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Consult and procedure incidence outcomes following establishment of a fertility preservation program for children with cancer

  • Fertility Preservation
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Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

A Correction to this article was published on 02 February 2021

This article has been updated

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.

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Data availability

The data that support the findings of this study are available upon reasonable request from the corresponding author (AC). The data are not publicly available due to them containing information that could compromise research participant privacy/consent.

Change history

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Acknowledgments

We thank all members of Pediatric Hematology/Oncology, Pediatric Endocrinology, Pediatric Surgery, Urology, Obstetrics and Gynecology, Pediatrics, and the In Vitro Fertilization lab at Mayo Clinic, Rochester, for their ongoing support in the success of this project.

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Author notes

    Authors and Affiliations

    1. Children’s Research Center, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA

      Supriya Behl, Adriana M. Delgado & Julia H. Byrne

    2. Department of Urology, Mayo Clinic, Rochester, MN, USA

      Vidhu B. Joshi, Patricio C. Gargollo & Candace F. Granberg

    3. Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt

      Reda S. Hussein

    4. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA

      Reda S. Hussein, David L. Walker, Yulian Zhao & Zaraq Khan

    5. Division of Pediatric and Adolescent Gynecology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA

      Kari L. Lampat & Asma J. Chattha

    6. In Vitro Fertilization Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA

      Anthony G. Krenik, Kathrynne M. Barud, Jolene R. Fredrickson, Terri M. Galanits, Katherine J. Rian & Yulian Zhao

    7. Division of Pediatric Surgery, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA

      Dean Potter Jr

    8. Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA

      Siobhan T. Pittock

    9. Division of Pediatric Hematology and Oncology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA

      Carola A. S. Arndt

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    1. Supriya Behl
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    Contributions

    SB, VBJ, RSH, and AC designed the study. SB and VBJ performed data abstraction. All authors discussed the results and contributed to the final manuscript.

    Corresponding author

    Correspondence to Asma J. Chattha.

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    Conflict of interest

    The authors declare that they have no conflict of interest.

    Ethics approval

    This research study was conducted retrospectively from data obtained for clinical purposes. We consulted extensively with the Mayo Clinic Institutional Review Board who determined that our study did not need ethical approval. An IRB official waiver of ethical approval was granted from the Mayo Clinic Institutional Review Board (Study # 19-006156). Methods were carried out in accordance with relevant guidelines and regulations.

    Consent to participate

    All patients included in this study have authorized their records to be used for research through the Minnesota Research Authorization.

    Consent for publication

    All patients included in this study have authorized their records to be used for research through the Minnesota Research Authorization.

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    Not applicable.

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    The original online version of this article was revised: the other affiliation of Reda S. Hussein, Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt, should be included in the article.

    Supriya Behl and Vidhu B. Joshi equally contributed to this work.

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    Behl, S., Joshi, V.B., Hussein, R.S. et al. Consult and procedure incidence outcomes following establishment of a fertility preservation program for children with cancer. J Assist Reprod Genet 38, 495–501 (2021). https://doi.org/10.1007/s10815-020-02042-8

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