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. 2023 Mar;40(3):443-454.
doi: 10.1007/s10815-022-02679-7. Epub 2022 Dec 21.

Pediatric oncofertility care in limited versus optimum resource settings: results from 39 surveyed centers in Repro-Can-OPEN Study Part I & II

M Salama  1 , L Nahata  2   3 , Y Jayasinghe  4 , V Gomez-Lobo  5   6 , M M Laronda  7 , M B Moravek  8 , L R Meacham  9   10 , M S Christianson  11 , M Lambertini  12   13 , A Anazodo  14 , G P Quinn  15 , T K Woodruff  16
Affiliations

Pediatric oncofertility care in limited versus optimum resource settings: results from 39 surveyed centers in Repro-Can-OPEN Study Part I & II

M Salama et al. J Assist Reprod Genet. 2023 Mar.

Abstract

Purpose: As a secondary report to elucidate the diverse spectrum of oncofertility practices for childhood cancer around the globe, we present and discuss the comparisons of oncofertility practices for childhood cancer in limited versus optimum resource settings based on data collected in the Repro-Can-OPEN Study Part I & II.

Methods: We surveyed 39 oncofertility centers including 14 in limited resource settings from Africa, Asia, and Latin America (Repro-Can-OPEN Study Part I), and 25 in optimum resource settings from the USA, Europe, Australia, and Japan (Repro-Can-OPEN Study Part II). Survey questions covered the availability of fertility preservation and restoration options offered in case of childhood cancer as well as their degree of utilization.

Results: In the Repro-Can-OPEN Study Part I & II, responses for childhood cancer and calculated oncofertility scores showed the following characteristics: (1) higher oncofertility scores in optimum resource settings than in limited resource settings for ovarian and testicular tissue cryopreservation; (2) frequent utilization of gonadal shielding, fractionation of anticancer therapy, oophoropexy, and GnRH analogs; (3) promising utilization of oocyte in vitro maturation (IVM); and (4) rare utilization of neoadjuvant cytoprotective pharmacotherapy, artificial ovary, in vitro spermatogenesis, and stem cells reproductive technology as they are still in preclinical or early clinical research settings.

Conclusions: Based on Repro-Can-OPEN Study Part I & II, we presented a plausible oncofertility best practice model to help optimize care for children with cancer in various resource settings. Special ethical concerns should be considered when offering advanced and innovative oncofertility options to children.

Keywords: Best practice; Childhood cancer; Fertility preservation; Limited resource settings; Oncofertility; Optimum resource settings.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Limited versus optimum resource settings affecting oncofertility practice on national (grey) and local (white) levels
Fig. 2
Fig. 2
Oncofertility score calculation
Fig. 3
Fig. 3
Oncofertility options and scores (%) for childhood cancer in limited versus optimum resource settings, based on empirical data from 39 surveyed centers in Repro-Can-OPEN Study Part I & II [14, 15]
See this image and copyright information in PMC

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