Developing clinical practice guidelines in paediatric and adolescent oncofertility

Area of Science:

• Oncofertility
• Reproductive medicine
• Oncology

Background:

• International oncofertility guidelines recommend fertility discussions and preservation for child, adolescent, and young adult (CAYA) cancer patients.
• Significant global disparities exist in implementing these recommendations, hindering equitable care.
• Unclear distinctions between experimental and established fertility preservation techniques create barriers for patients, clinicians, and policymakers.

Purpose of the Study:

• To provide an overview of CAYA oncofertility guidance from six peak bodies across four continents.
• To identify similarities and differences among key international guidelines to address local knowledge gaps.
• To determine stakeholder priorities for developing national guidelines in Australia and New Zealand.

Main Methods:

• Review of CAYA oncofertility recommendations and evidence levels from international guidelines.
• Delphi consensus among Australian and New Zealand Consortium in CAYA Oncofertility (ANZCO) members.
• Development of priority questions for local guideline development.

Main Results:

• Oncofertility guidance varies significantly across different international bodies.
• A need for localized guidelines was identified to standardize care and improve coordination among centers.
• ANZCHOG guidelines tailored to the local CAYA context were prioritized.

Conclusions:

• Developing context-specific national guidelines is essential for standardizing CAYA oncofertility care.
• Such guidelines will provide clear direction and governance for pediatric cancer care providers.
• Addressing disparities requires a concerted effort in guideline development and implementation.