Fertility Preservation Counseling: A Must for Kids with Cancer

Jeannette Y. Wick, RPh, MBA, FASCP

Cancer patients identified fertility as a key survivorship concern.

Cancer patients identified fertility as a key survivorship concern.

Cancer’s long-term side effects on fertility — lowered sperm production, early ovarian failure, and other equally limiting effects – demand that doctors be informed.

The American Society of Clinical Oncology (ASCO) updated their clinical practice guidelines regarding fertility preservation in 2013, but it's unclear if pediatric oncologists use them routinely. Since the previous ASCO guidelines were published,

oocyte cryopreservation has become a reality. A study that appears in the Journal of Adolescent and Young Adult Oncology asked three questions:

· Do pediatric oncologists counsel patients regarding fertility preservation?

· Do they use the updated guidelines used?

· How can reproductive endocrinologists educate providers and patients?

The researchers sent online surveys to participants in the Children’s Oncology Group.

Two hundred and thirty-four providers responded to the survey, a response rate of 16%.

Results showed that of the 95% of respondents who discussed fertility preservation with their patients before commencing treatment, oncologists tended to use two fertility treatment options most often: sperm banking and referral to reproductive endocrinologists.

Only 35% of respondents had read the updated guidelines, indicating an opportunity for better provider education. Venues to provide such education may include training programs, webinars, and conferences.

The ASCO guidelines, in keeping with the American Society for Reproductive Medicine Fertility Preservation committee's recommendations, specifically advised oocyte cryopreservation and ovarian tissue cryopreservation.

The authors concluded, “Familiarity of the ASCO guidelines is limited, revealing that the established methods for fertility preservation in women — embryo and oocyte cryopreservation – may be offered less than experimental methods in this younger patient population.” The authors believe that these differences demonstrate a need to educate providers.