Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (JHU), Baltimore, Maryland, USA.
Department of Pediatrics, Division of Hematology/Oncology, University of Florida, Gainesville, Florida, USA.
Cancer Rep (Hoboken). 2023 Feb;6(2):e1753. doi: 10.1002/cnr2.1753. Epub 2022 Nov 8.
Oncofertility is a developing field of increasing importance, particularly in pediatric oncology, where most patients are likely to survive long-term and have not yet had the opportunity to have children.
We performed a quality improvement initiative to increase our rates of fertility preservation counseling and referral through the implementation of a pediatric oncofertility team, and we report outcomes 7 years following implementation of our initiative.
We compare our baseline oncofertility survey to 44 post-intervention survey respondents and electronic medical record documentation for 149 patients treated in 2019. Ninety-five percent of post-intervention survey respondents recalled fertility counseling (baseline 70%, p = .004) and 89.3% were appropriately referred for fertility preservation (baseline 50%, p = .017). Counseling was documented in 60.4% of charts; 81% of patients analyzed by chart review were appropriately referred for fertility preservation. Fertility preservation outcomes differed by sex assigned at birth.
Creation of an oncofertility team produced improvements in fertility counseling and fertility preservation referral across an extended period of time.
肿瘤生育力是一个日益重要的发展领域，特别是在儿科肿瘤学中，大多数患者很可能长期存活，且尚未有机会生育。
我们实施了一项质量改进计划，通过建立儿科肿瘤生育力团队，提高生育力保存咨询和转诊的比例，并报告我们实施该计划 7 年后的结果。
我们将基线肿瘤生育力调查与 44 名干预后调查受访者和 2019 年治疗的 149 名患者的电子病历记录进行比较。95%的干预后调查受访者回忆起生育力咨询（基线为 70%，p=0.004），89.3%的患者得到了适当的生育力保存转诊（基线为 50%，p=0.017）。60.4%的病历记录了咨询情况；81%的经病历回顾分析的患者得到了适当的生育力保存转诊。生育力保存的结果因出生时的性别而异。
成立肿瘤生育力团队在较长时间内提高了生育力咨询和生育力保存转诊的比例。
