Interest in fertility status assessment among young adult survivors of childhood cancer

Abstract

Background Cancer survivors who received gonadotoxic treatment are at‐risk for future infertility and may desire a fertility status assessment (FSA), defined as semen analysis for males and consultation with a reproductive specialist for females. The purpose of this study was to describe the proportion of, and factors associated with, interest in FSA among young adult survivors of childhood cancer. Methods This retrospective single‐institution review included patients with prior gonadotoxic treatment, aged 18–25 years and >1 year from cancer treatment completion, who received a fertility‐focused discussion during survivorship. Documentation of interest in and completion of FSA, worry about infertility, sociodemographic, and clinical characteristics were abstracted from medical records. Multivariable logistic regression was performed to calculate odds ratios (OR) and 95% confidence intervals (95%CI) for factors associated with interest in FSA. Results Survivors ( N = 259) were on average 19.2 ± 1.2 years at their fertility discussion; 55.6% were male and 57.9% non‐Hispanic white. Interest in FSA was reported by 50.7% of males and 46.1% of females. Factors related to interest in FSA for males and females respectively, included worry about infertility (OR 2.40, 95%CI 1.11–5.27, p = 0.026 and OR 4.37, 95%CI 1.71–12.43, p = 0.003) and ≥2 fertility discussions (OR 3.78, 95%CI 1.70–8.75, p = 0.001 and 2.45, 95%CI 1.08–5.67, p = 0.033). Among males, fertility preservation consult/procedure at diagnosis (OR 3.02, 95%CI 1.09–9.04, p = 0.039) and high‐risk for infertility (OR 2.47, 95%CI 1.07–5.87, p = 0.036) were also associated with interest in FSA. Conclusions Cancer survivors are interested in FSA, particularly those who have had repeated fertility‐focused discussions during survivorship care and who report worry about infertility.

The evolution of fertility preservation care models in a large pediatric cancer and blood disorders center

“…Posttreatment consults comprised 21.0% of the FP program consults in the final year of Model 3 (Figure 2). As part of our institution's standard survivorship care, all survivors receive a posttreatment discussion of reproductive late effects and survivors with a history of gonadotoxic treatment receive a focused fertility discussion at 18 years of age 15,24 . If a survivor chose to pursue a fertility status assessment (e.g., semen analysis or consultation with an REI), they received an appropriate referral, were assisted by the FP nurse navigators, and were categorized as having a posttreatment FP consult, which was captured in the FP database.…”

“…As part of our institution's standard survivorship care, all survivors receive a posttreatment discussion of reproductive late effects and survivors with a history of gonadotoxic treatment receive a focused fertility discussion at 18 years of age. 15,24 If a survivor chose to pursue a fertility status assessment (e.g., semen analysis or consultation with an REI), they received an appropriate referral, were assisted by the FP nurse navigators, and were categorized as having a posttreatment FP consult, which was captured in the FP database. Many patients had posttreatment reproductive late effects discussions, but did not opt for a fertility status assessment and thus were not categorized as FP consults.…”

Children's Oncology Group 2023 blueprint: Nursing discipline

“…Cherven et al 37 Cherven et al 36 Delivery of care for pediatric patients receiving blinatumomab Original research project U10CA180886 Thompson et al 52…”

“…Traineeship opportunities across the past decade, made possible through cooperative group infrastructure support grants (U10CA098543 and U10CA180886), have yielded opportunities for mentored and independent YI projects aligned with the discipline's key aims. [29][30][31][32][33][34][35][36][37] Additionally, valuable training opportunities supported through funding sources beyond the cooperative group have yielded outstanding opportunities for doctorally prepared YI nurses, advanced practice nurses, and direct-care nurses to engage in scientific discovery. [38][39][40][41][42][43][44][45][46][47][48] Findings from these projects have contributed to new knowledge generated by the work of the discipline (Table 3).…”

Diminished ovarian reserve in adolescent cancer survivors treated with heavy metal chemotherapy

“…As survival rates from childhood cancer have increased, concern over long-term fertility outcomes has emerged as a priority among survivors. [1][2][3] Treatment-related ovarian dysfunction can range from diminished ovarian reserve (DOR) with normal hormonal function to more extensive damage with premature ovarian insufficiency, early menopause, and infertility. 4,5 Anti-Mullerian hormone (AMH) can be used as a surrogate for ovarian reserve.…”