Fertility preservation and reproductive health in the pediatric, adolescent, and young adult female cancer patient

Trudgen, Kourtney; Ayensu-Coker, Leslie

doi:10.1097/gco.0000000000000107

Cited by 27 publications

(12 citation statements)

References 51 publications

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“…On the other hand, several classic risk factors were not associated for a number of potential reasons. Age was not associated possibly due to the fact that this was a relatively young population (median age of 48) where age-related effects on BMD may have been introduced prematurely as a result of chemotherapy, radiation, transplant, and steroid use (50-52). Furthermore, we believe that effects of hypogonadism and other endocrine dysfunction were not associated because they may also have been attenuated by the strength of the treatment-related effects.…”

Section: Discussionmentioning

confidence: 99%

Characterization and Risk Factor Analysis of Osteoporosis in a Large Cohort of Patients with Chronic Graft-versus-Host Disease

Pirsl

Curtis

Steinberg

et al. 2016

Biology of Blood and Marrow Transplantation

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The NIH Chronic Graft-versus-Host Disease (cGVHD) Consensus Project Ancillary and Supportive Care Guidelines recommend annual assessment of bone mineral density (BMD) to monitor bone health. The study of osteoporosis in patients with cGVHD has been limited to small numbers of patients and the guidelines are based on experiences in other chronic diseases and expert opinion. We hypothesized that the prevalence of osteoporosis is high in a cohort of 258 patients with moderate to severe cGVHD due to prolonged exposure to risk factors for osteoporosis after allogeneic hematopoietic stem cell transplantation. We defined osteoporosis using BMD criteria (T-score ≤ -2.5) at three anatomical sites (femoral neck – FN, lumbar spine – LS, total hip – TH) and characterized risk factors through univariate and multivariate analyses. We found that low body weight (FN p<0.0001, LS p=0.0002, TH p<0.0001), malnutrition (FN p=0.0002, LS p=0.03, TH p=0.0076), higher platelet count (FN p=0.0065, TH p=0.0025), higher average NIH organ score (FN p=0.038), higher prednisone dose (LS p=0.032), lower complement component 3 (LS p=0.0073), and physical inactivity (FN p=0.01) were associated with osteoporosis in one or more site. T-scores were significantly lower in the FN than in the other two sites (p<0.0001 for both). The prevalence of osteoporosis and osteopenia was high (17% and 60%, respectively), supporting current recommendations for frequent monitoring of BMD. The association of higher platelet count in cGVHD patients with osteoporosis has not been previously reported and presents a new area of interest in the study of osteoporosis after allogeneic hematopoietic stem cell transplantation.

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Section: Discussionmentioning

confidence: 99%

Characterization and Risk Factor Analysis of Osteoporosis in a Large Cohort of Patients with Chronic Graft-versus-Host Disease

Pirsl

Curtis

Steinberg

et al. 2016

Biology of Blood and Marrow Transplantation

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“…For example, fertility preservation (defined as egg, embryo, or ovarian tissue cryopreservation) for young women with cancer who are at-risk for fertility loss has gained wide acceptance, and egg and embryo cryopreservation are now considered standards in clinical practice (Loren et al, 2013; Practice Committees of the American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology, 2013). Egg and embryo cryopreservation are typically performed in conjunction with ovarian stimulation prior to the onset of cancer treatment (Kasum, Beketić-Orešković, Peddi, Orešković, & Johnson, 2014; Trudgen & Ayensu-Coker, 2014). Ovarian tissue cryopreservation is an experimental option that when performed within a research protocol can be appropriate for young women who urgently need to undergo chemotherapy and/or radiation treatment (Practice Committee of the American Society for Reproductive Medicine, 2014).…”

mentioning

confidence: 99%

Reasons Why Young Women Accept or Decline Fertility Preservation After Cancer Diagnosis

Hershberger¹,

Sipsma²,

Finnegan³

et al. 2016

Journal of Obstetric, Gynecologic & Neonatal Nursing

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Objective To understand young women’s reasons for accepting or declining fertility preservation following cancer diagnosis to aid in the development of theory regarding decision making in this context. Design Qualitative descriptive. Setting Participants’ homes or other private location. Participants Twenty-seven young women (mean age = 29 years) diagnosed with cancer and eligible for fertility preservation. Methods Recruitment was conducted via the Internet and in fertility centers. Participants completed demographic questionnaires and in-depth semi-structured interviews. Tenets of grounded theory guided an inductive and deductive analysis. Results Young women’s reasons for deciding whether to undergo fertility preservation were linked to four theoretical dimensions: Cognitive Appraisals, Emotional Responses, Moral Judgments, and Decision Partners. Women who declined fertility preservation described more reasons in the Cognitive Appraisals dimension, including financial cost and human risks, than women who accepted. In the Emotional Responses dimension, most women who accepted fertility preservation reported a strong desire for biological motherhood, whereas women who declined tended to report a strong desire for surviving cancer. Three participants who declined reported reasons linked to the Moral Judgments dimension, and the majority were influenced by Decision Partners, including husbands, boyfriends, parents, and clinicians. Conclusion The primary reason upon which many but not all participants based decisions related to fertility preservation was whether the immediate emphasis of care should be placed on surviving cancer or securing options for future biological motherhood. Nurses and other clinicians should base education and counseling on the four theoretical dimensions to effectively support young women with cancer.

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“…The degree of damage is related to the chemotherapy agent and dose 343 and site of radiotherapy 332 . Alkylating agents are particularly gondadotoxic and can cause long-term fertility impairment in both sexes and premature menopause in women 344,345 .…”

Section: Fertility Issuesmentioning

confidence: 99%

“…In addition, pelvic radiotherapy in women is associated with sexual dysfunction issues both pre-conception and during pregnancy 344,345 , while radiotherapy to the testes causes permanent impairment of sperm production in male patients 332 (see also Chapter 4).…”

Section: Fertility Issuesmentioning

confidence: 99%

The Information Security Organization

Alhassan

Adjei-Quaye

2016

FISMA Principles and Best Practices

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Fertility preservation and reproductive health in the pediatric, adolescent, and young adult female cancer patient

Cited by 27 publications

References 51 publications

Characterization and Risk Factor Analysis of Osteoporosis in a Large Cohort of Patients with Chronic Graft-versus-Host Disease

Characterization and Risk Factor Analysis of Osteoporosis in a Large Cohort of Patients with Chronic Graft-versus-Host Disease

Reasons Why Young Women Accept or Decline Fertility Preservation After Cancer Diagnosis

The Information Security Organization

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