The Reproductive Medicine and IVF Unit, Kaplan Medical Center, 76100, Rehovot, Israel.
Sackler Faculty of Medicine, Tel Aviv University, P.O.B. 39040, Ramat Aviv, 69978, Tel Aviv, Israel.
Bone Marrow Transplant. 2019 Nov;54(11):1747-1755. doi: 10.1038/s41409-019-0519-z. Epub 2019 Apr 5.
With the increase in cancer survival, men and women have a chance to conceive children post-recovery. This study aims to better understand hematopoietic cell transplant (HCT) specialist practices and opinions related to fertility preservation for hematological malignancy patients. Survey requests were emailed to 586 European Society for Blood and Marrow Transplantation (EBMT) members. Respondents completed the mostly multiple-choice questionnaire on the IVF-Worldwide.com website. Results were reported as a percentage of respondents. Responses were submitted by 150 HCT specialists from 41 (of 195) countries worldwide. The survey showed that most HCT specialists (87%) are aware of and inform patients that chemotherapy, radiotherapy, and transplantation could harm fertility. Specialists referred 56% of their male patients to fertility preservation but only 36% of their female patients; many pre-pubertal or near post-menopausal patients were not referred. This indicates that barriers may be preventing specialists from referring patients for fertility preservation. Many HCT specialists do not know about or use international fertility preservation recommendations, indicating that new protocols for enhancing awareness are needed. Establishing a referral process protocol to reproductive specialists should be considered. When non-urgent treatment can be deferred for 10-20 days, patients can have a sufficient window to undergo certain fertility preservation procedures.
随着癌症存活率的提高，男性和女性都有机会在康复后生育子女。本研究旨在更好地了解造血细胞移植（HCT）专家在与血液恶性肿瘤患者生育力保存相关的实践和意见。向 586 名欧洲血液和骨髓移植学会（EBMT）成员发送了调查请求。受访者在 IVF-Worldwide.com 网站上完成了大部分多项选择题的问卷。结果以受访者的百分比报告。来自全球 41 个（195 个中的 41 个）国家的 150 名 HCT 专家提交了调查回复。调查显示，大多数 HCT 专家（87%）知晓并告知患者化疗、放疗和移植可能会损害生育能力。专家将 56%的男性患者转介进行生育力保存，但仅将 36%的女性患者转介；许多青春期前或接近绝经后的患者未被转介。这表明可能存在障碍阻止专家将患者转介进行生育力保存。许多 HCT 专家不了解或不使用国际生育力保存建议，这表明需要制定新的提高认识的方案。应考虑建立向生殖专家转介的流程协议。当非紧急治疗可以推迟 10-20 天时，患者就有足够的时间窗口来进行某些生育力保存程序。
