Female Fertility Cryopreservation Outcomes in Childhood Cancer: A Systematic Review
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New article you should know by Dr. Cecilia Gigena. Selected by Dr. Jose Campos & the Chilean Society of pediatric Surgery
"Female Fertility Cryopreservation Outcomes in Childhood Cancer: A Systematic Review"
Authors: Srinithya R. Gillipelli, Luca Pio, Paul D. Losty, Abdelhafeez H. Abdelhafeez
Full article: https://gcmd.co/3QNpBML
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.
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Do you indicate cryopreservation in girls that are going to need chemotherapy? Hi, I'm Cecilia Jigena from Cincinnati Children's Hospital, and I think this is an article that you should know about. This is a systematic review that aimed to highlight the outcomes of cryopreservation in pediatric female patients with cancer. They included 12, Studies with 612 patients, of them, 501 patients underwent ovary tissue cryopreservation, but only 30 of them received the ovarian tissue transplantation. Of these 30 patients, 9 got pregnant, but only 6 had a live birth. So even though cryopreservation can be successful, we still need more high quality studies to understand it better and improve its outcomes. Let us know what you think and stay tuned for more articles that you should know about.