The positive effect of a dedicated adolescent and young adult fertility program on the rates of documentation of therapy-associated infertility risk and fertility preservation options

Lewin, Jeremy; Zheng, Justin Ming; Mitchell, Laura E.; Tam, Seline; Puri, Natasha; Stephens, Derek; Srikanthan, Amirrtha; Bedard, Philippe L.; Razak, Albiruni R. Abdul; Crump, Michael; Warr, David; Giuliani, Meredith; Gupta, Abha

doi:10.1007/s00520-017-3597-8

Cited by 50 publications

(29 citation statements)

References 44 publications

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“…A critical and frequent late effect of HCT is gonadal dysfunction. Among young patients, fertility preservation after transplantation can have a significant influence on quality of life [84,85]. AYA HCT recipients may already be at high risk for gonadal damage and infertility from previous (pretransplantation) exposure to chemotherapy and irradiation.…”

Section: Late Effects Quality Of Life and Fertilitymentioning

confidence: 99%

“…In most cases, these costs are not covered by insurance [95]. Improving access to both standard and investigational fertility preservation techniques before HCT is an important and increasingly necessary part of pretransplantation counseling that can have a long-lasting impact on quality of life after HCT for AYAs [85].…”

Section: Late Effects Quality Of Life and Fertilitymentioning

confidence: 99%

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Unique Challenges of Hematopoietic Cell Transplantation in Adolescent and Young Adults with Hematologic Malignancies

Mehta

Rotz

Majhail

2018

Biology of Blood and Marrow Transplantation

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Slow but definite progress has been made in recognizing the differences in disease biology, host factors, and psychosocial issues related to management of hematologic malignancies, including hematopoietic cell transplantation (HCT), in the adolescent and young adult (AYA) population. Improvement in survival rates among AYAs undergoing HCT for hematologic malignancies have paralleled those seen among children and older adults in the contemporary era. However, overall outcomes remain inferior compared with those in children owing largely to higher rates of treatment related mortality and late relapses in AYA HCT recipients. We review the unique issues and challenges facing AYAs with hematologic malignancies undergoing HCT, identify unmet needs and gaps in care, and describe potential strategies to address them. A patient-centric and multidisciplinary approach to AYA HCT care with lifelong follow-up is necessary to ensure long-term health.

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Section: Late Effects Quality Of Life and Fertilitymentioning

confidence: 99%

Section: Late Effects Quality Of Life and Fertilitymentioning

confidence: 99%

Unique Challenges of Hematopoietic Cell Transplantation in Adolescent and Young Adults with Hematologic Malignancies

Mehta

Rotz

Majhail

2018

Biology of Blood and Marrow Transplantation

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“…This is evident from the number of publications and guidelines that have been recently published (2)(3)(4)(5)(6). Despite these recommendations, the provision of fertility preservation remains low (7,8). Lack of health care provider knowledge has been documented as a possible reason for lack of fertility preservation discussions and referrals.…”

Section: Introductionmentioning

confidence: 99%

Fertility preservation in post-pubescent female cancer patients: A practical guideline for clinicians

et al. 2017

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Abstract. Increasing accessibility of fertility preservation (FP) options has permitted women to retain fertility following anticancer therapies. Several published guidelines have made recommendations for FP however their implementation into practice is currently unknown. In this review, we aim to provide oncology clinicians practical information about FP options for post-pubescent female cancer patients and recommendations for care delivery in order to answer preliminary questions and help triage whether FP referral is appropriate. Herein, we present a resource for oncology providers to guide them with FP discussions. Key points that are discussed in this critical review include: i) All cancer patients beginning a new plan of care should be informed of potential fertility risk. ii) If a woman requests further information on FP interventions, referral to a FP clinic should be made. iii) Given the evolving technologies in this area, patients should be informed of those which are proven and unproven, with oocyte and embryo preservation recognized as standard practice. iv) Random start (independent of menstrual cycle day) techniques are available to minimize oncologic treatment delays. v) Specific protocols for ovarian stimulation may be center-specific. vi) There is unlikely an increased cancer recurrence risk as a result of stimulation protocols in women with hormone-sensitive cancers. vii) Lastly, given the absence of consensus in the literature, routine use of GnRH analogs is not recommended for all cancer patients, however may be considered in select cases, such as high-risk women in whom definitive FP is not possible or feasible.

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“…The ability to offer this option to patients prior to treatment requires access to a facility that can collect, test, and store the sperm. As a method to facilitate this option, some cancer centers established sperm banking programs for their patients [24]. …”

Section: Established Fertility Preservation Methods For Malesmentioning

confidence: 99%

New promising strategies in oncofertility

Hudson

Stanley

Nahata

et al. 2017

Expert Review of Quality of Life in Cancer Care

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Introduction Approximately 70,000 adolescent and young adults (AYA) are diagnosed with cancer each year. While advancements in treatment have led to improved prognosis and survival for patients, these same treatments can adversely affect AYA reproductive capacity. Localized treatments such as surgery and radiation therapy may affect fertility by removing or damaging reproductive organs, and systemic therapies such as chemotherapy can be toxic to gonads, (ovaries and testicles), thus affecting fertility and/or endocrine function. This can be traumatic for AYA with cancer as survivors often express desire to have genetic children and report feelings of regret or depression as a result of infertility caused by cancer treatments. Areas Covered Emerging technologies in the field of assisted reproductive technology offer new promise for preserving the reproductive capacity of AYA cancer patients prior to treatment as well as providing alternatives for survivors. The following review revisits contemporary approaches to fertility preservation as well newly developing technologies. Expert Commentary There are several advances in ART that hold promise for patients and survivors. However there are challenges that inhibit uptake including poor communication between providers and patients about risks and fertility preservation options; high costs; and lack of insurance coverage for fertility preservation services.

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The positive effect of a dedicated adolescent and young adult fertility program on the rates of documentation of therapy-associated infertility risk and fertility preservation options

Cited by 50 publications

References 44 publications

Unique Challenges of Hematopoietic Cell Transplantation in Adolescent and Young Adults with Hematologic Malignancies

Unique Challenges of Hematopoietic Cell Transplantation in Adolescent and Young Adults with Hematologic Malignancies

Fertility preservation in post-pubescent female cancer patients: A practical guideline for clinicians

New promising strategies in oncofertility

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