Supriya Behl1, Vidhu B Joshi2, Reda S Hussein3,4, David L Walker4, Kari L Lampat5, Anthony G Krenik6, Kathrynne M Barud6, Jolene R Fredrickson6, Terri M Galanits6, Katherine J Rian6, Adriana M Delgado1, Julia H Byrne1, Dean Potter7, Siobhan T Pittock8, Carola A S Arndt9, Yulian Zhao4,6, Patricio C Gargollo2, Candace F Granberg2, Zaraq Khan4, Asma J Chattha10. 1. Children's Research Center, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA. 2. Department of Urology, Mayo Clinic, Rochester, MN, USA. 3. Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt. 4. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA. 5. Division of Pediatric and Adolescent Gynecology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA. 6. In Vitro Fertilization Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA. 7. Division of Pediatric Surgery, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA. 8. Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA. 9. Division of Pediatric Hematology and Oncology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA. 10. Division of Pediatric and Adolescent Gynecology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA. Chattha.Asma@mayo.edu.
Abstract
PURPOSE: Fertility is a quality of life outcome adversely affected by cancer therapy. Many childhood cancer patients, however, are not offered options to preserve their fertility. Providers acknowledge difficulty discussing impaired fertility to patients due to lack of knowledge of available options. Our objective was to review the impact of a pediatric multidisciplinary fertility preservation program on providers' fertility preservation counseling and discussion of options. METHODS: A retrospective medical chart review was conducted for pediatric cancer patients prior to and following program establishment. Fertility preservation discussions, consults, and incidence were noted. Following filtering and stratification, 198 and 237 patients were seen prior to and following program establishment, respectively. RESULTS: Following program establishment, provider-patient discussions of impaired fertility (p = 0.007), fertility preservation consults (p = 0.01), and incidence of fertility preservation procedures (p < 0.001) increased among patients. Furthermore, the number of patients who received fertility preservation consults after receiving gonadotoxic treatment decreased (p < 0.001). This trend was particularly noted in pre-pubertal and female patients, for whom fertility preservation options are limited without an established program. CONCLUSION: The establishment of a formal program greatly improved access to fertility preservation consults and procedures in children with cancer.
PURPOSE: Fertility is a quality of life outcome adversely affected by cancer therapy. Many childhood cancer patients, however, are not offered options to preserve their fertility. Providers acknowledge difficulty discussing impaired fertility to patients due to lack of knowledge of available options. Our objective was to review the impact of a pediatric multidisciplinary fertility preservation program on providers' fertility preservation counseling and discussion of options. METHODS: A retrospective medical chart review was conducted for pediatric cancer patients prior to and following program establishment. Fertility preservation discussions, consults, and incidence were noted. Following filtering and stratification, 198 and 237 patients were seen prior to and following program establishment, respectively. RESULTS: Following program establishment, provider-patient discussions of impaired fertility (p = 0.007), fertility preservation consults (p = 0.01), and incidence of fertility preservation procedures (p < 0.001) increased among patients. Furthermore, the number of patients who received fertility preservation consults after receiving gonadotoxic treatment decreased (p < 0.001). This trend was particularly noted in pre-pubertal and female patients, for whom fertility preservation options are limited without an established program. CONCLUSION: The establishment of a formal program greatly improved access to fertility preservation consults and procedures in children with cancer.
Authors: Jeremy Lewin; Justin Ming Zheng Ma; Laura Mitchell; Seline Tam; Natasha Puri; Derek Stephens; Amirrtha Srikanthan; Philippe Bedard; Albiruni Razak; Michael Crump; David Warr; Meredith Giuliani; Abha Gupta Journal: Support Care Cancer Date: 2017-02-02 Impact factor: 3.603
Authors: Branavan Vakeesan; Danielle R Weidman; Anne Marie Maloney; Lisa Allen; Armando J Lorenzo; Abha A Gupta Journal: J Pediatr Date: 2017-12-06 Impact factor: 4.406
Authors: Mirjam M Garvelink; Moniek M ter Kuile; Rinske M Bakker; Willemijn J Geense; Esther Jenninga; Leoni A Louwé; Carina G J M Hilders; Anne M Stiggelbout Journal: Health Expect Date: 2013-05-05 Impact factor: 3.377