Magdalena Balcerek1,2, Ralph Schilling1, Julianne Byrne3, Uta Dirksen4,5, Holger Cario6, Marta Julia Fernandez-Gonzalez1, Tomas Kepak7, Elisabeth Korte1, Jarmila Kruseova8, Marina Kunstreich9, Herwig Lackner10, Thorsten Langer11, Malgorzata Sawicka-Zukowska12, Joanna Stefanowicz13, Gabriele Strauß14, Anja Borgmann-Staudt15. 1. Charité - Universitätsmedizin, Berlin, Germany. 2. Berlin Institute of Health (BIH), Berlin, Germany. 3. Boyne Research Institute, Drogheda, Ireland. 4. West German Cancer Centre, University Hospital Essen Paediatrics III, Essen, Germany. 5. German Cancer Research Centre (DKTK), Heidelberg, Germany. 6. Department of Paediatrics and Adolescent Medicine, University Medical Centre, Ulm, Germany. 7. University Hospital, Brno, Czech Republic. 8. Motol Teaching Hospital, Prague, Czech Republic. 9. Department of Paediatric Oncology, Haematology and Immunology, Medical Faculty, Heinrich-Heine, University of, Düsseldorf, Germany. 10. Medical University of Graz, Graz, Austria. 11. Lübeck Universitätklinik, Lübeck, Germany. 12. Uniwersytet Medyczny w Białymstoku, Białystok, Poland. 13. Klinika Pediatrii, Hematologii I Onkologii Gdanski Uniwersytet, Gdansk, Poland. 14. Helios Kliniken Berlin-Buch, Klinik für Kinder- und Jungendmedizin, Berlin, Germany. 15. Charité - Universitätsmedizin, Berlin, Germany. anja.borgmann@charite.de.
Abstract
Infertility is a relevant late-effect following cancer treatment; yet, a large proportion of survivors cannot recall having been informed of this risk. In an intervention study, we examined if and how supportive patient information material on fertility/fertility-preserving measures influences utilization of cryopreservation in adolescent cancer patients. The control group, recruited 03/2014-01/2016, received the usual patient education at initial diagnosis. The intervention group, recruited 04/2016-10/2017, received patient education supported by a fertility flyer and brochure. Patients and parents were each asked questions on utilization of cryopreservation in a questionnaire 3 and 6 months after initial diagnosis. Patient core and therapy data were obtained from medical records. Overall, cryopreservation rates showed no significant difference between the control (32.7%, n = 37/113) and intervention group (36.6%, n = 37/101). In the control group, cryopreservation was associated with gender (OR 0.100, CI 0.023-0.427), age (OR 1.559, CI 1.077-2.258) and recalling information on fertility protection (OR 33.663, CI 2.100-539.574); in the intervention group, cryopreservation was related to gender (OR 0.093, CI 0.026-0.330) and the estimated infertility risk (OR 43.665, CI 2.157-883.974). Conclusion: Cryopreservation rates did not overall increase following the intervention; however, the individual risk seemed to be brought into attention more: Those at risk, including younger patients, cryopreserved at higher rates.What is Known:•Infertility is a relevant late-effect following adolescent cancer.•Guidelines recommend to offer fertility protection before cancer treatment.•A relevant proportion of adolescents with cancer are not aware of this risk.•Fertility protection seems under-used in cancer patients at risk for infertility.What is New:•Information material on fertility and protection in adolescents did not increase overall rates of cryopreservation.•Cryopreservation rates were improved according to individual risk for infertility.•Our flyers and brochures on fertility in cancer patients are available in various languages.
Infertility is a relevant late-effect following cancer treatment; yet, a large proportion of survivors cannot recall having been informed of this risk. In an intervention study, we examined if and how supportive patient information material on fertility/fertility-preserving measures influences utilization of cryopreservation in adolescent cancerpatients. The control group, recruited 03/2014-01/2016, received the usual patient education at initial diagnosis. The intervention group, recruited 04/2016-10/2017, received patient education supported by a fertility flyer and brochure. Patients and parents were each asked questions on utilization of cryopreservation in a questionnaire 3 and 6 months after initial diagnosis. Patient core and therapy data were obtained from medical records. Overall, cryopreservation rates showed no significant difference between the control (32.7%, n = 37/113) and intervention group (36.6%, n = 37/101). In the control group, cryopreservation was associated with gender (OR 0.100, CI 0.023-0.427), age (OR 1.559, CI 1.077-2.258) and recalling information on fertility protection (OR 33.663, CI 2.100-539.574); in the intervention group, cryopreservation was related to gender (OR 0.093, CI 0.026-0.330) and the estimated infertility risk (OR 43.665, CI 2.157-883.974). Conclusion: Cryopreservation rates did not overall increase following the intervention; however, the individual risk seemed to be brought into attention more: Those at risk, including younger patients, cryopreserved at higher rates.What is Known:•Infertility is a relevant late-effect following adolescent cancer.•Guidelines recommend to offer fertility protection before cancer treatment.•A relevant proportion of adolescents with cancer are not aware of this risk.•Fertility protection seems under-used in cancerpatients at risk for infertility.What is New:•Information material on fertility and protection in adolescents did not increase overall rates of cryopreservation.•Cryopreservation rates were improved according to individual risk for infertility.•Our flyers and brochures on fertility in cancerpatients are available in various languages.
Authors: James L Klosky; L Elizabeth Anderson; Kathryn M Russell; Lu Huang; Hui Zhang; Leslie R Schover; Jessica L Simmons; William H Kutteh Journal: J Adolesc Health Date: 2016-12-18 Impact factor: 5.012
Authors: Alexandra S Rashedi; Saskia F de Roo; Lauren M Ataman; Maxwell E Edmonds; Adelino Amaral Silva; Anibal Scarella; Anna Horbaczewska; Antoinette Anazodo; Ayse Arvas; Bruno Ramalho de Carvalho; Cassio Sartorio; Catharina C M Beerendonk; Cesar Diaz-Garcia; Chang Suk Suh; Cláudia Melo; Claus Yding Andersen; Eduardo Motta; Ellen M Greenblatt; Ellen Van Moer; Elnaz Zand; Fernando M Reis; Flor Sánchez; Guillermo Terrado; Jhenifer K Rodrigues; João Marcos de Meneses E Silva; Johan Smitz; Jose Medrano; Jung Ryeol Lee; Katharina Winkler-Crepaz; Kristin Smith; Lígia Helena Ferreira Melo E Silva; Ludwig Wildt; Mahmoud Salama; María Del Mar Andrés; Maria T Bourlon; Mario Vega; Maurício Barbour Chehin; Michel De Vos; Mohamed Khrouf; Nao Suzuki; Osama Azmy; Paula Fontoura; Paulo Henrique Almeida Campos-Junior; Peter Mallmann; Ricardo Azambuja; Ricardo M Marinho; Richard A Anderson; Robert Jach; Roberto de A Antunes; Rod Mitchell; Rouhollah Fathi; Satish Kumar Adiga; Seido Takae; Seok Hyun Kim; Sergio Romero; Silvana Chedid Grieco; Talya Shaulov; Tatsuro Furui; Teresa Almeida-Santos; Willianne Nelen; Yasmin Jayasinghe; Yodo Sugishita; Teresa K Woodruff Journal: JCO Glob Oncol Date: 2020-03-02