METHODS: As an extrapolation for oncofertility best practice models in optimum resource settings, we surveyed 25 leading and well-resourced oncofertility centers and institutions from the USA, Europe, Australia, and Japan. The survey included questions on the availability and degree of utilization of fertility preservation options in case of childhood cancer, breast cancer, and blood cancer.
RESULTS: All surveyed centers responded to all questions. Responses and their calculated oncofertility scores showed three major characteristics of oncofertility practice in optimum resource settings: (1) strong utilization of sperm freezing, egg freezing, embryo freezing, ovarian tissue freezing, gonadal shielding, and fractionation of chemo- and radiotherapy; (2) promising utilization of GnRH analogs, oophoropexy, testicular tissue freezing, and oocyte in vitro maturation (IVM); and (3) rare utilization of neoadjuvant cytoprotective pharmacotherapy, artificial ovary, in vitro spermatogenesis, and stem cell reproductive technology as they are still in preclinical or early clinical research settings. Proper technical and ethical concerns should be considered when offering advanced and experimental oncofertility options to patients.
CONCLUSIONS: Our Repro-Can-OPEN Study Part 2 proposed installing specific oncofertility programs for common cancers in optimum resource settings as an extrapolation for best practice models. This will provide efficient oncofertility edification and modeling to oncofertility teams and related healthcare providers around the globe and help them offer the best care possible to their patients.
方法:作为最佳资源设置中的生育最佳实践模型的外推,我们调查了来自美国的25个领先且资源丰富的生育中心和机构,欧洲,澳大利亚,和日本。该调查包括有关儿童癌症情况下生育能力保留选项的可用性和利用程度的问题,乳腺癌,还有血癌.
结果:所有接受调查的中心都回答了所有问题。反应和他们计算的生育分数显示了在最佳资源环境中生育实践的三个主要特征:(1)精子冷冻的强烈利用,鸡蛋冷冻,胚胎冷冻,卵巢组织冷冻,性腺屏蔽,和化疗和放疗的分割;(2)GnRH类似物的有希望的利用,oophoroopexy,睾丸组织冷冻,和卵母细胞体外成熟(IVM);(3)罕见地利用新辅助细胞保护药物治疗,人工卵巢,体外精子发生,和干细胞生殖技术,因为它们仍处于临床前或早期临床研究环境中。在为患者提供高级和实验性的生育选择时,应考虑适当的技术和道德问题。
结论:我们的Repro-Can-OPEN研究第2部分建议在最佳资源环境中为常见癌症安装特定的肿瘤生育计划,作为最佳实践模型的外推。这将为全球各地的生育团队和相关医疗保健提供者提供有效的生育教育和建模,并帮助他们为患者提供最佳护理。