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Hum. Reprod. Advance Access published online on July 9, 2008
Human Reproduction, doi:10.1093/humrep/den252
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© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Do doctors discuss fertility issues before they treat young patients with cancer?

Richard A. Anderson1, Annette Weddell1, Helen A. Spoudeas2, Carolyn Douglas3, Stephen M. Shalet4, Gill Levitt5 and W. Hamish B. Wallace1,6

1 Division of Developmental and Reproductive Science, University of Edinburgh, Edinburgh, UK 2 London Centre for Paediatric Endocrinology, Great Ormond Street Hospital and University College Hospitals, London, UK 3 Children's Cancer and Leukaemia Group, Leicester, UK 4 Department of Endocrinology, Christie Hospital, Manchester, UK 5 Department of Haematology/Oncology, Great Ormond Street Hospital for Sick Children, London, UK

6 Correspondence address. Royal Hospital for Sick Children, Edinburgh EH9 1LF, UK. E-mail: hamish.wallace{at}luht.scot.nhs.uk

BACKGROUND: Many children treated for cancer are at risk of infertility, but for girls and prepubertal boys, all fertility preservation techniques remain experimental. We have assessed UK practice relating to information provision about the effects of cancer treatment on fertility and options for fertility preservation.

METHODS: Paediatric oncologists prospectively completed a data form for each new patient registered over a 12 month period.

RESULTS: Data were available on 1030 patients (68% of total registered). The effect of cancer treatment on fertility was discussed with 63% of patients. Of these, 61% were judged to be at high or medium risk of fertility problems. Discussions took place more commonly with boys than girls; the commonest reason for discussion not occurring was young age. The majority (83%) of post-pubertal boys assessed as high/medium risk of infertility were referred for semen cryopreservation. This rate fell to 39% of those in early puberty. Only 1% (n=4) of girls were referred to an assisted conception unit.

CONCLUSIONS: These data indicate a high awareness of the potential adverse effects of therapy on fertility among UK paediatric oncologists. High referral rates for older boys indicate that current guidelines are followed, but there is a need for fertility preservation techniques for girls and younger boys.

Key words: cancer/fertility/puberty/children

Submitted on March 25, 2008; resubmitted on May 27, 2008; accepted on June 6, 2008.


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