Timing Is Everything! Fertility Preservation Process From Patient Cancer Diagnosis Through Ovarian Tissue Cryopreservation to the Start of Treatment

Abstract

Children diagnosed with cancer today can expect a greater than 80% chance of 5-year survival. Childhood cancer survivors are significantly more likely to be infertile or have difficulty getting pregnant than their siblings. Studies have shown that infertility is one of the primary concerns of cancer survivors. Fertility preservation (FP) completed before treatment starts gives the patient the best fertility potential for a biological child in the future. Infertility is a significant risk factor for those treated with gonadotoxic therapy for cancer in childhood or adolescence. Infertility risk counseling and FP procedures may have the greatest success of fertility and hormone restoration if performed before the initiation of gonadotoxic therapy.

A single-institution retrospective chart review was completed of patients enrolled in an institutional-review-board-approved ovarian tissue cryopreservation protocol from 2011 to 2019. Data collected include demographics and the timing of various stages of the FP process. One hundred five patients were included in this chart review (58 prepubertal and 47 postpubertal).

Most consult requests were from the solid tumor diagnosis group. The time from diagnosis to consultation was 18 days, the time from consult to ovarian tissue cryopreservation surgery was 7 days, and the time from surgery to treatment was 5 days. Further investigation of time to consult revealed timing was justified in most patient situations.

Workflow, education, and outreach were established. Future analyses will include defining the incidents and efficiencies in providing fertility and hormone consultations in female and male patients who do not undergo FP procedures.