Fertility & Hormone Preservation & Restoration Program, Division of Pediatric Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Division of Pediatric Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Pediatr Blood Cancer. 2024 Oct;71(10):e31232. doi: 10.1002/pbc.31232. Epub 2024 Jul 31.
Treatment for certain childhood cancers and nonmalignant conditions can lead to future infertility and gonadal failure. The risk of treatment delay must be considered when offering fertility preservation (FP) options. We examined the timeline from FP referral to return to treatment (RTT) in pediatric patients who underwent FP due to iatrogenic risk for infertility.
A retrospective review was performed of patients with FP consultation due to an increased risk of iatrogenic infertility at Ann & Robert H. Lurie Children's Hospital of Chicago from 2018 to 2022. Data on diagnosis, age, treatment characteristics, and procedure were collected.
A total of 337 patients (n = 149 with ovaries, n = 188 with testes) had an FP consultation. Of patients with ovaries, 106 (71.1%) underwent ovarian tissue cryopreservation (OTC), 10 (6.7%) completed ovarian stimulation/egg retrieval (OSER), and 33 (22.1%) declined FP. Of the patients with testes, 98 (52.1%) underwent testicular tissue cryopreservation (TTC), 48 (25.5%) completed sperm banking (SB), and 42 (22.3%) declined FP. Median time from referral to FP consultation was short (ovaries: 2 days, range: 0-6; testes: 1 day, range: 0-5). OSER had a significantly longer RTT versus OTC and no FP (52.5 vs.19.5 vs. 12 days, p = .01). SB had a significantly quicker RTT compared to TTC or no FP (9.0 vs. 21.0 vs. 13.5 days; p = .008). For patients who underwent OTC/TTC and those who declined FP, there was no significant difference in time from consultation to treatment.
It is feasible to promptly offer and complete FP with minimal delay to disease-directed treatment.
某些儿童癌症和非恶性疾病的治疗可能导致未来的不孕和性腺功能衰竭。在提供生育力保存 (FP) 选择时，必须考虑治疗延迟的风险。我们研究了因医源性不孕风险而接受 FP 的儿科患者从 FP 转诊到返回治疗 (RTT) 的时间线。
对 2018 年至 2022 年在芝加哥安和罗伯特·H·卢里儿童医院因增加医源性不孕风险而进行 FP 咨询的患者进行回顾性研究。收集了诊断、年龄、治疗特征和程序的数据。
共有 337 名患者（卵巢 149 例，睾丸 188 例）进行了 FP 咨询。卵巢组 106 例（71.1%）行卵巢组织冷冻保存（OTC），10 例（6.7%）行卵巢刺激/卵母细胞采集（OSER），33 例（22.1%）拒绝 FP。睾丸组 98 例（52.1%）行睾丸组织冷冻保存（TTC），48 例（25.5%）行精子库（SB），42 例（22.3%）拒绝 FP。从转诊到 FP 咨询的中位时间较短（卵巢：2 天，范围：0-6；睾丸：1 天，范围：0-5）。与 OTC 和无 FP 相比，OSER 的 RTT 明显更长（52.5 天比 19.5 天比 12 天，p=0.01）。与 TTC 或无 FP 相比，SB 的 RTT 明显更快（9.0 天比 21.0 天比 13.5 天；p=0.008）。对于接受 OTC/TTC 和拒绝 FP 的患者，从咨询到治疗的时间没有显著差异。
迅速提供并完成 FP，使疾病导向治疗的时间最小化是可行的。
