PurposeOncofertility focuses on providing fertility and endocrine-sparing options to
patients who undergo life-preserving but gonadotoxic cancer treatment. The
resources needed to meet patient demand often are fragmented along
disciplinary lines. We quantify assets and gaps in oncofertility care on a
global scale.MethodsSurvey-based questionnaires were provided to 191 members of the Oncofertility
Consortium Global Partners Network, a National Institutes of
Health–funded organization. Responses were analyzed to measure trends
and regional subtleties about patient oncofertility experiences and to
analyze barriers to care at sites that provide oncofertility services.ResultsSixty-three responses were received (response rate, 25%), and 40 were
analyzed from oncofertility centers in 28 countries. Thirty of 40 survey
results (75%) showed that formal referral processes and psychological care
are provided to patients at the majority of sites. Fourteen of 23
respondents (61%) stated that some fertility preservation services are not
offered because of cultural and legal barriers. The growth of oncofertility
and its capacity to improve the lives of cancer survivors around the globe
relies on concentrated efforts to increase awareness, promote collaboration,
share best practices, and advocate for research funding.ConclusionThis survey reveals global and regional successes and challenges and provides
insight into what is needed to advance the field and make the discussion of
fertility preservation and endocrine health a standard component of the
cancer treatment plan. As the field of oncofertility continues to develop
around the globe, regular assessment of both international and regional
barriers to quality care must continue to guide process improvements.
This study suggests that targeted short-course fluconazole prophylaxis in very low birth weight and ELBW infants may be efficacious and cost effective.
Purpose To determine benefits of cleavage-stage preimplantation genetic screening (PGS) by array comparative genomic hybridization (CGH). Methods A retrospective case-control study was performed at a tertiary care university-affiliated medical center. Implantation rate was looked at as a primary outcome. Secondary outcomes included clinical and ongoing pregnancy rates, as well as multiple pregnancy and miscarriage rates. Thirty five patients underwent 39 fresh cycles with PGS by aCGH and 311 similar patients underwent 394 invitro fertilization cycles. Result(s) The implantation rate in the CGH group doubled when compared to the control group (52.63 % vs. 19.15 %, p=<0.001), clinical pregnancy rate was higher (69.23 % vs. 43.91 %, p=0.0002), ongoing pregnancy rate almost doubled (61.54 % vs. 32.49 %, p=<0.0001), multiple pregnancy rate decreased (8.33 % vs. 34.38 %, p=0.0082) and miscarriage rate trended lower (11.11 % vs. 26.01 %, p=0.13). Conclusion Cleavage stage PGS with CGH is a feasible and safe option for aneuploidy screening that shows excellent outcomes when used in fresh cycles. This is the first report of cleavage stage PGS by CGH showing improved ongoing pregnancy rates.
Older GA, male gender and higher platelet count at time of treatment of hemodynamically significant PDA are predictors of successful ductal closure with indomethacin.
Although the pregnancy rate is lower than conventional IVF, IVM is a safer and simpler alternative to conventional IVF. Future research needs to focus on improving implantation and live birth rates before universal implementation.
In our experience, perioperative outcomes are comparable between CL and RALS in both early and advanced/recurrent disease and not inferior to laparotomy, making CL and RALS an acceptable approach in selected patients.
PurposeIn the accompanying article, “Analysis of Fertility Preservation
Options Available to Patients With Cancer Around the Globe,” we
showed that specific fertility preservation services may not be offered at
various sites around the world because of cultural and legal barriers. We
assessed global and regional experiences as well as the legal status of
third-party reproduction and adoption to serve as a comprehensive
international data set and resource for groups that wish to begin
oncofertility interventions.MethodsWe provide data on the legalities of third-party assisted reproductive
technologies and other family-building options in the 28
oncofertility-practicing countries surveyed.ResultsWe found regional and country differences that will be important in the
development of tailored resources for physicians and for patient brochures
that are sensitive to these local restrictions and cultural norms.ConclusionBecause many patients first consult Web-based materials, the formal
assessment of the availability of these options provides members of the
global oncofertility community with data to which they might otherwise not
have ready access to better serve their patients.
PurposeLittle is known about oncofertility practice in developing countries that usually suffer from a shortage of health services, especially those related to cancer care. Materials and MethodsTo learn more about oncofertility practice in developing countries, we generated a survey to explore the barriers and opportunities associated with oncofertility practice in five developing countries from Africa and Latin America within our Oncofertility Consortium Global Partners Network. Responses from Egypt, Tunisia, Brazil, Peru, and Panama were collected, reviewed, and discussed. ResultsCommon barriers were identified by each country, including financial barriers (lack of insurance coverage and high out-of-pocket costs for patients), lack of awareness among providers and patients, cultural and religious constraints, and lack of funding to help to support oncofertility programs. ConclusionDespite barriers to care, many opportunities exist to grow the field of oncofertility in these five developing countries. It is important to continue to engage stakeholders in developing countries and use powerful networks in the United States and other developed countries to aid in the acceptance of oncofertility on a global level.
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