Female Fertility Cryopreservation Outcomes in Childhood Cancer | English-language publications | 12 studies | 7 countries | 2004 - 2022 | 612 patients (0-21 yrs old) with malignant disease | Hematological malignancy (81%) | CNS malignant tumors (56%) | Sarcomas (39%) | 501 patients Ovarian tissue cryopreservation (OTC) | 30 patients Ovarian tissue transplantation (OTT) | 27 patients desired pregnancy | 9 patients became pregnant | 6 patients had live births | Conclusion: Long-term research on pediatric OTC and OTT is especially needed in lower-income countries to standardize fertility preservation practices and improve outcomes for patients worldwide. | https://pubmed.ncbi.nlm.nih.gov/38519388/ | Source: Gillipelli SR et. al. | Baylor College of Medicine, Texas Medical Center, Houston, USA | @StayCurrentMD | @EmGootee MD | Cincinnati Children's | Journal of Pediatric Surgery
Female Fertility Cryopreservation Outcomes in Childhood Cancer: A Systematic Review
Infographic · Sep 2024 · 2 min read
In brief
In brief
This systematic review of 612 pediatric cancer patients across 7 countries found that while ovarian tissue cryopreservation is successfully performed, only 5.9% underwent transplantation, with 33% achieving pregnancy and 67% having live births. The study highlights critical gaps in long-term outcome data for prepubertal patients and calls for standardized fertility preservation protocols across all income levels.
- OTC performed in 501 pediatric cancer patients; only 5.9% underwent transplantation, with 33% achieving pregnancy and 67% having live births
- Most common cancers requiring fertility preservation: hematological malignancies (81%), CNS tumors (56%), and sarcomas (39%)
- Long-term outcome data for pediatric OTC is lacking; most studies focus on adult patients in high-income countries
- Standardized fertility preservation guidelines needed for childhood cancer patients across all income levels
- OTC shows promise but requires longitudinal studies to establish efficacy in prepubertal and pediatric populations
Written by the GCMD Library team from the infographic.
A teal and yellow infographic with a flow-chart layout. The top section displays study scope with an illustration of a healthcare provider. The middle section uses arrows and icons (snowflakes, ovary illustration) to show the progression from ovarian tissue cryopreservation through transplantation to pregnancy outcomes. A yellow conclusion banner appears at the bottom with source attribution.
Srinithya R Gillipelli, Luca Pio, Paul D Losty, Abdelhafeez H Abdelhafeez
Background and aims: As survival rates in childhood cancer progress significantly, health outcomes in adulthood are pivotal to quality of life (QoL). Female patients undergoing chemotherapy and radiation for childhood cancer may experience adverse effects such as gonadotoxicity-related ovarian insufficiency. Ovarian tissue cryopreservation (OTC) is well studied in adults, but has only recently started to be explored in an effort to preserve fertility in young patients with childhood cancer. This systematic review aims to critically highlight contemporary outcomes of cryopreservation in female pediatric cancer patients.
Methods: A systematic search was conducted in PubMed, Embase, and Web of Science databases to identify English-language full text articles and abstracts published between 2004 and 2022 describing cryopreservation among female children (0-21 years old) with cancer. Abstracts and full-text articles were screened for inclusion. Subsequently, data from eligible studies was extracted and analyzed. Descriptive statistics were utilized to estimate overall outcomes of cryopreservation.
Results: Of 104 abstracts and 34 full-text articles, 12 studies were included. Data was collected from 7 world countries and involved some 612 pediatric and adolescent patients with malignant disease. Most common cancers included hematological malignant disease (81%), CNS nervous system malignant tumors (56%), and sarcomas (39%). Of the 6 studies with full reporting, OTC was undertaken in 501 patients, and 5.9% (30/501) of these patients underwent ovarian tissue transplantation (OTT). After OTT, 27 patients desired pregnancy and 33% (9/27) became pregnant. Six of these 9 patients (67%) had live births.
Conclusions: Preliminary analysis showed that OTC has been successfully performed but not yet studied thoroughly in pediatric cancer patients in a longitudinal manner. This study has further shown that cryopreservation outcomes are mainly reported among adult patients living in high income countries, demonstrating a crucial need for long-term outcome studies focused on pediatric and prepuberal OTC, subsequent OTT, and potential pregnancy. This work is considered critical to aid standardize recommendations of fertility preservation in childhood cancer patients and to better inform the efficacy of these procedures to benefit patients in world nations of all fiscal income levels.