Fertility Risk in Pediatric and Adolescent Cancers

Gracia, Clarisa R.; Ginsberg, Jill P.

doi:10.1007/978-0-387-72293-1_5

Cited by 22 publications

(12 citation statements)

References 106 publications

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“…It is believed that they act on undeveloped oocytes and possibly on the pre-granulosa cells of the primordial follicles [30]. By cross-linking DNA and introducing single-strand DNA breaks, alkylating agents destroy cells in a dose-dependent fashion [34]. Cell cycle-specific agents, like anti-metabolites, cause much less gonadotoxicity as their major effect is only on growing and dividing cells affecting ovarian follicle growth and maturation [35].…”

Section: Effect Of Chemotherapymentioning

confidence: 99%

Fertility in Female Childhood Cancer Survivors

Bruin

Broeder

Berg

et al. 2009

Endocrinopathy After Childhood Cancer Treatment

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Advances in childhood cancer treatment over the past decades have significantly improved survival, resulting in a rapidly enlarging group of childhood cancer survivors. There is much concern, however, about the effects of treatment on reproductive potential. In women there is evidence that both chemotherapy and radiotherapy may have an adverse effect on ovarian function, ovarian reserve and uterine function, clinically leading to sub-fertility, infertility, premature menopause and/or adverse pregnancy outcomes. Here we will first address normal female fertility and methods to detect decreased fertility. Hence we will focus on direct effects as well as late fertility-related adverse effects caused by chemotherapy and radiotherapy, and we will conclude with a summary of current options for fertility preservation in female childhood cancer survivors.

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Section: Effect Of Chemotherapymentioning

confidence: 99%

Fertility in Female Childhood Cancer Survivors

Bruin

Broeder

Berg

et al. 2009

Endocrinopathy After Childhood Cancer Treatment

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“…Our study presents data from 209 participants, outnumbering participation in the majority of similar studies (pre-or post-ASCOR) [3,5,6,[10][11][12][13][14]. Nonetheless, it is important to note that the response rate to this survey was low.…”

Section: Study Limitationsmentioning

confidence: 95%

“…Since release of the ASCOR, only a few studies have been published regarding fertility preservation utilization among pediatric oncology patients [10][11][12][13][14]. Despite the existence of the ASCO recommendations, similar themes emerge from these studies, including a need for improved communication between pediatric oncology providers and specialists in reproductive medicine, a lack of fertility preservation counseling by health care providers, patient and patient guardian misconceptions, and poor patient guardian fertility preservation satisfaction rates [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Fertility Preservation

2012

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Purpose Diminished reproductive capacity is a devastating consequence of life-sparing therapies for childhood malignancy. In 2006, the American Society of Clinical Oncology (ASCO) published fertility preservation recommendations (ASCOR) emphasizing the importance of early discussion and intervention for fertility preservation strategies. Using the Survey for Preservation of Adolescent REproduction (SPARE), we sought to determine fertility preservation attitudes and practice patterns post-ASCOR from pediatric oncology specialists nationwide. Materials and methods The SPARE survey consists of 22 questions assessing pediatric oncology specialists' attitudes and practice patterns toward fertility preservation. Broad perspectives on fertility preservation, including a willingness to discuss fertility, knowledge of current fertility preservation methods and awareness of ASCOR, were assessed.Capsule The SPARE survey captured marked disparities between pediatric oncologists' attitudes and practice patterns regarding fertility preservation for male and female pediatric oncology patients.

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“…Haematological malignancies, sarcomas, lesions in the central nervous system, renal cancers and bone cancers are among the subtypes that strike young children. 37 An estimated 10,730 new cases were expected to occur among children from birth to 14 years of age in 2009, with 1,380 deaths predicted (about one-third of these from leukaemia). Despite these statistics, it is important to note that the mortality rates for childhood cancer have declined by 50% since 1975, and nearly 80% of children diagnosed with cancer now survive.…”

Section: Children With Cancermentioning

confidence: 99%

“…The investigational technique of spermatogonia stem cell cryopreservation is being pursued as a possible option. 37 For post-pubertal boys and young men, cryopreservation of sperm is the most accepted method of fertility preservation when performed prior to the initiation of therapy.…”

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confidence: 99%

Fertility Preservation Options for Patients with Cancer

Hulvat¹,

Jeruss²

2010

European Oncology &Amp; Haematology

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Improving survival for many cancers that affect children and young adults, together with advances in fertility preservation, make a cancer-free future that includes a family a realistic possibility for patients who desire this option. Although it is difficult for many clinicians and patients to reconcile fears surrounding a life-threatening diagnosis with hope for long-term survival and even a future family, addressing this vital survivorship issue early in the course of diagnosis and treatment is imperative if the fullest range of fertility-preserving options is to be offered.Oncological therapies, including chemotherapy, radiation and surgery, pose various threats to fertility. Children, adolescents and young men and women with cancer have different options for maintaining their ability to have biological children. The current state of the science for fertility preservation in each of these demographic groups is discussed in this article. A multidisciplinary approach to the care of young cancer patients, a timely assessment of threats to fertility and opportunities for intervention provide young cancer patients with the best chance for a healthy future that includes biological offspring. KeywordsFertility preservation, oncofertility, cancer, chemotherapy, embryo cyropreservation A discussion of a patient's desires for future fertility is a challenging topic to raise in the early stages of a cancer diagnosis. It is difficult for many clinicians and patients to reconcile fears surrounding a life-threatening diagnosis with hope for long-term survival and even a future family. Yet improved survival rates for many cancers that affect young patients and recent advances in fertility preservation, taken together, make planning for a cancer-free life that includes a family a reality. Both men and women have similar threats to fertility inherent to treatment for cancer, but the opportunities to intervene are quite different. The following is a review of the current state of the science of fertility preservation for cancer patients. Men with CancerFertility challenges in men with cancer are the most straightforward because of the relative ease of obtaining and cryopreserving sperm. This is not to say that significant threats to fertility do not exist.Treatments for cancer can cause direct damage to the germinal epithelium of the testis, disrupt the hypothalamic-pituitary-gonadal axis and cause psychological depression, which also affects fertility. High-dose pelvic irradiation used to treat these malignancies, as well as rectal malignancies, may also permanently damage testicular and erectile function.2 Radiation not directed towards the pelvis can also be toxic to sperm due to internal scatter, even at low doses. 3,4 Spermatogenesis is a process that is extremely vulnerable to the damaging effects of cytotoxic chemotherapy, and azoospermia or oligospermia frequently result. 5-7Cryopreservation of human sperm is an accepted technology in common use and there are reports of viable fertilisation with sperm store...

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Fertility Risk in Pediatric and Adolescent Cancers

Cited by 22 publications

References 106 publications

Fertility in Female Childhood Cancer Survivors

Fertility in Female Childhood Cancer Survivors

Fertility Preservation

Fertility Preservation Options for Patients with Cancer

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