How can fertility counseling be implemented for every newly diagnosed pediatric patient facing gonadotoxic treatment? : A single-center experience

  • Since the survival rates of pediatric patients undergoing cancer treatment or hematopoietic stem cell transplantation (HSCT) have increased rapidly in recent decades, the late effects of treatment are now an important focus of patient care. Access to fertility preservation (FP) procedures as well as their financing differs considerably across Europe. However, some countries in Europe have recently changed the legal basis for financing FP procedures; therefore, the implementation of structures is mandatory to give patients access to FP. In this prospective cohort study, we characterized the process for establishing pediatric fertility counseling, including the development of an in-house standard procedure for recommendations regarding FP with potentially gonadotoxic treatment and valuating data from all FP counseling sessions. All data concerning patient characteristics (pubertal status, disease group) and recommendation of FP measures were prospectively collected and adoption of FP measures analyzed. Prior to the establishment of a structured process for FP in our pediatric oncology and stem cell transplantation center, there was no standardized FP counseling. We demonstrate that with the establishment of an inhouse standard procedure, it is possible to give consistent yet individualized FP counseling to approximately 90% of our patients facing gonadotoxic treatment, counseling over 200 patients between 2017 and 2019. This pilot study could potentially be adapted in other pediatric hematology, oncology, and stem cell transplantation centers to allow a more standardized handling of FP counseling for all patients facing gonadotoxic treatment.
Author:Anke BarnbrockGND, Emilia Salzmann-Manrique, Nicole Sänger, Henning C. FiegelORCiDGND, Falk OchsendorfORCiDGND, Thomas KlingebielORCiDGND, Peter BaderORCiDGND, Andrea JarischORCiDGND
Parent Title (English):Annals of hematology
Place of publication:Berlin ; Heidelberg ; New York
Document Type:Article
Date of Publication (online):2021/09/18
Date of first Publication:2021/09/18
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2022/01/11
Tag:Fertility counseling; Indication for fertility preservation; Pediatric oncology; Pediatric stem cell transplantation
Page Number:11
First Page:2831
Last Page:2841
Open Access funding enabled and organized by Projekt DEAL. Funding was available through a parents' association, including for a physician scientist position (50%), as the German health insurance system did not yet cover the costs as mentioned in the manuscript. Otherwise, funding was used to support the families covering the costs of the fertility-preserving procedures.
We thank the parents' association 'Hilfe für Krebskranke Kinder Frankfurt e.V.' for funding the project.
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0