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Development of a new reproductive tissue cryopreservation clinical service for children: the Oxford programme
K Lakhoo1,2, J Davies3, S Chakraborty4
1Department of Paediatric Surgery, University of Oxford and Oxford University Hospitals, Oxford, UK. Kokila.lakhoo@nds.ox.ac.uk.
Insights
A new fertility preservation service was developed for children at risk of infertility. This reproductive tissue cryopreservation program offers safe and effective treatment, prioritizing patient proximity to home.
Area of Science:
- Reproductive medicine
- Oncology
- Paediatric healthcare
Background:
- Children undergoing cancer treatment face risks of infertility.
- The NHS sought to establish fertility preservation services amidst financial constraints.
Purpose of the Study:
- To describe the development of a reproductive tissue cryopreservation service for children at high risk of infertility.
- To outline the phased implementation within the NHS.
Main Methods:
- A two-phase development plan was implemented.
- Phase 1 focused on childhood cancer patients at a specific treatment center.
- Phase 2 expanded the service across England, Wales, and Ireland, addressing resource challenges and patient accessibility.
Main Results:
- Developed comprehensive information resources, eligibility criteria, and referral pathways.
- Established multidisciplinary teams and a network of third-party sites.
- Secured a dedicated theatre list and implemented a case management database, receiving positive patient feedback.
Conclusions:
- The Oxford Reproductive Cryopreservation programme successfully provides fertility preservation to pediatric and young adult patients.
- The program operates safely, effectively, and with a focus on patient convenience.
- Future plans include seeking national funding for program sustainability and recognition.
Purpose:
This article describes the development of a new reproductive tissue cryopreservation clinical service for children at high risk of infertility in the NHS during times of severe financial constraints in the health service.
Method:
A development plan with two phases was drawn up. Phase 1 restricted the service to childhood cancer patients referred to the Oxford Paediatric Oncology and Haematology Principle Treatment Centre. It was estimated that there would be 10 patients/year and used existing staff and facilities from paediatric oncology, surgery, anaesthetics radiology, pathology, psychology, teenage-young adult gynaecology, and an existing Human Tissue Authority tissue bank with a licence for storage of tissue under a Human Sector Licence. Phase 2 extended the service to include children and young adults across England, Wales and Ireland-patients from Scotland having access to a research programme in Edinburgh. The main challenge in phase 2 being resources and the need for patients to be able to be treated as close to home as safely as possible.
Results:
The Oxford team developed information resources and eligibility criteria based on published best practice, referral and treatment pathways, multidisciplinary team meetings, a network of third party sites, and a dedicated case management and database. As the programme expanded, the Oxford team was able to justify to management the need for a dedicated theatre list. Patient feedback through questionnaires, qualitative work conducted as part of a Ph.D. thesis as well as direct patient stories and interviews in TV, and radio features underpins the positive impact the programme has on patients and their families.
Conclusion:
The Oxford Reproductive Cryopreservation programme delivers fertility preservation treatment to children and young adults at high risk of infertility safely, effectively and as close to home as possible. The onward view is to apply for national funding for this programme for recognition and sustainability.
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