Abstract
Purpose
Diminished reproductive capacity is a devastating consequence of life-sparing therapies for childhood malignancy. In 2006, the American Society of Clinical Oncology (ASCO) published fertility preservation recommendations (ASCOR) emphasizing the importance of early discussion and intervention for fertility preservation strategies. Using the Survey for Preservation of Adolescent REproduction (SPARE), we sought to determine fertility preservation attitudes and practice patterns post-ASCOR from pediatric oncology specialists nationwide.
Materials and methods
The SPARE survey consists of 22 questions assessing pediatric oncology specialists’ attitudes and practice patterns toward fertility preservation. Broad perspectives on fertility preservation, including a willingness to discuss fertility, knowledge of current fertility preservation methods and awareness of ASCOR, were assessed.
Results
The majority of respondents acknowledged that fertility threats are a major concern for them and agreed that all pubertal cancer patients should be offered a fertility consultation, but only 46% reported they refer male pubertal cancer patients to a fertility specialist prior to cancer treatment >50% of the time, and only 12% reported they refer female pubertal cancer patients to a fertility specialist prior to cancer treatment > 50% of the time. While 44% of respondents were familiar with the 2006 ASCOR, only 39% of those utilized them to guide decision-making in greater than half of their patients.
Conclusion
Our study demonstrates pediatric oncologists’ motivation to preserve fertility in pediatric cancer patients; however, barriers to both gamete cryopreservation and referral to fertility specialists persist. Female pubertal patients are referred to fertility preservation specialists with much less frequency than are male pubertal patients, highlighting a disparity.
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Capsule
The SPARE survey captured marked disparities between pediatric oncologists’ attitudes and practice patterns regarding fertility preservation for male and female pediatric oncology patients.
Statement of Financial Support
This research was supported by the Oncofertility Consortium NIH 1 UL1 RR024926-01 as part of the NIH Roadmap Interdisciplinary Research Consortia and the NIH/NRSA Reproductive Biology Training Grant T32 HD07068.
The Authors have no financial disclosures to report.
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Köhler, T.S., Kondapalli, L.A., Shah, A. et al. 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 28, 269–277 (2011). https://doi.org/10.1007/s10815-010-9504-6
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DOI: https://doi.org/10.1007/s10815-010-9504-6