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Fertility Preservation Options for Female Pediatric and Adolescent Oncology Patients

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Textbook of Oncofertility Research and Practice

Abstract

Maintaining the ability to have biological children has been identified as an important component of quality of life in pediatric and adolescent cancer survivors, yet their fertility may be compromised by the interventions used to cure their cancer. Advances in reproductive technologies have increased the options for fertility preservation in this population. For postpubertal females, standard options for fertility preservation include oocyte and embryo cryopreservation. Ovarian tissue cryopreservation is an experimental methodology that may have efficacy when standard interventions are not possible due to time constraints. Ovarian tissue cryopreservation is the only option to cryopreserve ovarian follicles in prepubertal females diagnosed with cancer as they are not able to respond to ovarian stimulation. Type of cancer, age, pubertal development, the severity of illness at the time of diagnosis, and type of treatment all impact decision making related to these and other fertility preservation options. Discussions of fertility should occur at diagnosis and following treatment, as many survivors will have retained ovarian function post-treatment but may be at risk of premature menopause. This chapter summarizes the current options for fertility preservation for female pediatric and adolescent cancer patients.

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References

  1. Anderson RA, Mitchell RT, Kelsey TW, Spears N, Telfer EE, Wallace WH. Cancer treatment and gonadal function: experimental and established strategies for fertility preservation in children and young adults. Lancet Diabetes Endocrinol. 2015;3(7):556–67. https://doi.org/10.1016/S2213-8587(15)00039-X.

    Article  CAS  PubMed  Google Scholar 

  2. Armour KL. An overview of surrogacy around the world: trends, questions and ethical issues. Nurs Womens Health. 2012;16(3):231–6. https://doi.org/10.1111/j.1751-486X.2012.01734.x.

    Article  PubMed  Google Scholar 

  3. Ayensu-Coker L, Essig E, Breech LL, Lindheim S. Ethical quandaries in gamete-embryo cryopreservation related to oncofertility. J Law Med Ethics. 2013;41(3):711–9. https://doi.org/10.1111/jlme.12081.

    Article  PubMed  Google Scholar 

  4. Babayev SN, Arslan E, Kogan S, Moy F, Oktay K. Evaluation of ovarian and testicular tissue cryopreservation in children undergoing gonadotoxic therapies. J Assist Reprod Genet. 2013;30(1):3–9. https://doi.org/10.1007/s10815-012-9909-5.

    Article  PubMed  Google Scholar 

  5. Barton SE, Najita JS, Ginsburg ES, Leisenring WM, Stovall M, Weathers RE, Sklar CA, Robison LL, Diller L. Infertility, infertility treatment, and achievement of pregnancy in female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study cohort. Lancet Oncol. 2013;14(9):873–81. https://doi.org/10.1016/S1470-2045(13)70251-1.

    Article  PubMed  Google Scholar 

  6. Barton SE, Politch JA, Benson CB, Ginsburg ES, Gargiulo AR. Transabdominal follicular aspiration for oocyte retrieval in patients with ovaries inaccessible by transvaginal ultrasound. Fertil Steril. 2011;95(5):1773–6. https://doi.org/10.1016/j.fertnstert.2011.01.006.

    Article  PubMed  Google Scholar 

  7. Basco D, Campo-Engelstein L, Rodriguez S. Insuring against infertility: expanding state infertility mandates to include fertility preservation technology for cancer patients. J Law Med Ethics. 2010;38(4):832–9. https://doi.org/10.1111/j.1748-720X.2010.00536.x.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Bastings L, Baysal O, Beerendonk CC, Braat DD, Nelen WL. Referral for fertility preservation counselling in female cancer patients. Hum Reprod. 2014;29(10):2228–37. https://doi.org/10.1093/humrep/deu186.

    Article  CAS  PubMed  Google Scholar 

  9. Bastings L, Beerendonk CC, Westphal JR, Massuger LF, Kaal SE, van Leeuwen FE, Braat DD, Peek R. Autotransplantation of cryopreserved ovarian tissue in cancer survivors and the risk of reintroducing malignancy: a systematic review. Hum Reprod Update. 2013;19(5):483–506. https://doi.org/10.1093/humupd/dmt020.

    Article  CAS  PubMed  Google Scholar 

  10. Bisharah M, Tulandi T. Laparoscopic preservation of ovarian function: an underused procedure. Am J Obstet Gynecol. 2003;188(2):367–70.

    Article  PubMed  Google Scholar 

  11. Blumenfeld Z, Zur H, Dann EJ. Gonadotropin-releasing hormone agonist cotreatment during chemotherapy may increase pregnancy rate in survivors. Oncologist. 2015;20(11):1283–9. https://doi.org/10.1634/theoncologist.2015-0223.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Burns KC, Boudreau C, Panepinto JA. Attitudes regarding fertility preservation in female adolescent cancer patients. J Pediatr Hematol Oncol. 2006;28(6):350–4.

    Article  PubMed  Google Scholar 

  13. Cakmak H, Katz A, Cedars MI, Rosen MP. Effective method for emergency fertility preservation: random-start controlled ovarian stimulation. Fertil Steril. 2013;100(6):1673–80. https://doi.org/10.1016/j.fertnstert.2013.07.1992.

    Article  PubMed  Google Scholar 

  14. Campbell JE, Assanasen C, Robinson RD, Knudtson JF. Fertility preservation counseling for pediatric and adolescent cancer patients. J Adolesc Young Adult Oncol. 2016;5(1):58–63. https://doi.org/10.1089/jayao.2015.0040.

    Article  PubMed  Google Scholar 

  15. Campo-Engelstein L. Consistency in insurance coverage for iatrogenic conditions resulting from cancer treatment including fertility preservation. J Clin Oncol. 2010;28(8):1284–6. https://doi.org/10.1200/JCO.2009.25.6883.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Cardozo ER, Huber WJ, Stuckey AR, Alvero RJ. Mandating coverage for fertility preservation – a step in the right direction. N Engl J Med. 2017;377(17):1607–9. https://doi.org/10.1056/NEJMp1709585.

    Article  PubMed  Google Scholar 

  17. Caserta D, Ralli E, Matteucci E, Marci R, Moscarini M. Fertility preservation in female cancer patients: an emerging challenge for physicians. Panminerva Med. 2014;56(1):85–95.

    CAS  PubMed  Google Scholar 

  18. Chemaitilly W, Li Z, Krasin MJ, Brooke RJ, Wilson CL, Green DM, Klosky JL, Barnes N, Clark KL, Farr JB, Fernandez-Pineda I, Bishop MW, Metzger M, Pui CH, Kaste SC, Ness KK, Srivastava DK, Robison LL, Hudson MM, Yasui Y, Sklar CA. Premature ovarian insufficiency in childhood cancer survivors: a report from the St. Jude Lifetime Cohort. J Clin Endocrinol Metab. 2017;102(7):2242–50. https://doi.org/10.1210/jc.2016-3723.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Chemaitilly W, Mertens AC, Mitby P, Whitton J, Stovall M, Yasui Y, Robison LL, Sklar CA. Acute ovarian failure in the childhood cancer survivor study. J Clin Endocrinol Metab. 2006;91(5):1723–8. https://doi.org/10.1210/jc.2006-0020.

    Article  CAS  PubMed  Google Scholar 

  20. Crowne E, Gleeson H, Benghiat H, Sanghera P, Toogood A. Effect of cancer treatment on hypothalamic-pituitary function. Lancet Diabetes Endocrinol. 2015;3(7):568–76. https://doi.org/10.1016/S2213-8587(15)00008-X.

    Article  CAS  PubMed  Google Scholar 

  21. De Vos M, Smitz J, Woodruff TK. Fertility preservation in women with cancer. Lancet. 2014;384(9950):1302–10. https://doi.org/10.1016/S0140-6736(14)60834-5.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Demeestere I, Simon P, Dedeken L, Moffa F, Tsepelidis S, Brachet C, Delbaere A, Devreker F, Ferster A. Live birth after autograft of ovarian tissue cryopreserved during childhood. Hum Reprod. 2015;30(9):2107–9. https://doi.org/10.1093/humrep/dev128.

    Article  PubMed  Google Scholar 

  23. Dolmans MM, Marinescu C, Saussoy P, Van Langendonckt A, Amorim C, Donnez J. Reimplantation of cryopreserved ovarian tissue from patients with acute lymphoblastic leukemia is potentially unsafe. Blood. 2010;116(16):2908–14. https://doi.org/10.1182/blood-2010-01-265751.

    Article  CAS  PubMed  Google Scholar 

  24. Ginsberg JP. New advances in fertility preservation for pediatric cancer patients. Curr Opin Pediatr. 2011;23(1):9–13. https://doi.org/10.1097/MOP.0b013e3283420fb6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Goedeke S, Daniels K, Thorpe M, Du Preez E. Building extended families through embryo donation: the experiences of donors and recipients. Hum Reprod. 2015;30(10):2340–50. https://doi.org/10.1093/humrep/dev189.

    Article  CAS  PubMed  Google Scholar 

  26. Gomez-Hidalgo NR, Darin MC, Dalton H, Jhingran A, Fleming N, Brown J, Ramirez PT. Ovarian torsion after laparoscopic ovarian transposition in patients with gynecologic cancer: a report of two cases. J Minim Invasive Gynecol. 2015;22(4):687–90. https://doi.org/10.1016/j.jmig.2015.02.009.

    Article  PubMed  Google Scholar 

  27. Gracia CR, Chang J, Kondapalli L, Prewitt M, Carlson CA, Mattei P, Jeffers S, Ginsberg JP. Ovarian tissue cryopreservation for fertility preservation in cancer patients: successful establishment and feasibility of a multidisciplinary collaboration. J Assist Reprod Genet. 2012;29(6):495–502. https://doi.org/10.1007/s10815-012-9753-7.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Greze V, Brugnon F, Chambon F, Halle P, Canis M, Amiot C, Gremeau AS, Pereira B, Yanez Peralta Y, Tchirkov A, Kanold J. Highly sensitive assessment of neuroblastoma minimal residual disease in ovarian tissue using RT-qPCR-A strategy for improving the safety of fertility restoration. Pediatr Blood Cancer. 2017;64(5). https://doi.org/10.1002/pbc.26287.

  29. Hirshfeld-Cytron J, Grobman WA, Milad MP. Fertility preservation for social indications: a cost-based decision analysis. Fertil Steril. 2012;97(3):665–70. https://doi.org/10.1016/j.fertnstert.2011.12.029.

    Article  PubMed  Google Scholar 

  30. Irtan S, Orbach D, Helfre S, Sarnacki S. Ovarian transposition in prepubescent and adolescent girls with cancer. Lancet Oncol. 2013;14(13):e601–8. https://doi.org/10.1016/S1470-2045(13)70288-2.

    Article  PubMed  Google Scholar 

  31. Jensen AK, Rechnitzer C, Macklon KT, Ifversen MR, Birkebaek N, Clausen N, Sorensen K, Fedder J, Ernst E, Andersen CY. Cryopreservation of ovarian tissue for fertility preservation in a large cohort of young girls: focus on pubertal development. Hum Reprod. 2017;32(1):154–64. https://doi.org/10.1093/humrep/dew273.

    Article  CAS  PubMed  Google Scholar 

  32. Jeruss JS, Woodruff TK. Preservation of fertility in patients with cancer. N Engl J Med. 2009;360(9):902–11. https://doi.org/10.1056/NEJMra0801454.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Keskin U, Ercan CM, Yilmaz A, Babacan A, Korkmaz C, Duru NK, Ergun A. Random-start controlled ovarian hyperstimulation with letrozole for fertility preservation in cancer patients: case series and review of literature. J Pak Med Assoc. 2014;64(7):830–2.

    PubMed  Google Scholar 

  34. Kim J, Kim KH, Mersereau JE. Building a successful fertility preservation program at a major cancer center. J Gynecol Oncol. 2014;25(2):148–54. https://doi.org/10.3802/jgo.2014.25.2.148.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Kohler TS, Kondapalli LA, Shah A, Chan S, Woodruff TK, Brannigan RE. Results from the survey for preservation of adolescent reproduction (SPARE) study: gender disparity in delivery of fertility preservation message to adolescents with cancer. J Assist Reprod Genet. 2011;28(3):269–77. https://doi.org/10.1007/s10815-010-9504-6.

    Article  PubMed  Google Scholar 

  36. Laronda MM, Rutz AL, Xiao S, Whelan KA, Duncan FE, Roth EW, Woodruff TK, Shah RN. A bioprosthetic ovary created using 3D printed microporous scaffolds restores ovarian function in sterilized mice. Nat Commun. 2017;8:15261. https://doi.org/10.1038/ncomms15261.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Levine JM, Kelvin JF, Quinn GP, Gracia CR. Infertility in reproductive-age female cancer survivors. Cancer. 2015;121(10):1532–9. https://doi.org/10.1002/cncr.29181.

    Article  PubMed  Google Scholar 

  38. Levine JM, Whitton JA, Ginsberg JP, Green DM, Leisenring WM, Stovall M, Robison LL, Armstrong GT, Sklar CA. Nonsurgical premature menopause and reproductive implications in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Cancer. 2018;124(5):1044–52. https://doi.org/10.1002/cncr.31121.

    Article  PubMed  Google Scholar 

  39. Loren AW, Mangu PB, Beck LN, Brennan L, Magdalinski AJ, Partridge AH, Quinn G, Wallace WH, Oktay K, American Society of Clinical O. Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31(19):2500–10. https://doi.org/10.1200/JCO.2013.49.2678.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Massarotti C, Scaruffi P, Lambertini M, Remorgida V, Del Mastro L, Anserini P. State of the art on oocyte cryopreservation in female cancer patients: a critical review of the literature. Cancer Treat Rev. 2017;57:50–7. https://doi.org/10.1016/j.ctrv.2017.04.009.

    Article  PubMed  Google Scholar 

  41. Metzger ML, Meacham LR, Patterson B, Casillas JS, Constine LS, Hijiya N, Kenney LB, Leonard M, Lockart BA, Likes W, Green DM. Female reproductive health after childhood, adolescent, and young adult cancers: guidelines for the assessment and management of female reproductive complications. J Clin Oncol. 2013;31(9):1239–47. https://doi.org/10.1200/JCO.2012.43.5511.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Moore HC, Unger JM, Phillips KA, Boyle F, Hitre E, Porter D, Francis PA, Goldstein LJ, Gomez HL, Vallejos CS, Partridge AH, Dakhil SR, Garcia AA, Gralow J, Lombard JM, Forbes JF, Martino S, Barlow WE, Fabian CJ, Minasian L, Meyskens FL Jr, Gelber RD, Hortobagyi GN, Albain KS, Investigators PS. Goserelin for ovarian protection during breast-cancer adjuvant chemotherapy. N Engl J Med. 2015;372(10):923–32. https://doi.org/10.1056/NEJMoa1413204.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Noyes N, Knopman JM, Long K, Coletta JM, Abu-Rustum NR. Fertility considerations in the management of gynecologic malignancies. Gynecol Oncol. 2011a;120(3):326–33. https://doi.org/10.1016/j.ygyno.2010.09.012.

    Article  PubMed  Google Scholar 

  44. Noyes N, Knopman JM, Melzer K, Fino ME, Friedman B, Westphal LM. Oocyte cryopreservation as a fertility preservation measure for cancer patients. Reprod Biomed Online. 2011b;23(3):323–33. https://doi.org/10.1016/j.rbmo.2010.11.011.

    Article  CAS  PubMed  Google Scholar 

  45. Peccatori FA, Azim HA Jr, Orecchia R, Hoekstra HJ, Pavlidis N, Kesic V, Pentheroudakis G, Group EGW. Cancer, pregnancy and fertility: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24(Suppl 6):vi160–70. https://doi.org/10.1093/annonc/mdt199.

    Article  PubMed  Google Scholar 

  46. Pereira N, Voskuilen-Gonzalez A, Hancock K, Lekovich JP, Schattman GL, Rosenwaks Z. Random-start ovarian stimulation in women desiring elective cryopreservation of oocytes. Reprod Biomed Online. 2017;35(4):400–6. https://doi.org/10.1016/j.rbmo.2017.06.002.

    Article  PubMed  Google Scholar 

  47. Practice Committee of American Society for Reproductive M. Ovarian hyperstimulation syndrome. Fertil Steril. 2008;90(5 Suppl):S188–93. https://doi.org/10.1016/j.fertnstert.2008.08.034.

    Article  Google Scholar 

  48. Practice Committee of American Society for Reproductive M. Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion. Fertil Steril. 2013;100(5):1214–23. https://doi.org/10.1016/j.fertnstert.2013.08.012.

    Article  Google Scholar 

  49. Practice Committee of the American Society for Reproductive M. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil Steril. 2015;103(3):e9–17. https://doi.org/10.1016/j.fertnstert.2014.12.093.

    Article  Google Scholar 

  50. Practice Committees of American Society for Reproductive M, Society for Assisted Reproductive T. Mature oocyte cryopreservation: a guideline. Fertil Steril. 2013;99(1):37–43. https://doi.org/10.1016/j.fertnstert.2012.09.028.

    Article  Google Scholar 

  51. Quinn GP, Block RG, Clayman ML, Kelvin J, Arvey SR, Lee JH, Reinecke J, Sehovic I, Jacobsen PB, Reed D, Gonzalez L, Vadaparampil ST, Laronga C, Lee MC, Pow-Sang J, Eggly S, Franklin A, Shah B, Fulp WJ, Hayes-Lattin B. If you did not document it, it did not happen: rates of documentation of discussion of infertility risk in adolescent and young adult oncology patients’ medical records. J Oncol Pract. 2015a;11(2):137–44. https://doi.org/10.1200/JOP.2014.000786.

    Article  PubMed  Google Scholar 

  52. Quinn GP, Vadaparampil ST, King L, Miree CA, Wilson C, Raj O, Watson J, Lopez A, Albrecht TL. Impact of physicians’ personal discomfort and patient prognosis on discussion of fertility preservation with young cancer patients. Patient Educ Couns. 2009a;77(3):338–43. https://doi.org/10.1016/j.pec.2009.09.007.

    Article  PubMed  Google Scholar 

  53. Quinn GP, Vadaparampil ST, Lee JH, Jacobsen PB, Bepler G, Lancaster J, Keefe DL, Albrecht TL. Physician referral for fertility preservation in oncology patients: a national study of practice behaviors. J Clin Oncol. 2009b;27(35):5952–7. https://doi.org/10.1200/JCO.2009.23.0250.

    Article  PubMed  Google Scholar 

  54. Quinn GP, Zebrack BJ, Sehovic I, Bowman ML, Vadaparampil ST. Adoption and cancer survivors: findings from a learning activity for oncology nurses. Cancer. 2015b;121(17):2993–3000. https://doi.org/10.1002/cncr.29322.

    Article  PubMed  Google Scholar 

  55. Reinecke JD, Kelvin JF, Arvey SR, Quinn GP, Levine J, Beck LN, Miller A. Implementing a systematic approach to meeting patients’ cancer and fertility needs: a review of the Fertile Hope Centers of Excellence program. J Oncol Pract. 2012;8(5):303–8. https://doi.org/10.1200/JOP.2011.000452.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Schover LR. Psychosocial aspects of infertility and decisions about reproduction in young cancer survivors: a review. Med Pediatr Oncol. 1999;33(1):53–9.

    Article  CAS  PubMed  Google Scholar 

  57. Shapira M, Raanani H, Barshack I, Amariglio N, Derech-Haim S, Marciano MN, Schiff E, Orvieto R, Meirow D. First delivery in a leukemia survivor after transplantation of cryopreserved ovarian tissue, evaluated for leukemia cells contamination. Fertil Steril. 2018;109(1):48–53. https://doi.org/10.1016/j.fertnstert.2017.09.001.

    Article  PubMed  Google Scholar 

  58. Shea LD, Woodruff TK, Shikanov A. Bioengineering the ovarian follicle microenvironment. Annu Rev Biomed Eng. 2014;16:29–52. https://doi.org/10.1146/annurev-bioeng-071813-105131.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Shnorhavorian M, Harlan LC, Smith AW, Keegan TH, Lynch CF, Prasad PK, Cress RD, Wu XC, Hamilton AS, Parsons HM, Keel G, Charlesworth SE, Schwartz SM, Group AHSC. Fertility preservation knowledge, counseling, and actions among adolescent and young adult patients with cancer: a population-based study. Cancer. 2015;121(19):3499–506. https://doi.org/10.1002/cncr.29328.

    Article  PubMed  Google Scholar 

  60. Smitz J, Dolmans MM, Donnez J, Fortune JE, Hovatta O, Jewgenow K, Picton HM, Plancha C, Shea LD, Stouffer RL, Telfer EE, Woodruff TK, Zelinski MB. Current achievements and future research directions in ovarian tissue culture, in vitro follicle development and transplantation: implications for fertility preservation. Hum Reprod Updat. 2010;16(4):395–414. https://doi.org/10.1093/humupd/dmp056.

    Article  CAS  Google Scholar 

  61. Sonmezer M, Turkcuoglu I, Coskun U, Oktay K. Random-start controlled ovarian hyperstimulation for emergency fertility preservation in letrozole cycles. Fertil Steril. 2011;95(6):2125 e2129–11. https://doi.org/10.1016/j.fertnstert.2011.01.030.

    Article  CAS  Google Scholar 

  62. Stegmann BJ. Unique ethical and legal implications of fertility preservation research in the pediatric population. Fertil Steril. 2010;93(4):1037–9. https://doi.org/10.1016/j.fertnstert.2009.11.047.

    Article  PubMed  Google Scholar 

  63. Telfer EE, Zelinski MB. Ovarian follicle culture: advances and challenges for human and nonhuman primates. Fertil Steril. 2013;99(6):1523–33. https://doi.org/10.1016/j.fertnstert.2013.03.043.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Terenziani M, Piva L, Meazza C, Gandola L, Cefalo G, Merola M. Oophoropexy: a relevant role in preservation of ovarian function after pelvic irradiation. Fertil Steril. 2009;91(3):935 e915–36. https://doi.org/10.1016/j.fertnstert.2008.09.029.

    Article  Google Scholar 

  65. Wallace WH, Kelsey TW, Anderson RA. Fertility preservation in pre-pubertal girls with cancer: the role of ovarian tissue cryopreservation. Fertil Steril. 2016;105(1):6–12. https://doi.org/10.1016/j.fertnstert.2015.11.041.

    Article  PubMed  Google Scholar 

  66. Walter JR, Xu S, Woodruff TK. A call for fertility preservation coverage for breast cancer patients: the cost of consistency. J Natl Cancer Inst. 2017;109(5). https://doi.org/10.1093/jnci/djx006.

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Author information

Authors and Affiliations

  1. Pediatric Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Michael Kinnaman

  2. Pediatric Hematology/Oncology/Stem Cell Transplantation, Columbia University Medical Center, New York, NY, USA

    Kathleen Shea

  3. Pediatric Hematology and Oncology, Weill Cornell Medicine, New York, NY, USA

    Jennifer Levine

Authors
  1. Michael Kinnaman
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  2. Kathleen Shea
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  3. Jennifer Levine
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Corresponding author

Correspondence to Jennifer Levine .

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynecology, Northwestern University , Chicago, IL, USA

    Teresa K. Woodruff

  2. Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA

    Divya K. Shah

  3. Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA

    Wendy S. Vitek

Review Questions and Answers

Review Questions and Answers

  1. Q1.

    You have just diagnosed a 5-year-old girl with a rhabdomyosarcoma of the pelvis. Her treatment includes multiagent chemotherapy including cyclophosphamide and radiation to the tumor site. Which of the following would be an appropriate fertility preservation option for this patient?

    1. (a)

      Embryo cryopreservation

    2. (b)

      Ovarian tissue cryopreservation

    3. (c)

      Use of GnRH agonist in conjunction with therapy

    4. (d)

      Oocyte cryopreservation

  1. A1.

    (b). Ovarian tissue cryopreservation is the only option available to prepubertal females.

  2. Q2.

    A 16-year-old female who has just been diagnosed with nonmetastatic Ewing’s sarcoma wishes to pursue oocyte cryopreservation. Her oncologist has agreed to a 3-week window to start therapy. Her last menstrual cycle started 10 days ago. Because the patient is mid-cycle, she cannot complete oocyte cryopreservation in the desired timeframe. True/False

  3. A2.

    False. Ovarian hyperstimulation can utilize a random start protocol which, if the systems are in place to facilitate a rapid referral, should allow for stimulation and recovery of oocytes within the time frame outlined above.

  1. Q3.

    An 18-year-old female survivor of Hodgkin lymphoma, off therapy for 5 years, is being seen in long-term follow-up. She was treated with four cycles of BEACOPP and four cycles of COPP/ABV. Her menstrual cycle resumed 9 months after the completion of therapy and has been regular since then. She did not undergo any fertility preservation procedures prior to the start of therapy. Appropriate interventions at the current clinic visit include:

    1. (a)

      Check FSH, LH, and estradiol

    2. (b)

      Discuss risk of premature menopause

    3. (c)

      Discuss consideration of embryo or oocyte cryopreservation

    4. (d)

      All of the above

  1. A3.

    (d) Female survivors who are treated with alkylating agents, particularly procarbazine, are at increased risk of developing premature menopause and should be monitored by checking reproductive hormones. They should also have a discussion about options for family building including consideration of embryo or oocyte cryopreservation.

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Kinnaman, M., Shea, K., Levine, J. (2019). Fertility Preservation Options for Female Pediatric and Adolescent Oncology Patients. In: Woodruff, T., Shah, D., Vitek, W. (eds) Textbook of Oncofertility Research and Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-02868-8_9

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