A Standardized Approach to Fertility Preservation Discussions

Pediatric oncology and bone marrow transplant patients are experiencing increased long-term survival, which has created a need to consider late-term effects of certain treatments—including fertility. A study presented during the 2021 ASCO Annual Meeting reviewed one institution’s program to streamline discussions surrounding fertility preservation options.

The researchers retrospectively collected records from 474 pediatric patients with new oncologic diagnosis at Children’s Mercy Hospital in Kansas City, MO, between 2014 and 2020, assessing how often reproductive health discussions were documented among pubertal males and females who required chemotherapy or radiation treatment. A standard fertility preservation note and patient handouts were implemented, and a survey was conducted to determine which diagnoses most significantly increased infertility risks, as well as what challenges hindered formalized fertility discussions. Results from the current study period were compared to those of a previous chart review, conducted between 2010 and 2013.

Among the patients diagnosed during the study period, 175 met the inclusion criteria, including 90 females and 80 males. In the female group, 61 patients (67.8%) received a fertility discussion; of these patients, eight (8.9%) completed oocyte or gonadal tissue preservation. In the male group, 52 patients (61.2%) received a fertility discussion, and 20 (23.5%) completed sperm cryopreservation. All of the female fertility discussions took place between 2017 and 2020, while among the males, discussions were evenly distributed throughout the whole study period. After an electronic fertility consult process and standardized fertility preservation documentation were implemented at the institution, documented fertility discussions significantly increased from the start of the study period (2014, 30%) to the end of the study period (2020, 63.6%).