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Infrastructure of Fertility Preservation Services for Pediatric Cancer Patients: A Report From the Children's

Natasha N Frederick1,2, James L Klosky3,4, Lillian R Meacham3,4

  • 1Center for Cancer and Blood Disorders, Connecticut Children's Medical Center, Hartford, CT.

JCO Oncology Practice
|October 28, 2021
PubMed

Insights

Fertility preservation services for pediatric cancer patients are limited, with many institutions lacking comprehensive options and facing significant barriers. Improving infrastructure is crucial for enhancing patient access to these vital reproductive health services.

Area of Science:

  • Oncology
  • Reproductive Medicine
  • Pediatric Healthcare

Background:

  • Fertility preservation (FP) is integral to comprehensive cancer care for pediatric patients.
  • The availability and scope of FP services for children and adolescents with cancer remain largely uncharacterized.

Purpose of the Study:

  • To assess the current capacity and infrastructure of fertility preservation services within pediatric oncology settings.
  • To identify barriers hindering the provision of comprehensive FP services to pediatric cancer patients.

Main Methods:

  • A cross-sectional survey was distributed to 220 Children's Oncology Group institutions.
  • Data collected included institutional characteristics, FP service offerings, and perceived barriers.
  • Multivariable logistic regression analyzed associations between site factors and FP service availability.

Main Results:

  • Of 144 responding institutions, only 36.8% had dedicated FP personnel.
  • While sperm banking was widely available (97.8%), cryopreservation of testicular, ovarian, or embryo/oocyte tissues was less common (27.0%-67.9%).
  • Barriers included cost (70.9%), inadequate training (60.7%), and staffing shortages (45.5%).

Conclusions:

  • Current fertility preservation infrastructure for pediatric cancer patients is inadequate for offering comprehensive services.
  • Dedicated FP personnel significantly correlate with the availability of advanced FP techniques.
  • Addressing identified barriers is essential to improve patient access to fertility preservation.
Abstract

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