Fertility Preservation in Patients With Cancer: ASCO Clinical Practice Guideline Update Summary

Oktay, Kutluk; Harvey, Brittany E.; Loren, Alison W.

doi:10.1200/jop.18.00160

Cited by 119 publications

(97 citation statements)

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“…This is the first consensus framework giving guidance about the core competencies of oncofertility care and implementation strategies. One hundred and eight statements gained international agreement that will enhance the implementation of FP guidelines . These guidelines establish best practice and give recommendations for FP uptake and use; however, they do not consider the skills required by HCPs or the oncofertility services to effectively implement these guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…One hundred and eight statements gained international agreement that will enhance the implementation of FP guidelines . These guidelines establish best practice and give recommendations for FP uptake and use; however, they do not consider the skills required by HCPs or the oncofertility services to effectively implement these guidelines. This is especially important in view of particular oncofertility requirements for pediatric patients, complex patients, patients in rural and regional centers, and patients with additional health care needs.…”

Section: Discussionmentioning

confidence: 99%

“…Despite numerous fertility preservation guidelines , there are several barriers that continue to hinder the implementation of oncofertility practice . Currently, oncofertility competencies do not exist.…”

Section: Introductionmentioning

confidence: 99%

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The Development of an International Oncofertility Competency Framework: A Model to Increase Oncofertility Implementation

et al. 2019

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Background. Despite international evidence about fertility preservation (FP), several barriers still prevent the implementation of equitable FP practice. Currently, oncofertility competencies do not exist. The aim of this study was to develop an oncofertility competency framework that defines the key components of oncofertility care, develops a model for prioritizing service development, and defines the roles that health care professionals (HCPs) play. Materials and Method. A quantitative modified Delphi methodology was used to conduct two rounds of an electronic survey, querying and synthesizing opinions about statements regarding oncofertility care with HCPs and patient and family advocacy groups (PFAs) from 16 countries (12 high and 4 middle income). Statements included the roles of HCPs and priorities for service development care across ten domains (communication, oncofertility decision aids, age-appropriate care, referral pathways, documentation, oncofertility training, reproductive survivorship care and fertility-related psychosocial support, supportive care, and ethical frameworks) that represent 33 different elements of care.Results. The first questionnaire was completed by 457 participants (332 HCPs and 125 PFAs). One hundred and thirty-eight participants completed the second questionnaire (122 HCPs and 16 PFAs). Consensus was agreed on 108 oncofertility competencies and the roles HCPs should play in oncofertility care. A three-tier service development model is proposed, withThe Oncologist 2019;24:e1450-e1459 www.TheOncologist.com Symptom Management and Supportive Care Implications for Practice: Despite international evidence about fertility preservation (FP), several barriers still prevent the implementation of equitable FP practice. The competency framework gives 108 competencies that will allow health care professionals (HCPs) and services a structure for the development of oncofertility care, as well as define the role HCPs play to provide care and support. The framework also proposes a three-tier oncofertility service development model which prioritizes the development of components of oncofertility care into essential, enhanced, and expert services, giving clear recommendations for service development. The competency framework will enhance the implementation of FP guidelines, improving the equitable access to medical and psychological oncofertility care. Initial QuestionnaireQuestionnaires were developed for HCPs and PFAs. These questionnaires were reviewed by PFA to ensure consensus on appropriate terminology and language and breadth of

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Development of an International Oncofertility Competency Framework: A Model to Increase Oncofertility Implementation

et al. 2019

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“…The current study findings reinforce the continued need to implement guideline-concordant care by providing counseling regarding the potential impact of breast cancer treatment on fertility and available fertility preservation options. 62 Additional investigation of disparities in the provision of fertility counseling as well as research to identify strategies that enhance the receipt of recommended counseling, such as web-based or telehealth decision aids to augment in-office counseling sessions, are merited.…”

Section: Discussionmentioning

confidence: 99%

Fertility‐related experiences after breast cancer diagnosis in the Sister and Two Sister Studies

Bressler

Mersereau

Anderson

et al. 2019

Cancer

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Background Commonly used chemotherapies can be toxic to the ovaries. To the authors’ knowledge, the majority of studies evaluating receipt of fertility counseling for women in their reproductive years have been performed in specific settings, thereby limiting generalizability. Methods A nationwide sample of US women diagnosed with breast cancer before age 45 years completed a survey assessing the prevalence of fertility counseling. Age‐adjusted log‐binomial regression was used to estimate prevalence ratios (PRs) and 95% CIs for fertility counseling. Results Among 432 survivors diagnosed between 2004 and 2011, 288 (67%) had not discussed the effects of treatment on fertility with a health care provider before or during treatment. Fertility discussion was associated with younger age (PR, 3.49 [95% CI, 2.66‐4.58] for aged <35 years vs ≥40 years) and lower parity (PR, 1.81 [95% CI, 1.29‐2.53] for parity 1 vs 2). Approximately 20% of respondents reported that they were interested in future fertility (87 of 432 respondents) at the time of their diagnosis, but not all of these individuals (66 of 87 respondents) received counseling regarding the impact of treatment on their fertility, and few (8 of 87 respondents) used fertility preservation strategies. Among 68 women with a fertility interest who provided reasons for not taking steps to preserve fertility, reasons cited included concern for an adverse impact on cancer treatment (56%), lack of knowledge (26%), decision to not have a child (24%), and cost (18%). Conclusions Across multiple treatment settings, the majority of women of reproductive age who are diagnosed with breast cancer did not discuss fertility with a health care provider or use fertility preservation strategies. Discussing the potential impact of cancer treatment on future fertility is an important aspect of patient education.

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“…In literature, the increase in AFP levels and a different histology from the dysgerminoma has been correlated to a greater incidence of recurrences. Therefore, in these cases a more extensive surgical treatment and a greater number of chemotherapy cycles could be indicated, after individualized evaluation of the risk factors [22][23][24] This is also reflected in terms of OS which in the literature is reported to be equal to 97% in cases of dysgerminoma while in non-germinomas is 60% (p < 0.001) [25].…”

Section: Methodsmentioning

confidence: 99%

Germinal Ovarian Tumors In Reproductive Age Women: Fertility-Sparing And Outcome

Dellino

Silvestris

Loizzi

et al. 2020

Preprint

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Purpose MOGCTs (malignant ovarian germ cell tumours) is a rare tumour, which mainly affects patients in reproductive age. The aim of this study is evaluate the fertility and survival outcomes in young women with MOCGTs treated with fertility-sparing surgery (FFS).Methods From 2000 to 2018 twenty-eight patients with diagnosis of MOGCTs in reproductive age at the University of Bari were collected. Most received FFS and in patients treated conservatively, the reproductive outcome and survival were investigated. Data of patient demographics, clinical presentation, oncology markers dosage, staging, type of surgery histological examination, survival and reproductive outcome were collected from hospital and office charts. All informed consent was obtained from all patientsResults Twenty-eight patients with diagnosis of MOGCTs were collected. The median age was 24 (range: 9-45). The majority of the patients had stage IIIC. Twenty-four woman received fertility-sparing surgery consisting in unilateral ovariectomy and omentectomy whereas only 4 women based on their stage (IIIC) received a radical surgery (hysterectomy with bilateral adnexectomy, lymphadenectomy and omentectomy). Our study shows that FFS in MOGCTs can produce good results both on reproductive outcomes and on survival. Indeed, in our group there was only one case of exitus as result of recurrence. On the other side, patients after FFS maintained normal ovarian function and 5/5 women who have looked for pregnancy, obtained it spontaneously. The median follow-up was 90 moth (range 3-159).Conclusion Conservative surgery for MOGCTs should be considered for women in the reproductive age group who desire preservation of fertility.

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Fertility Preservation in Patients With Cancer: ASCO Clinical Practice Guideline Update Summary

Cited by 119 publications

References 1 publication

The Development of an International Oncofertility Competency Framework: A Model to Increase Oncofertility Implementation

The Development of an International Oncofertility Competency Framework: A Model to Increase Oncofertility Implementation

Fertility‐related experiences after breast cancer diagnosis in the Sister and Two Sister Studies

Germinal Ovarian Tumors In Reproductive Age Women: Fertility-Sparing And Outcome

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