Incidence of fertility preservation procedures in prepubertal individuals with cancer. Issue 5 (October 2022)

• Record Type: Journal Article
• Authors: Ory, Jesse; Nassau, Daniel; Rodriguez, Carlos Delgado; Sathe, Aditya; Nackeeran, Sirpi; Manda, Pranay; Reddy, Akshay; Romao, Rodrigo LP.; Ramasamy, Ranjith
• Is Part Of: Journal of pediatric urology. Volume 18:Issue 5(2022)
• Page Start: 681.e1
• Page End: 681.e6
• Publication Date: 2022-10
• Subjects: Fertility preservation -- Gonadal biopsy -- Cryopreservation -- Pediatric cancer -- Survivorship; FP fertility preservation -- PHIS pediatric health information systems -- US United States; Pediatric urology -- Periodicals; Urologic Diseases -- Periodicals; Urogenital Diseases -- Periodicals; Urologic Surgical Procedures -- Periodicals; Child; Infant; Urologie pédiatrique -- Périodiques; Appareil urinaire -- Maladies -- Périodiques; Pédiatrie; Urologie; Pediatric urology; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); Electronic journals; Periodicals; Electronic journals; 618.926
• DOI: 10.1016/j.jpurol.2022.09.011
• Languages: English
• ISSNs: 1477-5131

Abstract

Summary: Background: Fertility Preservation (FP) for children and adolescents with cancer is underutilized. In prepubertal individuals, ovarian and testicular tissue can be frozen; however, this is still considered largely experimental. Our objective was to identify trends of FP in prepubertal individuals. Methods: We performed a retrospective study of prepubertal children with cancer identified through the Pediatric Health Information System from 2011 to 2020. Children who underwent a testicular or ovarian biopsy were included. Any patients with testicular or ovarian malignancy, or other diagnoses which may have required a gonadal biopsy were excluded. Results: A total of 418 boys under 13 and 333 girls under 12 who underwent a gonadal biopsy were identified. There was a total of 66, 929 new cancer diagnoses in girls and 86, 001 new cancer diagnoses in boys during this time. The most common cancer diagnosis was hematologic in both boys (50.96%) and girls (36.64%). A concurrent procedure at time of gonadal biopsy was performed in 84% of boys and 62% of girls, with line insertion being the most common. The only predictive variable of receiving a gonadal biopsy was increasing year. Overall, only 0.04% of children had a gonadal biopsy for FP during this time period. Conclusions: Gonadal biopsy rates have increased in prepubertal children with cancer, presumably for FP. While recent international guidelines support FP in this group, our findings highlight the need to establish protocols and tracking for FP procedures in the US. Summary Fig. 1 Incidence of gonadal biopsies per year amongst prepubertal individuals. Summary Fig. 1