Development of a Pediatric Fertility Preservation Program: A Report From the Pediatric Initiative Network of the Oncofertility Consortium

doi:10.1016/j.jadohealth.2018.10.297

Review

. 2019 May;64(5):563-573.

doi: 10.1016/j.jadohealth.2018.10.297. Epub 2019 Jan 14.

Development of a Pediatric Fertility Preservation Program: A Report From the Pediatric Initiative Network of the Oncofertility Consortium

Molly B Moravek¹, Leslie C Appiah², Antoinette Anazodo³, Karen C Burns⁴, Veronica Gomez-Lobo⁵, Holly R Hoefgen⁶, Olivia Jaworek Frias⁷, Monica M Laronda⁸, Jennifer Levine⁹, Lillian R Meacham¹⁰, Mary Ellen Pavone¹¹, Gwendolyn P Quinn¹², Erin E Rowell¹³, Andrew C Strine¹⁴, Teresa K Woodruff¹⁵, Leena Nahata¹⁶

Affiliations

¹ Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Michigan, Ann Arbor, Michigan. Electronic address: mpenderg@med.umich.edu.
² Department of Obstetrics and Gynecology, Division of General Obstetrics and Gynecology, Section of Pediatric and Adolescent Gynecology, The Ohio State University/Nationwide Children's Hospital, Columbus, Ohio; James Cancer Center, Columbus, Ohio.
³ Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia; Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, Australia; School of Women's and Children's, University of New South Wales, Sydney, Australia.
⁴ Department of Pediatrics, University of Cincinnati College of Medicine, Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
⁵ Division of Pediatric and Adolescent Gynecology, Washington Hospital Center, Children's National Medical Center, Georgetown University, Washington, DC.
⁶ Division of Pediatric and Adolescent Gynecology, Washington University School of Medicine, St. Louis, Missouri.
⁷ Division of Pediatric and Adolescent Gynecology, Comprehensive Fertility Care and Preservation Program, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
⁸ Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois; Division of Endocrinology, Department of Pediatrics, Northwestern University, Chicago, Illinois.
⁹ Division of Pediatric Hematology and Oncology, Weill Cornell Medicine, New York, New York.
¹⁰ Aflac Cancer Center, Children's Healthcare of Atlanta, Atlanta, Georgia; Department of Pediatrics, Division of Hematology/Oncology and Endocrinology, Emory University, Atlanta, Georgia.
¹¹ Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University, Chicago, Illinois.
¹² Department of Obstetrics and Gynecology, Division of Medical Ethics, New York University, New York, New York.
¹³ Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois; Department of Pediatric Surgery, Northwestern University, Chicago, Illinois.
¹⁴ Division of Urology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
¹⁵ Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
¹⁶ Department of Pediatrics, Division of Endocrinology and Center for Biobehavioral Health, The Ohio State University/Nationwide Children's Hospital, Columbus, Ohio.

PMID: 30655118
PMCID: PMC6478520
DOI: 10.1016/j.jadohealth.2018.10.297

Review

Development of a Pediatric Fertility Preservation Program: A Report From the Pediatric Initiative Network of the Oncofertility Consortium

Molly B Moravek et al. J Adolesc Health. 2019 May.

. 2019 May;64(5):563-573.

doi: 10.1016/j.jadohealth.2018.10.297. Epub 2019 Jan 14.

Authors

Affiliations

¹ Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Michigan, Ann Arbor, Michigan. Electronic address: mpenderg@med.umich.edu.
² Department of Obstetrics and Gynecology, Division of General Obstetrics and Gynecology, Section of Pediatric and Adolescent Gynecology, The Ohio State University/Nationwide Children's Hospital, Columbus, Ohio; James Cancer Center, Columbus, Ohio.
³ Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia; Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, Australia; School of Women's and Children's, University of New South Wales, Sydney, Australia.
⁴ Department of Pediatrics, University of Cincinnati College of Medicine, Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
⁵ Division of Pediatric and Adolescent Gynecology, Washington Hospital Center, Children's National Medical Center, Georgetown University, Washington, DC.
⁶ Division of Pediatric and Adolescent Gynecology, Washington University School of Medicine, St. Louis, Missouri.
⁷ Division of Pediatric and Adolescent Gynecology, Comprehensive Fertility Care and Preservation Program, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
⁸ Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois; Division of Endocrinology, Department of Pediatrics, Northwestern University, Chicago, Illinois.
⁹ Division of Pediatric Hematology and Oncology, Weill Cornell Medicine, New York, New York.
¹⁰ Aflac Cancer Center, Children's Healthcare of Atlanta, Atlanta, Georgia; Department of Pediatrics, Division of Hematology/Oncology and Endocrinology, Emory University, Atlanta, Georgia.
¹¹ Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University, Chicago, Illinois.
¹² Department of Obstetrics and Gynecology, Division of Medical Ethics, New York University, New York, New York.
¹³ Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois; Department of Pediatric Surgery, Northwestern University, Chicago, Illinois.
¹⁴ Division of Urology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
¹⁵ Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
¹⁶ Department of Pediatrics, Division of Endocrinology and Center for Biobehavioral Health, The Ohio State University/Nationwide Children's Hospital, Columbus, Ohio.

PMID: 30655118
PMCID: PMC6478520
DOI: 10.1016/j.jadohealth.2018.10.297

Abstract

Infertility is known to decrease quality of life among adults. In some cases, infertility is caused by medical conditions and/or treatments prescribed in childhood, and using methods to protect or preserve fertility may expand future reproductive possibilities. Structured programs to offer counseling about infertility risk and fertility preservation options are essential in the care of pediatric patients facing fertility-threatening conditions or treatments, yet multiple barriers to program development exist. This report was developed from the institutional experiences of members of the Pediatric Initiative Network of the Oncofertility Consortium, with the intent of providing guidance for health care providers aiming to establish programs at institutions lacking pediatric fertility preservation services. The mechanics of building a fertility preservation program are discussed, including essential team members, target populations, fertility preservation options (both established and experimental), survivorship issues, research opportunities, and ethical considerations. Common barriers to program development and utilization, including low referral rates and financial concerns, are also discussed, and recommendations made for overcoming such barriers.

Keywords: Adolescent; Child; Fertility preservation; Program development; Tissue preservation.

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Conflict of interest statement

Disclosures:

Dr. Pavone serves on the Ferring advisory board. All other authors have no conflicts of interest.

Comment in

Pediatric Fertility Counseling.
Tishelman AC. Tishelman AC. J Adolesc Health. 2019 May;64(5):547-548. doi: 10.1016/j.jadohealth.2019.02.004. J Adolesc Health. 2019. PMID: 31010548 No abstract available.

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References

1. Fallat ME, Hutter J, American Academy of Pediatrics Committee on B, American Academy of Pediatrics Section on HO, American Academy of Pediatrics Section on S. Preservation of fertility in pediatric and adolescent patients with cancer. Pediatrics. 2008;121(5):e1461–1469. - PubMed
1. Oktay K, Harvey BE, Loren AW. Fertility Preservation in Patients With Cancer: ASCO Clinical Practice Guideline Update Summary. J Oncol Pract. 2018;14(6):381–385. - PubMed
1. Ethics Committee of American Society for Reproductive M. Fertility preservation and reproduction in patients facing gonadotoxic therapies: a committee opinion. FertilSteril. 2013;100(5):1224–1231. - PubMed
1. Grover NS, Deal AM, Wood WA, Mersereau JE. Young Men With Cancer Experience Low Referral Rates for Fertility Counseling and Sperm Banking. J Oncol Pract. 2016;12(5):465–471. - PubMed
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[1] Fallat ME, Hutter J, American Academy of Pediatrics Committee on B, American Academy of Pediatrics Section on HO, American Academy of Pediatrics Section on S. Preservation of fertility in pediatric and adolescent patients with cancer. Pediatrics. 2008;121(5):e1461–1469. - PubMed

[2] Fallat ME, Hutter J, American Academy of Pediatrics Committee on B, American Academy of Pediatrics Section on HO, American Academy of Pediatrics Section on S. Preservation of fertility in pediatric and adolescent patients with cancer. Pediatrics. 2008;121(5):e1461–1469. - PubMed

[3] Oktay K, Harvey BE, Loren AW. Fertility Preservation in Patients With Cancer: ASCO Clinical Practice Guideline Update Summary. J Oncol Pract. 2018;14(6):381–385. - PubMed

[4] Oktay K, Harvey BE, Loren AW. Fertility Preservation in Patients With Cancer: ASCO Clinical Practice Guideline Update Summary. J Oncol Pract. 2018;14(6):381–385. - PubMed

[5] Ethics Committee of American Society for Reproductive M. Fertility preservation and reproduction in patients facing gonadotoxic therapies: a committee opinion. FertilSteril. 2013;100(5):1224–1231. - PubMed

[6] Ethics Committee of American Society for Reproductive M. Fertility preservation and reproduction in patients facing gonadotoxic therapies: a committee opinion. FertilSteril. 2013;100(5):1224–1231. - PubMed

[7] Grover NS, Deal AM, Wood WA, Mersereau JE. Young Men With Cancer Experience Low Referral Rates for Fertility Counseling and Sperm Banking. J Oncol Pract. 2016;12(5):465–471. - PubMed

[8] Grover NS, Deal AM, Wood WA, Mersereau JE. Young Men With Cancer Experience Low Referral Rates for Fertility Counseling and Sperm Banking. J Oncol Pract. 2016;12(5):465–471. - PubMed

[9] Goodman LR, Balthazar U, Kim J, Mersereau JE. Trends of socioeconomic disparities in referral patterns for fertility preservation consultation. Hum Reprod. 2012;27(7):2076–2081. - PMC - PubMed

[10] Goodman LR, Balthazar U, Kim J, Mersereau JE. Trends of socioeconomic disparities in referral patterns for fertility preservation consultation. Hum Reprod. 2012;27(7):2076–2081. - PMC - PubMed

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Development of a Pediatric Fertility Preservation Program: A Report From the Pediatric Initiative Network of the Oncofertility Consortium

Affiliations

Development of a Pediatric Fertility Preservation Program: A Report From the Pediatric Initiative Network of the Oncofertility Consortium

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