of Social Work, Ann Arbor, Michigan, USA
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Varlas VN, Borș RG, Crețoiu R, Bălescu I, Bacalbașa N, Cîrstoiu M. Fertility-sparing surgery: a hopeful strategy for young women with cancer. J Med Life 2023; 16:974-980. [PMID: 37900072 PMCID: PMC10600681 DOI: 10.25122/jml-2023-0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/25/2023] [Indexed: 10/31/2023] Open
Abstract
Fertility preservation in cancer patients is currently based on either assisted reproductive technology or fertility-sparing surgery. Loss of fertility may be caused by excisional surgery associated with an adnexal or uterine pathology or secondary to gonadal insufficiency caused by chemotherapy or radiation. The counseling of these patients is very important, being carried out jointly by the oncologist, gynecologist, and reproductive medicine specialist. Reproductive surgery usually requires avoiding laparotomy to significantly reduce the formation of adhesions and trauma or tissue damage. This is done using standard laparoscopic surgery or robotic surgery (computer-assisted laparoscopy), a method increasingly used and accessible to all specialists who want to maintain the fertility of their patients with various oncological diseases.
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Affiliation(s)
- Valentin Nicolae Varlas
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, Bucharest, Romania
- Department of Obstetrics Gynecology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Roxana Georgiana Borș
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, Bucharest, Romania
| | - Rebeca Crețoiu
- Department of Pituitary and Neuroendocrine Disorders, C.I. Parhon National Institute of Endocrinology, Bucharest, Romania
| | - Irina Bălescu
- Department of Surgery, Ponderas Academic Hospital, Bucharest, Romania
| | - Nicolae Bacalbașa
- Department of Visceral Surgery, Fundeni Clinical Institute, Bucharest, Romania
| | - Monica Cîrstoiu
- Department of Obstetrics and Gynecology, University Emergency Hospital Bucharest, Romania
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Tanase A, Ciocoiu M, Tănase G. Fertility options after chemotherapy in young premenopausal patients. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2023; 19:398-402. [PMID: 38356982 PMCID: PMC10863951 DOI: 10.4183/aeb.2023.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Context Infertility affects more and more younger patients nowadays. Life-saving cancer treatments - chemotherapy and radiation therapy unfortunately damage oocytes and reduce the window of fertility in women. There were an estimated 14.1 million cases of cancer worldwide in 2012, of which 6.7 million were in women. Aim We are reviewing fertility options and treatments for women fighting oncological diseases. It is important to promote that there is a possibility for these patients to know all they can do in order to preserve their fertility and our government should help all these young patients.The trend of delayed childbearing has increased worldwide duet o increased life costs, difficulty of finding a suitable partner and carier options, while the number of women facing a cancer diagnosis is rising. Material and methods We describe a review regarding the impact of these treatments for the fertility of these patients. Results Show that informed patients can better cope with their diagnostic and have a better prognosis. Conclusions Improving survival rates and current data have created a new medical field oncofertility. The term was first introduced in 2015 and is being used all over clinics that treat young patients nowadays.
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Affiliation(s)
- A. Tanase
- Obstetrics and Gynecology, “Grigore T Popa” University of Medicine and Pharmacy Iasi
| | - M. Ciocoiu
- Pathophysiology, “Grigore T Popa” University of Medicine and Pharmacy Iasi
| | - G.V. Tănase
- Anesthesiology and Intensive Care Unit, Iasi, Romania
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Jegaden M, Bleas C, Debras E, Couet D, Pourcelot AG, Capmas P, Fernandez H. Asherman Syndrome after Uterine Artery Embolization: A Cohort Study about Surgery Management and Fertility Outcomes. J Minim Invasive Gynecol 2023; 30:494-501. [PMID: 36813132 DOI: 10.1016/j.jmig.2023.02.012] [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: 01/22/2023] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/23/2023]
Abstract
STUDY OBJECTIVE To study the severity of intrauterine adhesions (IUA) after uterine arterial embolization and to evaluate fertility, pregnancy, and obstetrical outcomes after hysteroscopic treatment. DESIGN Retrospective cohort. SETTING French University Hospital. PATIENTS Thirty-three patients under the age of 40 years who were treated by uterine artery embolization with nonabsorbable microparticles between 2010 and 2020 for symptomatic fibroids or adenomyosis, or postpartum hemorrhage. INTERVENTIONS All patients had a diagnosis of IUA after embolization. All patients desired future fertility. IUA was treated with operative hysteroscopy. MEASUREMENTS AND MAIN RESULTS Severity of IUA, number of operative hysteroscopies performed to obtain a normal cavity shape, pregnancy rate, and obstetrical outcomes. Of our 33 patients, 81.8% had severe IUA (state IV et V according to the European Society of Gynecological Endoscopy or state III according to the American fertility society classification). To restore fertility potential, an average of 3.4 operative hysteroscopies had to be performed [CI 95% (2.56-4.16)]. We reported a very low rate of pregnancy (8/33, 24%). Obstetrical outcomes reported are 50% of premature birth and 62.5% of delivery hemorrhage partly due to 37.5% of placenta accreta. We also reported 2 neonatal deaths. CONCLUSION IUA after uterine embolization is severe, and more difficult to treat than other synechiae, probably related to endometrial necrosis. Pregnancy and obstetrical outcomes have shown a low pregnancy rate, an increased risk of preterm delivery, a high risk of placental disorders, and very severe postpartum hemorrhage. Those results have to alert gynecologists and radiologists to the use of uterine arterial embolization in women who desire future fertility.
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Affiliation(s)
- Margaux Jegaden
- Department of Gynecology and Obstetrics, 8 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France (all authors); Faculty of medicine, University Paris-Saclay (Drs. Jegaden, Debras, Capmas, Fernandez), 63 rue Gabriel Péri, 94270 Le Kremlin Bicêtre, France.
| | - Cécile Bleas
- Department of Gynecology and Obstetrics, 8 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France (all authors)
| | - Elodie Debras
- Department of Gynecology and Obstetrics, 8 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France (all authors); Faculty of medicine, University Paris-Saclay (Drs. Jegaden, Debras, Capmas, Fernandez), 63 rue Gabriel Péri, 94270 Le Kremlin Bicêtre, France
| | - Déborah Couet
- Department of Gynecology and Obstetrics, 8 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France (all authors)
| | - Anne-Gaëlle Pourcelot
- Department of Gynecology and Obstetrics, 8 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France (all authors)
| | - Perrine Capmas
- Department of Gynecology and Obstetrics, 8 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France (all authors); Faculty of medicine, University Paris-Saclay (Drs. Jegaden, Debras, Capmas, Fernandez), 63 rue Gabriel Péri, 94270 Le Kremlin Bicêtre, France; Université Paris-Saclay, UVSQ, Inserm, CESP (Drs. Capmas, Fernandez), Villejuif, France
| | - Hervé Fernandez
- Department of Gynecology and Obstetrics, 8 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France (all authors); Faculty of medicine, University Paris-Saclay (Drs. Jegaden, Debras, Capmas, Fernandez), 63 rue Gabriel Péri, 94270 Le Kremlin Bicêtre, France; Université Paris-Saclay, UVSQ, Inserm, CESP (Drs. Capmas, Fernandez), Villejuif, France
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9
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Reproductive Outcomes in Young Breast Cancer Survivors Treated (15-39) in Ontario, Canada. Curr Oncol 2022; 29:8591-8599. [PMID: 36421330 PMCID: PMC9689574 DOI: 10.3390/curroncol29110677] [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: 09/19/2022] [Revised: 10/30/2022] [Accepted: 11/01/2022] [Indexed: 11/16/2022] Open
Abstract
We conducted a population-based, retrospective, matched-cohort study to examine the impact of breast cancer diagnosis and treatment on fertility outcomes. Relative risks of infertility, childbirth, premature ovarian insufficiency (POI; age < 40) and early menopause (age < 45) were calculated using modified Poisson regression. Our primary cohort included young women (15-39) with early stage BC diagnosed 1995-2014. Five cancer-free patients were matched to each BC patient by birth year and census subdivision. The BC cohort was further divided by treatment with chemotherapy vs. no chemotherapy treatment. 3903 BC patients and 19,515 cancer-free women. BC patients treated with chemotherapy were at increased risk of infertility (RR 1.81; 95% CI 1.60-2.04), and POI (RR 6.25; 95% CI 5.15-7.58) and decreased childbirth (RR 0.85; 95% CI 0.75-0.96), compared to women without cancer. BC patients who did not receive chemotherapy were also at increased risk of infertility (RR 1.80 95% CI 1.48-2.18) and POI (RR 2.12 95% CI 1.37-3.28). All young BC survivors face an increased risk of diagnosed infertility and POI relative to women without cancer, independent of chemotherapy. These results emphasize the importance of pre-treatment fertility counselling for young women diagnosed with BC.
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10
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Cargnelutti F, Di Nisio A, Pallotti F, Spaziani M, Tarsitano MG, Paoli D, Foresta C. Risk factors on testicular function in adolescents. J Endocrinol Invest 2022; 45:1625-1639. [PMID: 35286610 PMCID: PMC9360118 DOI: 10.1007/s40618-022-01769-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/13/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Adolescence represents an important window for gonadal development. The aim of this review is to carry out a critical excursus of the most recent literature on endogenous and exogenous risk factors related to testicular function, focusing the research on adolescence period. METHODS A comprehensive literature search within PubMed was performed to provide a summary of currently available evidence regarding the impact on adolescence of varicocele, cryptorchidism, cancer, diabetes, lifestyle factors, endocrine disruptors, obesity and sexually transmitted diseases. We focused on human studies that evaluated a possible impact of these factors on puberty timing and their effects on andrological health. RESULTS Evidence collected seems to suggest that andrological health in adolescence may be impaired by several factors, as varicocele, cryptorchidism, and childhood cancer. Despite an early diagnosis and treatment, many adolescents might still have symptoms and sign of a testicular dysfunction in their adult life and at the current time it is not possible to predict which of them will experience andrological problems. Lifestyle factors might have a role in these discrepancies. Most studies point out towards a correlation between obesity, insulin resistance, alcohol, smoking, use of illegal drugs and testicular function in pubertal boys. Also, endocrine disruptors and sexually transmitted diseases might contribute to impair reproductive health, but more studies in adolescents are needed. CONCLUSION According to currently available evidence, there is an emerging global adverse trend of high-risk and unhealthy behaviors in male adolescents. A significant proportion of young men with unsuspected and undiagnosed andrological disorders engage in behaviors that could impair testicular development and function, with an increased risk for later male infertility and/or hypogonadism during the adult life. Therefore, adolescence should be considered a key time for intervention and prevention of later andrological diseases.
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Affiliation(s)
- F Cargnelutti
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - A Di Nisio
- Department of Medicine, Operative Unit of Andrology and Medicine of Human Reproduction, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy
| | - F Pallotti
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - M Spaziani
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - M G Tarsitano
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - D Paoli
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
| | - C Foresta
- Department of Medicine, Operative Unit of Andrology and Medicine of Human Reproduction, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy
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11
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Ehrenberg S, Stransky OM, Wright CE, Jain R, Kazmerski TM. Partner perspectives on women's sexual and reproductive healthcare in cystic fibrosis. J Cyst Fibros 2022; 22:217-222. [PMID: 35970694 DOI: 10.1016/j.jcf.2022.08.003] [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: 04/01/2022] [Revised: 06/30/2022] [Accepted: 08/07/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Women with cystic fibrosis (CF) face many sexual and reproductive health (SRH) concerns. Studies suggest that educating and involving partners in SRH care can improve outcomes. This study investigated partners' perceptions of and preferences for women's SRH care in CF. METHODS We surveyed partners of women with CF from ten United States (U.S.) CF centers regarding their attitudes and preferences related to CF SRH care. Items assessed experiences with SRH care, sexual relationships, family planning, pregnancy, fertility, and parenthood. We used descriptive statistics to assess results related to the timing, content, setting and delivery of CF SRH care. RESULTS A total of 94 partners completed the survey (94% male; average age 36±1 years; 70% married; 36% parents). Among those who/whose partners experienced a pregnancy, 48% received preconception counseling and 29% fertility testing/treatment. One-third of all respondents (32%) worried their children would have CF and 86% would undergo CF genetic testing if their CF partner became pregnant. One-third (34%) indicated that they did not have any SRH conversations with their partner's CF team, while 70% would like to have such discussions. The topics that respondents would most like to discuss were pregnancy (50%), fertility (43%), sexual functioning (36%), sexual activity (31%) and parenthood (29%). CONCLUSIONS Partners report gaps in SRH care and counseling despite the majority wanting to discuss SRH concerns with their partner's CF team. CF partners serve as key supports for women with CF and results can be used to design patient-centered interventions to optimize CF SRH care.
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Affiliation(s)
- Sarah Ehrenberg
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Olivia M Stransky
- Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, Pittsburgh, PA, United States
| | - Catherine E Wright
- Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, Pittsburgh, PA, United States
| | - Raksha Jain
- University of Texas Southwestern, Dallas, TX, United States
| | - Traci M Kazmerski
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, Pittsburgh, PA, United States.
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12
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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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13
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Tomioka A, Obama K, Okada H, Yamauchi E, Iwase K, Maru M. Nurse’s perceptions of support for sexual and reproductive issues in adolescents and young adults with cancer. PLoS One 2022; 17:e0265830. [PMID: 35675269 PMCID: PMC9176807 DOI: 10.1371/journal.pone.0265830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 03/08/2022] [Indexed: 11/30/2022] Open
Abstract
Adolescent and young adult (AYA) with cancer are at risk for developing sexual and reproductive problems; therefore, they have special needs. AYA with cancer treated in both pediatric and adult wards are a minority in Japan; thus, accumulating experience for supporting this unique patient population is difficult for nurses. Hence, this study aimed to clarify nurses’ perceptions on support for sexual and reproductive issues among AYA with cancer. A questionnaire survey was administered to nurses at designated cancer hospitals across Japan who had been working for at least 1 year in a department involved in the treatment or follow-up of patients aged 15–39 years. Nurses were asked regarding their perceptions on support for sexual and reproductive issues faced by AYA with cancer. A total of 865 nurses responded to this survey; nurses affiliated with adult departments, those with more experience in cancer nursing, those affiliated with cancer-related academic and professional societies, and certified nurse specialists or certified nurses significantly recognized insufficient support for sexual and reproductive issues. However, nurses were hesitant and found it difficult to intervene in such issues. Nurses recognized the importance of providing support for sexual and reproductive issues but faced difficulties in addressing them. They need to discuss these issues and improve the care provided to AYA with cancer.
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Affiliation(s)
- Akiko Tomioka
- Faculty of Healthcare, Tokyo Healthcare University, Tokyo, Japan
- * E-mail:
| | - Kyoko Obama
- Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Hiromi Okada
- Faculty of Healthcare, Tokyo Healthcare University, Tokyo, Japan
| | - Eiko Yamauchi
- Faculty of Medicine, Ehime University, Matsuyama, Ehime, Japan
| | - Kimiko Iwase
- Faculty of Nursing & Rehabilitation, Konan Women’s University, Kobe, Hyogo, Japan
| | - Mitsue Maru
- College of Nursing Art & Science, University of Hyogo, Kobe, Japan
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14
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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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15
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Development and Validity Testing of an Assessment Tool for Oncofertility Barriers in Multidisciplinary Healthcare Providers on the Breast Cancer Team. THE JOURNAL OF NURSING RESEARCH : JNR 2022; 30:e195. [PMID: 35234209 DOI: 10.1097/jnr.0000000000000479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Multidisciplinary healthcare providers, especially clinical nurses, lack a valid tool to assess the comprehensive barriers affecting oncofertility care in breast cancer treatment. PURPOSE The aims of the research were to develop a self-assessment scale on oncofertility barriers and test its validity and reliability. METHODS This was a methodological study. The initial 36 items of the developed Oncofertility Barrier Scale (OBS) were generated through qualitative study and a review of the literature. This scale was further refined using expert validity (n = 10), face validity (n = 10), and item analysis (n = 184). Exploratory factor analysis with principal axis factoring and direct oblimin rotation was used to determine the construct validity. The reliability of the OBS was evaluated using internal consistency and test-retest analyses. RESULTS The mean item-level and scale-level content validity indices of the initial OBS were higher than .96. The data were shown to be feasible for the factor analysis, and a six-factor solution was chosen that accounted for approximately 57.6% of the total variance. These factors included (a) lack of information and education, (b) rigid thinking toward oncofertility care, (c) cancer patient stereotypes, (d) fertility risk, (e) insufficient support, and (f) interrupted oncofertility care. The Cronbach's alpha of the 27-item OBS was .91, and the test-retest reliability coefficient was .55. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The final version of the developed OBS has acceptable reliability, content validity, and construct validity. This scale is appropriate for use in research and clinical practice settings to identify the barriers to fertility cancer care that should be resolved by the breast cancer care team.
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16
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Zaami S, Melcarne R, Patrone R, Gullo G, Negro F, Napoletano G, Monti M, Aceti V, Panarese A, Borcea MC, Scorziello C, Ventrone L, Mamedov SN, Meggiorini ML, Vergine M, Giacomelli L. Oncofertility and Reproductive Counseling in Patients with Breast Cancer: A Retrospective Study. J Clin Med 2022; 11:jcm11051311. [PMID: 35268402 PMCID: PMC8911138 DOI: 10.3390/jcm11051311] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/22/2022] [Accepted: 02/25/2022] [Indexed: 12/25/2022] Open
Abstract
Introduction. Improving the prognosis of breast cancer patients is of utmost importance in terms of increasing survival rates. Modern medicine has therefore prioritized better quality of life for patients, even after the disease, through a better management of the potential long-term side effects induced by anticancer treatments. Fertility preservation and family planning are therefore crucial issues to be addressed in all cancer patients of reproductive age. Along those lines, a new branch of medicine with distinct multidisciplinary characteristics has developed over the years: oncofertility. Although both national and international guidelines value reproductive counseling as an essential aspect of the diagnostic-therapeutic pathway, part and parcel of the informed consent process, it is not included within the protocols adopted by the operating units for the care and management of neoplastic diseases. Objective. This study aimed to evaluate the activity of the Breast Unit of the Policlinico Umberto I Hospital, Rome, Italy, and the degree of compliance with guidelines. By knowing the strengths and weaknesses of such approaches, the standards of care offered to breast cancer patients can be improved. Materials and methods. A retrospective study based on a review of medical records was conducted between 2014 and 2021. Patients under 40 years of age diagnosed with non-metastatic malignancies were included who received chemotherapy treatment, namely neoadjuvant, adjuvant or adjuvant hormone therapy. Results. The data were extracted from the medical records of 51 patients who met the inclusion criteria, 41% of whom received reproductive counseling, and of these, 43% decided to undertake a path of fertility preservation. Factors such as the absence of children and young age reportedly favored both the interest in counseling proposals by the medical staff and the decision to undertake a path of fertility preservation. Conclusions. The study shows that there has been growing interest in the topic of oncofertility, especially in light of law 219/2017. Therefore, since 2018, multiple proposals for reproductive counseling have been set forth, but there was not an equally growing demand for fertility preservation practices, which can be explained by the invasive nature of such practices, the patients’ concern about their own state of health, and poor or inadequate information. Such impediments highlight the importance of standardized counseling and the need for a multidisciplinary medical team to support the patient in the decision-making process. The study also revealed a drop in the number of patients receiving counseling due to the COVID-19 pandemic, contrary to the positive trend that was recorded prior to the pandemic.
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Affiliation(s)
- Simona Zaami
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (F.N.); (G.N.)
- Correspondence:
| | - Rossella Melcarne
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (R.M.); (M.C.B.); (C.S.); (L.V.); (S.N.M.); (M.V.); (L.G.)
| | - Renato Patrone
- ICTUS, University of Naples Federico II, 80131 Naples, Italy;
| | - Giuseppe Gullo
- In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, University of Palermo, 90146 Palermo, Italy;
| | - Francesca Negro
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (F.N.); (G.N.)
| | - Gabriele Napoletano
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (F.N.); (G.N.)
| | - Marco Monti
- Department of Maternal and Child Health and Urological Sciences, Policlinico Umberto I, “Sapienza” University of Rome, 00161 Rome, Italy; (M.M.); (M.L.M.)
| | - Valerio Aceti
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, 00161 Rome, Italy;
| | - Alessandra Panarese
- General and Transplant Surgery Department, Dipartimento di Scienze Cliniche Applicate e Biotecnologiche (DISCAB), University of L’Aquila, 67100 L’Aquila, Italy;
| | - Maria Carola Borcea
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (R.M.); (M.C.B.); (C.S.); (L.V.); (S.N.M.); (M.V.); (L.G.)
| | - Chiara Scorziello
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (R.M.); (M.C.B.); (C.S.); (L.V.); (S.N.M.); (M.V.); (L.G.)
| | - Luca Ventrone
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (R.M.); (M.C.B.); (C.S.); (L.V.); (S.N.M.); (M.V.); (L.G.)
| | - Samira Nicole Mamedov
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (R.M.); (M.C.B.); (C.S.); (L.V.); (S.N.M.); (M.V.); (L.G.)
| | - Maria Letizia Meggiorini
- Department of Maternal and Child Health and Urological Sciences, Policlinico Umberto I, “Sapienza” University of Rome, 00161 Rome, Italy; (M.M.); (M.L.M.)
| | - Massimo Vergine
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (R.M.); (M.C.B.); (C.S.); (L.V.); (S.N.M.); (M.V.); (L.G.)
| | - Laura Giacomelli
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (R.M.); (M.C.B.); (C.S.); (L.V.); (S.N.M.); (M.V.); (L.G.)
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17
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Mujumdar V, Shivashankar K, Madding R, Levy AT, Gordhandas S, Rosenblum NG, Richard S, Monseur B. An assessment of oncofertility content on reproductive endocrinology and infertility clinic websites. J Assist Reprod Genet 2022; 39:957-962. [PMID: 35217946 PMCID: PMC9050974 DOI: 10.1007/s10815-022-02442-y] [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: 08/01/2021] [Accepted: 02/21/2022] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To assess oncofertility content on fertility clinic websites as indicated by eight relevant keywords. Additionally, we sought to describe the relationship between oncofertility content and five predetermined clinic characteristics. METHODS We examined 381 fertility clinic websites that are members of the Society for Associated Reproductive Technology (SART). Extracted data included clinic location, practice type (private vs academic), size (cycles/year), type of NCI designated center (cancer center vs comprehensive cancer center), and distance from the nearest NCI center. Additionally, we documented whether the clinic was located in a state mandating reproductive and infertility services and/or included fertility preservation for "iatrogenic infertility" as reported by the American Society for Reproductive Medicine (ASRM). Data were summarized using descriptive statistics and compared using chi-squared or t-test as appropriate. RESULTS Of the 381 fertility clinic websites analyzed, 322 (85%) contained at least one oncofertility-related keyword. Most frequently used terms included cancer (79%) and fertility preservation (78%), while less frequently used terms included suppression (9.4%) and shielding (5.0%). Practices that initiated ≥ 501 cycles per year were more likely to mention one of the oncofertility keywords (OR 1.2; 95% CI 1.1-1.3). The associations of oncofertility website content with practice type, state-mandated fertility insurance coverage, and distance from an NCI-designated cancer center were not statistically significant. Large clinic size was the only predictive factor for inclusion of oncofertility website content. Further studies are required to evaluate whether inclusion of oncofertility content on clinic websites impacts the use of these services by patients with cancer. CONCLUSION This is the first study correlating availability of oncofertility content on SART fertility clinic websites with consideration of geographic proximity to NCI designated cancer centers. Large clinic size was the only predictive factor for inclusion of oncofertility website content.
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Affiliation(s)
- Vaidehi Mujumdar
- Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, 833 Chestnut Street, 1st Floor, Philadelphia, PA, 19107, USA. .,Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, 82-86 164 St, New York, NY, 11432, USA.
| | - Kavya Shivashankar
- Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut St #100, Philadelphia, PA, 19107, USA
| | - Rachel Madding
- Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut St #100, Philadelphia, PA, 19107, USA
| | - Ariel T Levy
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Weill Cornell Medical College, 1305 York Ave, New York, NY, 10021, USA
| | - Sushmita Gordhandas
- Gynecology Service, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - Norman G Rosenblum
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, 925 Chestnut Street, Suite 320A, Philadelphia, PA, 19017, USA
| | - Scott Richard
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, 925 Chestnut Street, Suite 320A, Philadelphia, PA, 19017, USA
| | - Brent Monseur
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Stanford Hospital and Clinics, 1195 W. Fremont Avenue, Sunnyvale, CA, 94087, USA
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18
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Varlas VN, Borș RG, Pop AL, Năsui BA, Bacalbasa N, Bohîlțea R, Vlădăreanu R, Manolea C. Oncofertility and COVID-19: At the Crossroads between Two Time-Sensitive Fields. J Clin Med 2022; 11:jcm11051221. [PMID: 35268312 PMCID: PMC8911324 DOI: 10.3390/jcm11051221] [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: 12/19/2021] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 02/04/2023] Open
Abstract
Background: COVID-19 infection has dominated our lives and left its mark on it. The impact on fertility is major, and the long-term consequences may be disastrous. When we talk about oncofertility, we are talking about those patients worried about the delay in receiving medical services (possible cancelation of surgery, decreased availability of medical services, reorientation of medical resources) due to COVID-19. Finally, patients’ worsening biological and reproductive statuses, associated with high levels of anxiety and depression, are closely related to social restrictions, economic impact, reorientation of medical resources, health policies, and fears of SARS-CoV-2 infection. Aim: We reviewed the current literature on fertility during the COVID-19 pandemic and its effect on cancer patients. Specifically, how cancer treatment can affect fertility, the options to maintain fertility potential, and the recovery options available after treatment are increasingly common concerns among cancer patients. Methods: A systematic literature search was conducted using two main central databases (PubMed®/MEDLINE, and Web of Science) to identify relevant studies using keywords SARS-CoV-2, COVID-19, oncofertility, young cancer patient, cryopreservation, assisted reproductive techniques (ART), psychosocial, telemedicine. Results: In the present study, 45 papers were included, centered on the six main topics related to COVID-19. Conclusions: Fertility preservation (FP) should not be discontinued, but instead practiced with adjustments to prevent SARS-CoV-2 transmission. The increased risk of SARS-CoV-2 infection in cancer patients requires screening for COVID-19 before FP procedures, among both patients and medical staff in FP clinics, to prevent infection that would rapidly worsen the condition and lead to severe complications.
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Affiliation(s)
- Valentin Nicolae Varlas
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania
| | - Roxana Georgiana Borș
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania
- Correspondence: (R.G.B.); (R.B.)
| | - Anca Lucia Pop
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Clinical Laboratory, Food Safety, Carol Davila University of Medicine and Pharmacy, 6 Traian Vuia Street, 020945 Bucharest, Romania
| | - Bogdana Adriana Năsui
- Department of Community Health, Iuliu Hațieganu University of Medicine and Pharmacy, 6 Louis Pasteur Street, 400349 Cluj-Napoca, Romania;
| | - Nicolae Bacalbasa
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Obstetrics and Gynaecology, Cantacuzino Clinical Hospital, 030167 Bucharest, Romania
| | - Roxana Bohîlțea
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania
- Correspondence: (R.G.B.); (R.B.)
| | - Radu Vlădăreanu
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Obstetrics and Gynecology, Elias Clinical Hospital, 17 Mărăști Blvd., 011461 Bucharest, Romania
| | - Corina Manolea
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Assisted Reproduction Department, Columna Medical Center, 021522 Bucharest, Romania
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19
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Huang SM, Kao TS, Lien PJ, Hsieh PL, Chen PH, Tseng LM. Oncofertility care: A qualitative study to understand personal perspectives and barriers in the multidisciplinary breast care team in Taiwan. WOMEN'S HEALTH 2022; 18:17455057221078480. [PMID: 35156483 PMCID: PMC8848045 DOI: 10.1177/17455057221078480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Previous studies indicate significant gaps exist in current practices and perceptions of oncofertility care. Objectives: We aim to understand the clinical experience regarding oncofertility care among health providers in a multidisciplinary breast care team. Methods: A qualitative, descriptive study was conducted. Data were collected through in-depth interviews with 16 health care providers who worked in a hospital in Taipei. Verbatim transcriptions were analyzed using constant analysis methods. Results: Health care providers’ experiences regarding fertility care for reproductive-age women with breast cancer were divided into two themes: personal perspectives and barriers. Personal perspectives consisted of six subthemes including empathizing with the patient’s suffering during the diagnosis and treatment, safety as a prerequisite, satisfying the women’s needs, respecting the women’s choice, questioning women’s ability to raise children, and returning to family life. There were also six subthemes under barriers. These subthemes were poor communication among the multidisciplinary team, lack of initial screening, insufficient support in the women’s families, treatment considerations, lack of evidence-based information regarding oncofertility, and non-follow-up protocol. Conclusion: Nurses should evaluate the fertility needs of women with cancer and identify potential gaps during oncofertility care. Education strategies and tactics should be improved in order to overcome difficulties arising from health care providers’ personal perspectives and barriers to the provision of optimal fertility care in women with cancer.
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Affiliation(s)
| | - Teh-Sing Kao
- Department of Nursing, MacKay Medical College, New Taipei City
| | - Pei-Ju Lien
- Comprehensive Breast Health Center, Taipei Veterans General Hospital, Taipei City
| | - Pei-Ling Hsieh
- Department of Nursing, University of Kang Ning, Taipei City
| | - Ping-Ho Chen
- Department of Traditional Chinese Medicine, Taipei Medical University Hospital, Taipei City
| | - Ling-Ming Tseng
- Comprehensive Breast Health Center, Department of Surgery, Taipei Veterans General Hospital, Taipei City
- School of Medicine, National Yang Ming Chiao Tung University, Taipei City
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20
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Female Oncofertility: Current Understandings, Therapeutic Approaches, Controversies, and Future Perspectives. J Clin Med 2021; 10:jcm10235690. [PMID: 34884393 PMCID: PMC8658080 DOI: 10.3390/jcm10235690] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 11/25/2021] [Accepted: 12/02/2021] [Indexed: 12/14/2022] Open
Abstract
Recent advances in early detection and oncological therapies have ameliorated the survival rate of young cancer patients. Yet, ovarian impairment induced by chemotherapy and radiotherapy is still a challenging issue. This review, based on clinical and lab-based studies, summarizes the evidence of gonadotoxicity of chemoradiotherapy, the recent approaches, ongoing controversies, and future perspectives of fertility preservation (FP) in female patients who have experienced chemo- or radio-therapy. Existing data indicate that chemotherapeutic agents induce DNA alterations and massive follicle activation via the phosphoinositide 3-kinase (PI3K)/Akt signaling pathway. Meanwhile, the radiation causes ionizing damage, leading to germ cell loss. In addition to the well-established methods, numerous therapeutic approaches have been suggested, including minimizing the follicle loss in cryopreserved ovarian grafts after transplantation, in vitro activation or in vitro growing of follicles, artificial ovarian development, or fertoprotective adjuvant to prevent ovarian damage from chemotherapy. Some reports have revealed positive outcomes from these therapies, whereas others have demonstrated conflictions. Future perspectives are improving the live birth rate of FP, especially in patients with adverse ovarian reserve, eliminating the risk of malignancy reintroducing, and increasing society’s awareness of FP importance.
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21
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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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22
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Emens LA, Adams S, Cimino-Mathews A, Disis ML, Gatti-Mays ME, Ho AY, Kalinsky K, McArthur HL, Mittendorf EA, Nanda R, Page DB, Rugo HS, Rubin KM, Soliman H, Spears PA, Tolaney SM, Litton JK. Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of breast cancer. J Immunother Cancer 2021; 9:e002597. [PMID: 34389617 PMCID: PMC8365813 DOI: 10.1136/jitc-2021-002597] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2021] [Indexed: 12/17/2022] Open
Abstract
Breast cancer has historically been a disease for which immunotherapy was largely unavailable. Recently, the use of immune checkpoint inhibitors (ICIs) in combination with chemotherapy for the treatment of advanced/metastatic triple-negative breast cancer (TNBC) has demonstrated efficacy, including longer progression-free survival and increased overall survival in subsets of patients. Based on clinical benefit in randomized trials, ICIs in combination with chemotherapy for the treatment of some patients with advanced/metastatic TNBC have been approved by the United States (US) Food and Drug Administration (FDA), expanding options for patients. Ongoing questions remain, however, about the optimal chemotherapy backbone for immunotherapy, appropriate biomarker-based selection of patients for treatment, the optimal strategy for immunotherapy treatment in earlier stage disease, and potential use in histological subtypes other than TNBC. To provide guidance to the oncology community on these and other important concerns, the Society for Immunotherapy of Cancer (SITC) convened a multidisciplinary panel of experts to develop a clinical practice guideline (CPG). The expert panel drew upon the published literature as well as their clinical experience to develop recommendations for healthcare professionals on these important aspects of immunotherapeutic treatment for breast cancer, including diagnostic testing, treatment planning, immune-related adverse events (irAEs), and patient quality of life (QOL) considerations. The evidence-based and consensus-based recommendations in this CPG are intended to give guidance to cancer care providers treating patients with breast cancer.
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Affiliation(s)
- Leisha A Emens
- Department of Medicine, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sylvia Adams
- Perlmutter Cancer Center, New York University Langone, New York, New York, USA
| | - Ashley Cimino-Mathews
- Department of Pathology and Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mary L Disis
- Cancer Vaccine Institute, University of Washington, Seattle, Washington, USA
| | - Margaret E Gatti-Mays
- Pelotonia Institute for Immuno-Oncology, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Alice Y Ho
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kevin Kalinsky
- Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | | | - Elizabeth A Mittendorf
- Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Breast Oncology Program, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Rita Nanda
- Department of Medicine, Section of Hematology/Oncology, The University of Chicago Medicine Comprehensive Cancer Center, Chicago, Illinois, USA
| | - David B Page
- Earle A Chiles Research Institute, Portland, Oregon, USA
| | - Hope S Rugo
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California, USA
| | - Krista M Rubin
- Center for Melanoma, Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - Hatem Soliman
- Department of Breast Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Patricia A Spears
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Sara M Tolaney
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Jennifer K Litton
- Department of Breast Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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23
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Velez MP, Richardson H, Baxter NN, McClintock C, Greenblatt E, Barr R, Green M. Risk of infertility in female adolescents and young adults with cancer: a population-based cohort study. Hum Reprod 2021; 36:1981-1988. [PMID: 33611573 PMCID: PMC8213446 DOI: 10.1093/humrep/deab036] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 01/21/2021] [Indexed: 12/18/2022] Open
Abstract
STUDY QUESTION Do female adolescents and young adults (AYAs) with cancer have a higher risk of subsequent infertility diagnosis than AYAs without cancer? SUMMARY ANSWER Female AYAs with breast, hematological, thyroid and melanoma cancer have a higher risk of subsequent infertility diagnosis. WHAT IS KNOWN ALREADY Cancer therapies have improved substantially, leading to dramatic increases in survival. As survival improves, there is an increasing emphasis on optimizing the quality of life among cancer survivors. Many cancer therapies increase the risk of infertility, but we lack population-based studies that quantify the risk of subsequent infertility diagnosis in female AYAs with non-gynecological cancers. The literature is limited to population-based studies comparing pregnancy or birth rates after cancer against unexposed women, or smaller studies using markers of the ovarian reserve as a proxy of infertility among female survivors of cancer. STUDY DESIGN, SIZE, DURATION We conducted a population-based cohort study using universal health care databases in the province of Ontario, Canada. Using data from the Ontario Cancer Registry, we identified all women 15-39 years of age diagnosed with the most common cancers in AYAs (brain, breast, colorectal, leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, thyroid and melanoma) from 1992 to 2011 who lived at least 5 years recurrence-free (Exposed, n = 14,316). Women with a tubal ligation, bilateral oophorectomy or hysterectomy previous to their cancer diagnosis were excluded. We matched each exposed woman by age, census subdivision, and parity to five randomly selected unexposed women (n = 60,975) and followed subjects until 31 December 2016. PARTICIPANTS/MATERIALS, SETTING, METHODS Infertility diagnosis after 1 year of cancer was identified using information on physician billing codes through the Ontario Health Insurance Plan database (ICD-9 628). Modified Poisson regression models were used to assess the risk of infertility diagnosis (relative risk, RR) adjusted for income quintile and further stratified by parity at the time of cancer diagnosis (nulliparous and parous). MAIN RESULTS AND THE ROLE OF CHANCE Mean age at cancer diagnosis was 31.4 years. Overall, the proportion of infertility diagnosis was higher in cancer survivors compared to unexposed women. Mean age of infertility diagnosis was similar among cancer survivors and unexposed women (34.8 years and 34.9 years, respectively). The overall risk of infertility diagnosis was higher in cancer survivors (RR 1.30; 95% CI 1.23-1.37). Differences in infertility risk varied by type of cancer. Survivors of breast cancer (RR 1.46; 95% CI 1.30-1.65), leukemia (RR 1.56; 95% CI 1.09-2.22), Hodgkin lymphoma (RR 1.49; 95% CI 1.28-1.74), non-Hodgkin lymphoma (RR 1.42; 95% CI 1.14, 1.76), thyroid cancer (RR 1.20; 95% CI 1.10-1.30) and melanoma (RR 1.17; 95% CI 1.01, 1.35) had a higher risk of infertility diagnosis compared to women without cancer. After stratification by parity, the association remained in nulliparous women survivors of breast cancer, leukemia, lymphoma and melanoma, whereas it was attenuated in parous women. In survivors of thyroid cancer, the association remained statistically significant in both nulliparous and parous women. In survivors of brain or colorectal cancer, the association was not significant, overall or after stratification by parity. LIMITATIONS, REASONS FOR CAUTION Non-biological factors that may influence the likelihood of seeking a fertility assessment may not be captured in administrative databases. The effects of additional risk factors, including cancer treatment, which may modify the associations, need to be assessed in future studies. WIDER IMPLICATIONS OF THE FINDINGS Reproductive health surveillance in female AYAs with cancer is a priority, especially those with breast cancer, leukemia and lymphoma. Our finding of a potential effects of thyroid cancer (subject to over-diagnosis) and, to a lesser extent, melanoma need to be further studied, and, if an effect is confirmed, possible mechanisms need to be elucidated. STUDY FUNDING/COMPETING INTEREST(S) Funding was provided by the Faculty of Health Sciences and Department of Obstetrics and Gynecology, Queen's University. There are no competing interests to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- M P Velez
- Department of Obstetrics and Gynecology, Queen's University, Kingston General Hospital, Kingston, ON, Canada.,Department of Public Health Sciences, Queen's University, Kingston, ON, Canada.,ICES, Toronto, ON, Canada
| | - H Richardson
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - N N Baxter
- ICES, Toronto, ON, Canada.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Chad McClintock
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - E Greenblatt
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada
| | - R Barr
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - M Green
- ICES, Toronto, ON, Canada.,Department of Family Medicine, Queen's University, Kingston, ON, Canada
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24
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Oliveira BL, Ataman LM, Rodrigues JK, Birchal TS, Reis FM. Restricted access to assisted reproductive technology and fertility preservation: legal and ethical issues. Reprod Biomed Online 2021; 43:571-576. [PMID: 34332903 DOI: 10.1016/j.rbmo.2021.06.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 05/13/2021] [Accepted: 06/21/2021] [Indexed: 11/17/2022]
Abstract
Access to assisted reproductive technology (ART) and fertility preservation remains restricted in middle and low income countries. We sought to review the status of ART and fertility preservation in Brazil, considering social indicators and legislative issues that may hinder the universal access to these services. Although the Brazilian Constitution expressly provides the right to health, and ordinary law ensures the state is obliged to support family planning, access to services related to ART and fertility preservation is neither easy nor egalitarian in Brazil. Only a handful of public hospitals provide free ART, and their capacity far from meets demand. Health insurance does not cover ART, and the cost of private care is unaffordable to most people. Brazilian law supports, but does not command, the state provision of ART and fertility preservation to guarantee the right to family planning; therefore, the availability of state-funded treatments is still scarce, reinforcing social disparities. Economic projections suggest that including ART in the Brazilian health system is affordable and may actually become profitable to the state in the long term, not to mention the ethical imperative of recognizing infertility as a disease, with no reason to be excluded from a health system that claims to be 'universal'.
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Affiliation(s)
- Brenda Lc Oliveira
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Av. Alfredo Balena, 110, 9˚ andar 30130-100 Belo Horizonte MG, Brazil
| | - Lauren M Ataman
- Department of Obstetrics and Gynecology, Center for Reproductive Science, Feinberg School of Medicine, Northwestern University, Chicago Illinois, USA
| | - Jhenifer K Rodrigues
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Av. Alfredo Balena, 110, 9˚ andar 30130-100 Belo Horizonte MG, Brazil
| | - Telma S Birchal
- Department of Philosophy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fernando M Reis
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Av. Alfredo Balena, 110, 9˚ andar 30130-100 Belo Horizonte MG, Brazil.
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25
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Ahmad MF, Nik Abdul Ghani NAR, Abu MA, Abdul Karim AK, Shafiee MN. Oncofertility in Islam: The Malaysian Perspective. FRONTIERS IN REPRODUCTIVE HEALTH 2021; 3:694990. [PMID: 36304020 PMCID: PMC9580827 DOI: 10.3389/frph.2021.694990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/31/2021] [Indexed: 11/17/2022] Open
Abstract
The implementation of oncofertility services is of great importance among cancer survivors of reproductive age to ensure a good quality of life. However, the uptake of this service among Muslim patients is very challenging because of inconclusive laws or evidence based on the Islamic perspective. Hence, we summarized the limited evidence available to consolidate current recommendations for oncofertility practices in the Muslim population in Malaysia. The available “fatwa” and “muzakarah” regarding reproductive procedures and gamete cryopreservation in Islam was searched from the recommendations of local and international bodies, including published and unpublished sources. The relevant information was then extracted according to the current understanding of dilemmas in oncofertility practices in Malaysia, tabulated, and consolidated. Most of the available “fatwa” has been revised by recent “muzakarah” to suit current oncofertility practices. Most Islamic organizations support the practice of oncofertility in Muslim hence indicates that oncofertility services are permissible. Therefore, proper recommendations and counseling are paramount to ensure understanding among Muslim patients.
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Affiliation(s)
- Mohd Faizal Ahmad
- 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
- *Correspondence: Mohd Faizal Ahmad
| | | | - 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
| | - Abdul Kadir 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
| | - Mohamad Nasir Shafiee
- Department of Obstetrics and Gynaecology, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
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26
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Kusuhara A, Babayev E, Zhou LT, Singh VP, Gerton JL, Duncan FE. Immature Follicular Origins and Disrupted Oocyte Growth Pathways Contribute to Decreased Gamete Quality During Reproductive Juvenescence in Mice. Front Cell Dev Biol 2021; 9:693742. [PMID: 34222262 PMCID: PMC8244820 DOI: 10.3389/fcell.2021.693742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 05/24/2021] [Indexed: 12/26/2022] Open
Abstract
Egg quality dictates fertility outcomes, and although there is a well-documented decline with advanced reproductive age, how it changes during puberty is less understood. Such knowledge is critical, since advances in Assisted Reproductive Technologies are enabling pre- and peri-pubertal patients to preserve fertility in the medical setting. Therefore, we investigated egg quality parameters in a mouse model of the pubertal transition or juvenescence (postnatal day; PND 11-40). Animal weight, vaginal opening, serum inhibin B levels, oocyte yield, oocyte diameter, and zona pellucida thickness increased with age. After PND 15, there was an age-associated ability of oocytes to resume meiosis and reach metaphase of meiosis II (MII) following in vitro maturation (IVM). However, eggs from the younger cohort (PND 16-20) had significantly more chromosome configuration abnormalities relative to the older cohorts and many were at telophase I instead of MII, indicative of a cell cycle delay. Oocytes from the youngest mouse cohorts originated from the smallest antral follicles with the fewest cumulus layers per oocyte, suggesting a more developmentally immature state. RNA Seq analysis of oocytes from mice at distinct ages revealed that the genes involved in cellular growth signaling pathways (PI3K, mTOR, and Hippo) were consistently repressed with meiotic competence, whereas genes involved in cellular communication were upregulated in oocytes with age. Taken together, these data demonstrate that gametes harvested during the pubertal transition have low meiotic maturation potential and derive from immature follicular origins.
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Affiliation(s)
- Atsuko Kusuhara
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Elnur Babayev
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Luhan T. Zhou
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Vijay P. Singh
- Stowers Institute for Medical Research, Kansas City, MO, United States
| | | | - Francesca E. Duncan
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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27
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Ketterl TG. Closing the Gaps: Progress in the Care of Adolescents and Young Adults With Cancer. JCO Oncol Pract 2021; 17:302-304. [PMID: 34010020 DOI: 10.1200/op.21.00223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Tyler G Ketterl
- Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, WA.,Department of Pediatrics, University of Washington School of Medicine, Seattle, WA.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
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28
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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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29
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Katabi LJ, Ng HH, Streed CG, Arora KS. Ethical Considerations of Fertility Preservation for Transmasculine and Nonbinary Youth. Transgend Health 2020; 5:201-204. [PMID: 33381649 DOI: 10.1089/trgh.2020.0004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
An increasing number of young adolescents who identify as transgender or nonbinary are presenting to the health care system for gender affirmation therapy before the full progression of puberty. Gender-affirming therapy may impair future fertility, but options exist for fertility preservation. This perspective reviews these options for transmasculine and nonbinary youth, and explores related ethical considerations. The authors support the right of transgender and nonbinary youth to utilize available reproductive technologies, provide recommendations for treating health professionals, and advocate for increased research efforts and tools to aid patient decision making.
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Affiliation(s)
- Leila J Katabi
- Department of Bioethics, Case Western Reserve University, Cleveland, Ohio, USA.,School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Henry H Ng
- Center for LGBT Health, Cleveland Clinic Foundation, Cleveland, Ohio, USA.,Public Health and Science Department, Baldwin Wallace University, Berea, Ohio, USA
| | - Carl G Streed
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.,Center for Transgender Medicine and Surgery, Boston Medical Center, Boston, Massachusetts, USA
| | - Kavita S Arora
- Department of Bioethics, Case Western Reserve University, Cleveland, Ohio, USA.,Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, Ohio, USA
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30
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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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31
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Zhao Y, Zhang X, Zubizarreta ME, Xia Y, Li Y, Zhang X, Sheng M, Song Q, Xiao S. A Survey Study Reveals the Positive Impact of Oncofertility Knowledge and Attitude on Oncofertility Practice Among Oncologists in China. J Adolesc Young Adult Oncol 2020; 10:606-613. [PMID: 33121315 DOI: 10.1089/jayao.2020.0110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose: The advances of early cancer diagnoses and treatment methods allow many adolescent and young adult-aged cancer patients to live long lives after having cancer. There is a rising concern regarding cancer treatment-induced reproductive toxicities and infertility. Oncologists are the first line of medical professionals interacting with cancer patients and playing essential roles in oncofertility practice. This study aimed to assess the oncofertility knowledge, attitude, and practice of oncologists in China. Methods: We created an online questionnaire survey to examine 927 Chinese oncologists' demographics, knowledge, attitude, experience, and practice regarding young female cancer patients' infertility risk and fertility preservation. Results: Results showed that there is an inadequate oncofertility knowledge among surveyed oncologists, which was affected by oncologists' demographic background of education level, clinical title, and working experience. The majority of surveyed oncologists (84.8%-88.7%) held a positive attitude on young female cancer patients' infertility risk and their fertility preservation demand, but their attitude was impacted by marriage status and patients risk of cancer recurrence. Only 11.8% of surveyed oncologists often referred their patients for fertility preservation, while 66.3% and 21.9% of them have referred once or never, respectively. The oncologists' oncofertility practice was not correlated with their demographic background but was significantly influenced by their oncofertility knowledge and attitude. Conclusion: Our study demonstrates that there is an urgent unmet need to improve oncologists' oncofertility knowledge, attitude, and practice in China as well as remove the communication barrier between oncologists and fertility specialists.
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Affiliation(s)
- Yanjie Zhao
- Department of Medical Oncology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Xiaochen Zhang
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,School of Public Health, Nanjing Medical University, Nanjing, China
| | - Maria E Zubizarreta
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Yankai Xia
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yang Li
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xiaoxiao Zhang
- Department of Gynecology and Obstetrics, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Minjia Sheng
- Reproductive Center, China-Japan Union Hospital of Jilin University, Jilin, China
| | - Qingkun Song
- Department of Clinical Epidemiology and Evidence-Based Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Cancer Therapeutic Vaccines, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Shuo Xiao
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Environmental Health Sciences Institute, Rutgers University, Piscataway, New Jersey, USA
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32
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Coleman CEM, Pudwell J, McClintock C, Korkidakis A, Green M, Velez MP. Modest Increase in Fertility Consultations in Female Adolescents and Young Adults with Lymphoma: A Population-Based Study. J Adolesc Young Adult Oncol 2020; 10:342-345. [PMID: 32833556 PMCID: PMC8220549 DOI: 10.1089/jayao.2020.0101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
While survival after hematological malignancies in adolescent and young adult patients is improving, patients report poor oncofertility care. This population-based, retrospective, cohort study used data from the Ontario Cancer Registry and billing codes to identify fertility consultations for lymphoma patients between 2000 and 2018. Consultation trends across time and different patient and physician characteristics were analyzed. We identified 2088 patients and a consultation rate of 3.4% (increasing from 1% in 2000–2006 to 8% in 2014–2018). Patient parity and regional deprivation scores decreased rates. Despite mild improvement, there is ample missed opportunity for fertility discussions.
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Affiliation(s)
- Charlotte E M Coleman
- Undergraduate Medicine, Queen's University, Kingston, Ontario, Canada.,Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada
| | - Jessica Pudwell
- Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada
| | | | - Ann Korkidakis
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael Green
- ICES, Queen's University, Kingston, Ontario, Canada.,Department of Family Medicine, Queen's University, Kingston, Ontario, Canada
| | - Maria P Velez
- Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada.,ICES, Queen's University, Kingston, Ontario, Canada
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33
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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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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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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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La Rosa VL, Garzon S, Gullo G, Fichera M, Sisti G, Gallo P, Riemma G, Schiattarella A. Fertility preservation in women affected by gynaecological cancer: the importance of an integrated gynaecological and psychological approach. Ecancermedicalscience 2020; 14:1035. [PMID: 32419847 PMCID: PMC7221134 DOI: 10.3332/ecancer.2020.1035] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Indexed: 12/24/2022] Open
Abstract
Gynaecological cancer treatment significantly affects the fertility of women in reproductive age. Surgery, chemotherapy and radiotherapy are the mainstays of ovarian, cervical and endometrial cancers and anatomically or functionally impact the uterus and ovaries. Moreover, the sexual function and psychological wellbeing of patients are highly weakened after a cancer diagnosis: depression, anxiety and impairment of quality of life represent a relevant concern for patient care. The potential loss of fertility could be more distressing than cancer itself. For this reason, it is of paramount importance to try to preserve fertility in women affected by gynaecological cancers. Recently, tailored fertility preservation therapies have been developed to meet the childbearing demand from more than half of women between 18 and 40 years with a diagnosis of cancer. Currently, fertility preservation techniques play a significant role in improving the quality of life of women with gynaecological cancer. In this scenario, we propose a narrative overview of the recent literature about the importance of a multidisciplinary approach in the management of fertility preservation in the case of gynaecological cancers.
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Affiliation(s)
| | - Simone Garzon
- Department of Obstetrics and Gynaecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Giuseppe Gullo
- Department of Obstetrics and Gynaecology, AOOR Villa Sofia Cervello, IVF Public Center, Palermo, Italy
| | - Michele Fichera
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Giovanni Sisti
- Lincoln Medical and Mental Health Center, 234 East 149 Street, 5th Floor, Bronx, NY 10451, USA
| | - Pasquale Gallo
- Obstetrics and Gynaecology Unit, "Santa Maria delle Grazie" Hospital, Pozzuoli, Naples, Italy
| | - Gaetano Riemma
- Department of Woman, Child and General and Specialised Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonio Schiattarella
- Department of Woman, Child and General and Specialised Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
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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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Salama M, Anazodo A, Woodruff TK. Preserving fertility in female patients with hematological malignancies: a multidisciplinary oncofertility approach. Ann Oncol 2019; 30:1760-1775. [PMID: 31418765 DOI: 10.1093/annonc/mdz284] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Oncofertility is a new interdisciplinary field at the intersection of oncology and reproductive medicine that expands fertility options for young cancer patients. The most common forms of hematological malignancies that occur in girls and young women and therefore necessitate oncofertility care are acute lymphocytic leukemia, acute myeloid leukemia, non-Hodgkin's lymphoma, and Hodgkin's lymphoma. Aggressive gonadotoxic anticancer regimens including alkylating chemotherapy and total body irradiation are used often in treating girls and young women with hematological malignancies. The risks of gonadotoxicity and subsequent iatrogenic premature ovarian insufficiency and fertility loss depend mainly on the type and stage of the disease, dose of anticancer therapy as well as the age of the patient at the beginning of treatment. To avoid or at least mitigate the devastating complications of anticancer therapy-induced gonadotoxicity, effective and comprehensive strategies that integrate different options for preserving and restoring fertility ranging from established to experimental strategies should be offered before, during, and after chemotherapy or radiotherapy. A multidisciplinary approach that involves strong coordination and collaboration between hemato-oncologists, gynecologists, reproductive biologists, research scientists, and patient navigators is essential to guarantee high standard of care.
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Affiliation(s)
- M Salama
- Department of Obstetrics and Gynecology, Feinberg School of Medicine-Northwestern University, Chicago, USA
| | - A Anazodo
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia; Nelune Cancer Centre, Prince of Wales Hospital, Sydney, Australia; School of Women's and Children's Health, University of New South Wales, Sydney, Australia
| | - T K Woodruff
- Department of Obstetrics and Gynecology, Feinberg School of Medicine-Northwestern University, Chicago, USA.
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Speller B, Metcalfe K, Kennedy ED, Facey M, Greenblatt E, Scheer AS, Warner E, Joy AA, Wright FC, Baxter NN. The "Begin Exploring Fertility Options, Risks and Expectations" (BEFORE) decision aid: development and alpha testing of a fertility tool for premenopausal breast cancer patients. BMC Med Inform Decis Mak 2019; 19:203. [PMID: 31660965 PMCID: PMC6819618 DOI: 10.1186/s12911-019-0912-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 09/09/2019] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Premenopausal breast cancer patients are at risk of treatment-related infertility. Many patients do not receive sufficient fertility information before treatment. As such, our team developed and alpha tested the Begin Exploring Fertility Options, Risks, and Expectations decision aid (BEFORE DA). METHODS The BEFORE DA development process was guided by the International Patient Decision Aids Standards and the Ottawa Decision Support Framework. Our team used integrated knowledge translation by collaborating with multiple stakeholders throughout the development process including breast cancer survivors, multi-disciplinary health care providers (HCPs), advocates, and cancer organization representatives. Based on previously conducted literature reviews and a needs assessment by our team - we developed a paper prototype. The paper prototype was finalized at an engagement meeting with stakeholders and created into a graphically designed paper and mirrored online decision aid. Alpha testing was conducted with new and previously engaged stakeholders through a questionnaire, telephone interviews, or focus group. Iterative reviews followed each step in the development process to ensure a wide range of stakeholder input. RESULTS Our team developed an 18-page paper prototype containing information deemed valuable by stakeholders for fertility decision-making. The engagement meeting brought together 28 stakeholders to finalize the prototype. Alpha testing of the paper and online BEFORE DA occurred with 17 participants. Participants found the BEFORE DA usable, acceptable, and most provided enthusiastic support for its use with premenopausal breast cancer patients facing a fertility decision. Participants also identified areas for improvement including clarifying content/messages and modifying the design/photos. The final BEFORE DA is a 32-page paper and mirrored online decision aid ( https://fertilityaid.rethinkbreastcancer.com ). The BEFORE DA includes information on fertility, fertility options before/after treatment, values clarification, question list, next steps, glossary and reference list, and tailored information on the cost of fertility preservation and additional resources by geographic location. CONCLUSION The BEFORE DA, designed in collaboration with stakeholders, is a new tool for premenopausal breast cancer patients and HCPs to assist with fertility discussions and decision-making. The BEFORE DA helps to fill the information gap as it is a tool that HCPs can refer patients to for supplementary information surrounding fertility.
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Affiliation(s)
- Brittany Speller
- Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 040-16 Cardinal Carter Wing, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
| | - Kelly Metcalfe
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
| | - Erin D Kennedy
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Surgery, Mount Sinai Health System, Toronto, Canada
| | - Marcia Facey
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Ellen Greenblatt
- Mount Sinai Fertility, Department of Obstetrics and Gynecology, Sinai Health System, Toronto, Ontario, Canada
| | - Adena S Scheer
- Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 040-16 Cardinal Carter Wing, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
| | - Ellen Warner
- Department of Medical Oncology, Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Anil Abraham Joy
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Frances C Wright
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Nancy N Baxter
- Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 040-16 Cardinal Carter Wing, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
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40
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Insights into the Pathophysiology of Infertility in Females with Classical Galactosaemia. Int J Mol Sci 2019; 20:ijms20205236. [PMID: 31652573 PMCID: PMC6834160 DOI: 10.3390/ijms20205236] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 11/26/2022] Open
Abstract
Classical galactosaemia (CG) (OMIM 230400) is a rare inborn error of galactose metabolism caused by the deficiency of the enzyme galactose-1-phosphate uridylyltransferase (GALT, EC 2.7.7.12). Primary ovarian insufficiency (POI) is the most common long-term complication experienced by females with CG, presenting with hypergonadotrophic hypoestrogenic infertility affecting at least 80% of females despite new-born screening and lifelong galactose dietary restriction. In this review, we describe the hypothesized pathophysiology of POI from CG, implications of timing of the ovarian dysfunction, and the new horizons and future prospects for treatments and fertility preservation.
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Oncofertility: Pharmacological Protection and Immature Testicular Tissue (ITT)-Based Strategies for Prepubertal and Adolescent Male Cancer Patients. Int J Mol Sci 2019; 20:ijms20205223. [PMID: 31640294 PMCID: PMC6834329 DOI: 10.3390/ijms20205223] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 10/12/2019] [Accepted: 10/18/2019] [Indexed: 01/15/2023] Open
Abstract
While the incidence of cancer in children and adolescents has significantly increased over the last decades, improvements made in the field of cancer therapy have led to an increased life expectancy for childhood cancer survivors. However, the gonadotoxic effect of the treatments may lead to infertility. Although semen cryopreservation represents the most efficient and safe fertility preservation method for males producing sperm, it is not feasible for prepubertal boys. The development of an effective strategy based on the pharmacological protection of the germ cells and testicular function during gonadotoxic exposure is a non-invasive preventive approach that prepubertal boys could benefit from. However, the progress in this field is slow. Currently, cryopreservation of immature testicular tissue (ITT) containing spermatogonial stem cells is offered to prepubertal boys as an experimental fertility preservation strategy by a number of medical centers. Several in vitro and in vivo fertility restoration approaches based on the use of ITT have been developed so far with autotransplantation of ITT appearing more promising. In this review, we discuss the pharmacological approaches for fertility protection in prepubertal and adolescent boys and the fertility restoration approaches developed on the utilization of ITT.
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Blumenfeld Z. Fertility Preservation in Women With Malignancy: Future Endeavors. CLINICAL MEDICINE INSIGHTS. REPRODUCTIVE HEALTH 2019; 13:1179558119872490. [PMID: 31548799 PMCID: PMC6743198 DOI: 10.1177/1179558119872490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 08/07/2019] [Indexed: 12/13/2022]
Abstract
The area of fertility preservation is constantly developing. To date, the only
noninvestigational and unequivocally accepted methods for fertility preservation
are cryopreservation of embryos and unfertilized oocytes. This article is one of
several in a monogram on fertility preservation. The debate, pros and cons, and
equivocal data on the use of GnRH analogues for fertility preservation are
elaborated by 3 other manuscripts, in this monogram. A repeat of the arguments,
pros and cons of this debatable issue, would be a repetition and redundancy of
what is already included in this monogram. The subject of ovarian
cryopreservation for fertility preservation is also elaborated by several other
authors in this monogram. It is possible that, in the not too far future, the
technologies of in vitro maturation of primordial follicles to metaphase 2
oocytes, and the “artificial ovary,” will turn clinically available. These
technologies may bypass the risk of resuming malignancy by autotransplantation
of cryopreserved-thawed ovarian tissue in leukemia and diseases where malignant
cells may persist in the cryopreserved ovarian tissue. We summarize here the
suggested options for future endeavors in fertility preservation.
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Affiliation(s)
- Zeev Blumenfeld
- Reproductive Endocrinology, Ob/Gyn, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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43
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Huang SM, Tseng LM, Lai JCY, Lien PJ, Chen PH. Oncofertility to Evidence-Based Practice: Changes in Fertility Intention and Symptom Burden in Reproductive-Age Women With Breast Cancer. Worldviews Evid Based Nurs 2019; 16:381-388. [PMID: 31149771 DOI: 10.1111/wvn.12374] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Infertility is negatively related to the quality of life in reproductive-age women with breast cancer. The nurses who care for these patients lack a comprehensive understanding of the changes in fertility intention that patients undergo from the time of cancer diagnosis, throughout treatment, and after treatment. A fertility intention assessment is the first step in discerning the patient's ideas toward future pregnancy. AIMS This study examined the changes in fertility intention and symptom burden in reproductive-age women with breast cancer before, during, and after treatment. We also explored predictors of fertility intention among the women. METHODS The study was guided by the theory of planned behavior. A longitudinal and observational study was conducted with 151 women with breast cancer who were treated at a teaching hospital in Taipei. The participants were interviewed using a structured questionnaire before, during, and after chemotherapy from July 2016 to March 2018. Fertility intention was assessed using the Fertility Intention Scale. The M.D. Anderson Symptom Inventory-Taiwanese version was used to measure the symptom burden. The generalized linear mixed model was used for multivariate analysis. RESULTS Patients had significantly lower scores for fertility intention after treatment than before treatment. The study patients had substantially worse symptom burden during treatment than before or after treatment. Symptom burden scores, especially for symptom interference, correlated significantly with fertility intention. A higher Fertility Intention Scale score was significantly associated with younger age. LINKING EVIDENCE TO ACTION Fertility intention decreased over time in women with breast cancer. Understanding fertility intention and controlling symptom burden throughout the course of treatment and beyond might help nurses provide better care for preserving fertility and maintaining fertility options for these women with breast cancer.
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Affiliation(s)
- Sheng-Miauh Huang
- Department of Nursing, Mackay Medical College, New Taipei City, Taiwan
| | - Ling-Ming Tseng
- Department of Surgery, Taipei Veterans General Hospital, and Professor, National Yang-Ming University, Taipei, Taiwan
| | - Jerry Cheng-Yen Lai
- Department of Medical Research, Taitung Mackay Memorial Hospital, Taitung, Taiwan
| | - Pei-Ju Lien
- Comprehensive Breast Health Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ping-Ho Chen
- Department of Traditional Chinese Medicine, Taipei Medical University Hospital, Taipei, Taiwan
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44
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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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45
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Wang Y, Chen H, Ju K, Kopp MF, Johnson SB, Farrell KK, Yuan G, Ataman LM, Zheng W, Woodruff TK, Xiao S. Female oncofertility attitude and knowledge: a survey of reproductive health professionals in Shanghai, China. Future Oncol 2019; 15:371-379. [PMID: 30620219 DOI: 10.2217/fon-2018-0428] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
AIM To evaluate the female oncofertility attitude and knowledge of reproductive health professionals in China. METHODS An online survey was distributed to reproductive health professionals in Shanghai, China. RESULTS Female professionals were more likely to consider that cancer patients would want to preserve their fertility. Participants with higher educational background tended to have a more positive attitude toward oncofertility. The majority of the participants (71.0%) obtained a fair or low level of oncofertility knowledge, and only 25.3% of them received scores at the 'good knowledge' level. CONCLUSION There are significant gaps in the current oncofertility knowledge among reproductive health professionals in China, suggesting an urgent, unmet need for establishing an interdisciplinary fertility preservation training and service system.
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Affiliation(s)
- Yuqing Wang
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.,School of Public Health, Nanjing Medical University, Nanjing, 21009, PR China
| | - Hanyi Chen
- Science Research & Information Management Section, Shanghai Pudong New Area Center for Disease Control & Prevention, Shanghai, 200136, PR China.,Pudong Institute of Preventive Medicine, Fudan University, Shanghai, 20032, PR China
| | - Ke Ju
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.,School of Public Health, Nanjing Medical University, Nanjing, 21009, PR China
| | - Megan F Kopp
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Sarah B Johnson
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Katherine K Farrell
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Gehui Yuan
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.,School of Public Health, Nanjing Medical University, Nanjing, 21009, PR China
| | - Lauren M Ataman
- Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Weiwei Zheng
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 20032, PR China.,Institution for Water Pollution & Health Research, School of Public Health, Fudan University, Shanghai, 20032, PR China.,Department of Environmental Health, School of Public Health, Fudan University, Shanghai, 20032, PR China
| | - Teresa K Woodruff
- Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Shuo Xiao
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
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46
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Soanes L, White I. Sexuality and cancer: The experience of adolescents and young adults. Pediatr Blood Cancer 2018; 65:e27396. [PMID: 30216642 DOI: 10.1002/pbc.27396] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 07/08/2018] [Accepted: 07/09/2018] [Indexed: 12/30/2022]
Abstract
There are many components affecting the experience of sexuality for adolescents and young adults living with and beyond cancer. For patients, the interruption to normal socialization creates gaps in information and experience that potentially hinder development. In clinical practice, conversations relating to sexual consequences of illness or treatment are rare, as are age-appropriate assessment and intervention. In service design, the collaborative approach of oncofertility has yet to be replicated for sexuality. This paper considers how these obstacles can be overcome through local service development to address unmet need and promote sexual well-being for this group of patients.
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Affiliation(s)
- Louise Soanes
- Children and Young People's Cancer Services, University College Hospital NHS Foundation Trust, London, UK
| | - Isabel White
- The Royal Marsden NHS Foundation Trust, London, UK
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47
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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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49
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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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Woodruff TK. Communicating Endocrine Science: Part II. Endocrinology 2018; 159:3257-3258. [PMID: 30165398 DOI: 10.1210/en.2018-00683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 07/26/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Teresa K Woodruff
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois
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