Abstract：
BACKGROUND: Treatment for certain childhood cancers and nonmalignant conditions can lead to future infertility and gonadal failure. The risk of treatment delay must be considered when offering fertility preservation (FP) options. We examined the timeline from FP referral to return to treatment (RTT) in pediatric patients who underwent FP due to iatrogenic risk for infertility.
METHODS: A retrospective review was performed of patients with FP consultation due to an increased risk of iatrogenic infertility at Ann & Robert H. Lurie Children\'s Hospital of Chicago from 2018 to 2022. Data on diagnosis, age, treatment characteristics, and procedure were collected.
RESULTS: A total of 337 patients (n = 149 with ovaries, n = 188 with testes) had an FP consultation. Of patients with ovaries, 106 (71.1%) underwent ovarian tissue cryopreservation (OTC), 10 (6.7%) completed ovarian stimulation/egg retrieval (OSER), and 33 (22.1%) declined FP. Of the patients with testes, 98 (52.1%) underwent testicular tissue cryopreservation (TTC), 48 (25.5%) completed sperm banking (SB), and 42 (22.3%) declined FP. Median time from referral to FP consultation was short (ovaries: 2 days, range: 0-6; testes: 1 day, range: 0-5). OSER had a significantly longer RTT versus OTC and no FP (52.5 vs.19.5 vs. 12 days, p = .01). SB had a significantly quicker RTT compared to TTC or no FP (9.0 vs. 21.0 vs. 13.5 days; p = .008). For patients who underwent OTC/TTC and those who declined FP, there was no significant difference in time from consultation to treatment.
CONCLUSIONS: It is feasible to promptly offer and complete FP with minimal delay to disease-directed treatment.
METHODS: A retrospective review was performed of patients with FP consultation due to an increased risk of iatrogenic infertility at Ann & Robert H. Lurie Children\'s Hospital of Chicago from 2018 to 2022. Data on diagnosis, age, treatment characteristics, and procedure were collected.
RESULTS: A total of 337 patients (n = 149 with ovaries, n = 188 with testes) had an FP consultation. Of patients with ovaries, 106 (71.1%) underwent ovarian tissue cryopreservation (OTC), 10 (6.7%) completed ovarian stimulation/egg retrieval (OSER), and 33 (22.1%) declined FP. Of the patients with testes, 98 (52.1%) underwent testicular tissue cryopreservation (TTC), 48 (25.5%) completed sperm banking (SB), and 42 (22.3%) declined FP. Median time from referral to FP consultation was short (ovaries: 2 days, range: 0-6; testes: 1 day, range: 0-5). OSER had a significantly longer RTT versus OTC and no FP (52.5 vs.19.5 vs. 12 days, p = .01). SB had a significantly quicker RTT compared to TTC or no FP (9.0 vs. 21.0 vs. 13.5 days; p = .008). For patients who underwent OTC/TTC and those who declined FP, there was no significant difference in time from consultation to treatment.
CONCLUSIONS: It is feasible to promptly offer and complete FP with minimal delay to disease-directed treatment.
摘要：
背景：某些儿童癌症和非恶性疾病的治疗可导致未来的不孕症和性腺衰竭。在提供保留生育力（FP）选项时，必须考虑治疗延迟的风险。我们检查了由于医源性不孕风险而接受FP的儿科患者从FP转诊到返回治疗（RTT）的时间表。
方法：对2018年至2022年在芝加哥Ann&RobertH.Lurie儿童医院因医源性不孕症风险增加而进行FP咨询的患者进行了回顾性研究。诊断数据，年龄,治疗特点,和程序被收集。
结果：共337例患者（n=149例卵巢，n=188，有睾丸）进行了FP咨询。卵巢患者，106例（71.1%）卵巢组织冷冻保存（OTC），10（6.7％）完成卵巢刺激/取卵（OSER），33人（22.1%）下降FP。在有睾丸的患者中，98例（52.1%）接受了睾丸组织冷冻保存（TTC），48（25.5%）完成精子银行（SB），42人（22.3%）下降FP。从转诊到FP会诊的中位时间很短(卵巢：2天，范围：0-6；睾丸：1天，范围：0-5）。与OTC相比，OSER的RTT明显更长，并且没有FP（52.5vs.19.5vs.12天,p=.01）。与TTC或无FP相比，SB的RTT明显更快（9.0vs.21.0vs.13.5天；p=.008）。对于接受OTC/TTC和拒绝FP的患者，从咨询到治疗的时间没有显着差异。
结论：及时提供并完成FP是可行的，而对疾病定向治疗的延迟最小。
方法：对2018年至2022年在芝加哥Ann&RobertH.Lurie儿童医院因医源性不孕症风险增加而进行FP咨询的患者进行了回顾性研究。诊断数据，年龄,治疗特点,和程序被收集。
结果：共337例患者（n=149例卵巢，n=188，有睾丸）进行了FP咨询。卵巢患者，106例（71.1%）卵巢组织冷冻保存（OTC），10（6.7％）完成卵巢刺激/取卵（OSER），33人（22.1%）下降FP。在有睾丸的患者中，98例（52.1%）接受了睾丸组织冷冻保存（TTC），48（25.5%）完成精子银行（SB），42人（22.3%）下降FP。从转诊到FP会诊的中位时间很短(卵巢：2天，范围：0-6；睾丸：1天，范围：0-5）。与OTC相比，OSER的RTT明显更长，并且没有FP（52.5vs.19.5vs.12天,p=.01）。与TTC或无FP相比，SB的RTT明显更快（9.0vs.21.0vs.13.5天；p=.008）。对于接受OTC/TTC和拒绝FP的患者，从咨询到治疗的时间没有显着差异。
结论：及时提供并完成FP是可行的，而对疾病定向治疗的延迟最小。
