Fertility counseling and preservation: considerations for the pediatric endocrinologist

Abstract

Infertility is a distressing consequence of numerous pediatric medical conditions and treatments.The field of pediatric fertility preservation has expanded rapidly over the past decade, and clinical guidelines emphasize the importance of discussing infertility risk and fertility preservation options with patients and families in a timely manner. Understanding the various mechanisms and presentations of fertility issues across diagnoses is imperative to provide counseling to patients and families, and identify individuals who may benefit from fertility preservation. The goals of this manuscript are to outline current fertility preservation options in pediatrics, review populations at-risk for infertility that are seen in pediatric endocrinology, and discuss other important issues related to fertility preservation including ethical considerations.

A View from the past into our collective future: the oncofertility consortium vision statement

“…The goal of this survey is to leverage the Oncofertility Consortium's positive core strengths (as identified by all stakeholders) to design and redesign the organization to achieve a more effective and sustainable future. communication between provider and the patient-parent dyad (particularly for pediatric providers), a lack of referral pathways with no standardized models of care, cultural and religious constraints, uncertainties regarding exact risks of cancer-related infertility, insufficient funds to support oncofertility programs, and a lack of insurance coverage, and high out-of-pocket costs for patients [2,[51][52][53]. As such, we believe in the next 10 years, one major strategic goal of the OC is to improve access to care.…”

Disorders of sex differentiation: state of the problem 15 years after the Chicago consensus

“…Однако если все-таки на главное место при выборе пола, как это делается в большинстве рекомендаций, поставить ожидаемую фертильность, то назначение девочке мужского пола будет противоречить здравому смыслу, даже с учетом того, что при выраженной вирилизации способность зачатия и рождения ребенка может быть снижена. При этом надо иметь в виду и то, что современные репродуктивные технологии позволяют значительно улуч шить фертильность у таких пациенток [10,33,34].…”

Examining predictors and outcomes of fertility consults among children, adolescents, and young adults with cancer

“…The American Academy of Pediatrics and American Society of Clinical Oncology have guidelines on fertility counseling and preservation . Established fertility preservation (FP) options include sperm cryopreservation for males and oocyte/embryo cryopreservation for females . Experimental methods such as ovarian tissue cryopreservation (OTC) and testicular tissue cryopreservation (TTC) are becoming more common .…”

“…4,5 Established fertility preservation (FP) options include sperm cryopreservation for males and oocyte/embryo cryopreservation for females. 6 Experimental methods such as ovarian tissue cryopreservation (OTC) and testicular tissue cryopreservation (TTC) are becoming more common. 2,5,6 Emerging research suggests gonadotropin releasing hormone analogues (GnRHa) may prevent premature ovarian failure in postpubertal females, though this is still considered experimental.…”

“…6 Experimental methods such as ovarian tissue cryopreservation (OTC) and testicular tissue cryopreservation (TTC) are becoming more common. 2,5,6 Emerging research suggests gonadotropin releasing hormone analogues (GnRHa) may prevent premature ovarian failure in postpubertal females, though this is still considered experimental. 7 Studies show instituting a formal fertility program with a dedicated fertility navigator increases FP rates and improves patient satisfaction.…”