Hartup Lindsay A, Go Virginia-Arlene, Robinson Randal D
Department of Obstetrics and Gynecology, University of Texas Health Sciences Center San Antonio, San Antonio, Texas, USA.
Division of Reproductive Endocrine and Infertility, Department of Obstetrics and Gynecology, University of Texas Health Sciences Center San Antonio, San Antonio, Texas, USA.
J Adolesc Young Adult Oncol. 2024 Aug;13(4):614-621. doi: 10.1089/jayao.2024.0009. Epub 2024 Apr 5.
To investigate the role of formal reproductive endocrinology and infertility (REI) consultation in fertility preservation counseling in a pediatric/adolescent oncology patient population. Retrospective chart review was performed at an academic adult hospital from 2021 to 2022. Pre- and postpubertal patients admitted to the pediatric/adolescent oncology service with cancer diagnoses and imminent gonadotoxic chemotherapy plans were included. Baseline characteristics were collected, including patient age, sex, race, language, insurance, and cancer diagnosis. Primary outcomes were formal REI consultation and fertility preservation election. Nineteen of 58 eligible patients received a formal REI consultation. Patients were more likely to elect fertility preservation if they received a consult. Females were more likely to receive a consult than males and more likely to elect fertility preservation. Patients of age ≥16 years were more likely to receive consultation than younger patients. However, all patients of age <16 years who received a consult elected fertility preservation. There was no difference in consultation based on race, language, or insurance. Thirteen of 19 patients who received an REI consultation elected fertility preservation. Ten of 11 female elections were ovarian suppression, an unproven method of fertility preservation. The two male elections were semen cryopreservation. Underutilization of formal REI consults and a relative lack of proven fertility preservation elections may shed light on a need for increased fertility preservation awareness among young oncology patients and the providers who care for them. A streamlined process that automates formal REI consultation for all eligible patients may maximize the potential for comprehensive counseling and improve patient participation in fertility preservation.
探讨正规生殖内分泌与不孕症（REI）咨询在儿科/青少年肿瘤患者群体生育力保存咨询中的作用。2021年至2022年在一家学术性成人医院进行了回顾性病历审查。纳入了患有癌症诊断且有即将进行性腺毒性化疗计划的儿科/青少年肿瘤服务的青春期前和青春期后患者。收集了基线特征，包括患者年龄、性别、种族、语言、保险和癌症诊断。主要结局是正规REI咨询和生育力保存选择。58名符合条件的患者中有19名接受了正规REI咨询。接受咨询的患者更有可能选择生育力保存。女性比男性更有可能接受咨询，也更有可能选择生育力保存。≥16岁的患者比年轻患者更有可能接受咨询。然而，所有年龄<16岁且接受咨询的患者都选择了生育力保存。基于种族、语言或保险的咨询没有差异。19名接受REI咨询的患者中有13名选择了生育力保存。11名女性选择中有10名是卵巢抑制，这是一种未经证实的生育力保存方法。两名男性选择是精液冷冻保存。正规REI咨询的利用不足以及相对缺乏经证实的生育力保存选择可能揭示了年轻肿瘤患者及其护理提供者对生育力保存意识提高的需求。一个为所有符合条件的患者自动进行正规REI咨询的简化流程可能会最大限度地提高全面咨询的潜力，并改善患者对生育力保存的参与度。
