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Kutluk Oktay - One of the best experts on this subject based on the ideXlab platform.
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Fertility Preservation during cancer treatment clinical guidelines
Cancer management and research, 2014Co-Authors: Kenny A Rodriguezwallberg, Kutluk OktayAbstract:The majority of children, adolescents, and young adults diagnosed with cancer today will become long-term survivors. The threat to Fertility that cancer treatments pose to young patients cannot be prevented in many cases, and thus research into methods for Fertility Preservation is developing, aiming at offering cancer patients the ability to have biologically related children in the future. This paper discusses the current status of Fertility Preservation methods when inFertility risks are related to surgical oncologic treatments, radiation therapy, or chemotherapy. Several scientific groups and societies have developed consensus documents and guidelines for Fertility Preservation. Decisions about Fertility and imminent potentially gonadotoxic therapies must be made rapidly. Timely and complete information on the impact of cancer treatment on Fertility and Fertility Preservation options should be presented to all patients when a cancer treatment is planned.
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Approach to Fertility Preservation in Adult and Prepubertal Females
Fertility Preservation, 2011Co-Authors: Kenny A. Rodriguez-wallberg, Kutluk OktayAbstract:Fertility Preservation is recognized as an issue of great importance to patients diagnosed with cancer. InFertility is emotionally painful for many patients and female patients may see inFertility as a loss of their femininity. The available evidence suggests that inFertility resulting from cancer treatment may be still more devastating and is often associated with psychosocial distress. In Western countries, women are delaying initiation of childbearing to later in life. Since the incidence of most cancers increases with age, delayed childbearing results in more female cancer survivors interested in Fertility Preservation. Fertility Preservation is often possible in adult female patients before starting their gonadotoxic treatments. Embryos, oocytes, or ovarian tissue can be cryopreserved and stored until the time when the patients are disease-free and wish to start a family. In prepubertal girls, the only options are still experimental and most challenging. Because of differences in clinical presentation of the main disease, expected treatment, age of the patient, existence of a partner, and the time available before the onset of cancer treatment, each case is unique and therefore requires individual consideration with regard to the options for Fertility Preservation.
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Fertility Preservation in women with breast cancer.
Clinical Obstetrics and Gynecology, 2010Co-Authors: Kenny A. Rodriguez-wallberg, Kutluk OktayAbstract:Fertility Preservation is an important issue for young women diagnosed with breast cancer. The most well-established options for Fertility Preservation in cancer patients, embryo and oocyte cryoPreservation, have not been traditionally offered to breast cancer patients as estradiol rise during standard stimulation protocols may not be safe for those patients. Potentially safer stimulation protocols using tamoxifen and aromatase inhibitors induce lower levels of estradiol while similar results in terms of number of oocyte and embryo obtained to standard protocols. CryoPreservation of immature oocytes and ovarian cortical tissue, both still experimental methods, are also Fertility Preservation options for breast cancer patients.
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Fertility Preservation in gynecologic cancers
Current Opinion in Oncology, 2007Co-Authors: Kutluk Oktay, Murat SönmezerAbstract:Purpose of review This review focuses on the current options for Fertility Preservation in young women facing the risk of premature ovarian failure and inFertility as a sequel to the treatment of gynecologic cancer. Recent findings There is a wide range of options to preserve Fertility. Embryo freezing is the most established method and the success rate of in-vitro fertilization using frozen-thawed embryos now approaches that of using fresh embryos. Success rates with oocyte cryoPreservation are on the rise and begin to approach that of embryo freezing. Exposure to high levels of estrogen during ovarian stimulation can be minimized by utilizing aromatase inhibitors in women with estrogen-sensitive cancers undergoing embryo or ocyte cryoPreservation. Ovarian-tissue cryoPreservation is used to preserve Fertility in children and in patients with time restraints; however, the number of reported cases is very small. Likewise, in-vitro maturation and xenografting are experimental and their potential to preserve Fertility remains to be determined. Summary A number of Fertility-Preservation techniques have been developed and many others are in the experimental stages. Consistent with recent ASCO clinical guidelines, all young individuals with gynecologic cancer should be counseled about the available Fertility Preservation techniques.
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Fertility Preservation in female patients
Human Reproduction Update, 2004Co-Authors: Murat Sönmezer, Kutluk OktayAbstract:In the USA alone, >650 000 women will be afflicted by cancer in 2003, and 8% of these cases will be aged <40 years. Due to improvements in cancer therapy, cure rates of both adult and childhood cancers increased significantly over the past three decades. However, long-term consequences of cancer therapy and impact on quality of life are now being recognized. One of the major sequelae of cytotoxic chemotherapy is gonadal failure. Cytotoxic chemotherapy and/or radiotherapy are not only used to treat malignant diseases, but also non-malignant systemic conditions. Upon reviewing the extent and mechanism of gonadal damage due to chemo-/radiotherapy, this article discusses indications and the wide range of methods of Fertility Preservation in a comprehensive manner. All current, emerging, experimental as well as controversial approaches are reviewed. A comprehensive algorithm to manage Fertility Preservation through an individualized approach is presented.
Teresa K. Woodruff - One of the best experts on this subject based on the ideXlab platform.
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Fertility Preservation for Pediatric Patients: Current State and Future Possibilities
The Journal of Urology, 2017Co-Authors: Emilie K. Johnson, Mary Ellen Pavone, Robert E. Brannigan, Courtney Finlayson, Erin E. Rowell, Yasmin C Gosiengfiao, Barbara A. Lockart, Kyle E. Orwig, Teresa K. WoodruffAbstract:Purpose: This review provides an overview of pediatric Fertility Preservation. Topics covered include the patient populations who could benefit, the current state of Fertility Preservation options and research, and considerations related to ethics and program development.Materials and Methods: A broad Embase® and PubMed® search was performed to identify publications discussing investigational, clinical, ethical and health care delivery issues related to pediatric Fertility Preservation. Relevant publications were reviewed and summarized.Results: Populations who could benefit from Fertility Preservation in childhood/adolescence include oncology patients, patients with nononcologic conditions requiring gonadotoxic chemotherapy, patients with differences/disorders of sex development and transgender individuals. Peripubertal and postpubertal Fertility Preservation options are well established and include cryoPreservation of oocytes, embryos or sperm. Prepubertal Fertility Preservation is experimental. Multipl...
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Fertility Preservation in women with cancer
The Lancet, 2014Co-Authors: Johan Smitz, Teresa K. WoodruffAbstract:Summary Enhanced long-term survival rates of young women with cancer and advances in reproductive medicine and cryobiology have culminated in an increased interest in Fertility Preservation methods in girls and young women with cancer. Present data suggest that young patients with cancer should be referred for Fertility Preservation counselling quickly to help with their coping process. Although the clinical application of novel developments, including oocyte vitrification and oocyte maturation in vitro, has resulted in reasonable success rates in assisted reproduction programmes, experience with these techniques in the setting of Fertility Preservation is in its infancy. It is hoped that these and other approaches, some of which are still regarded as experimental (eg, ovarian tissue cryoPreservation, pharmacological protection against gonadotoxic agents, in-vitro follicle growth, and follicle transplantation) will be optimised and become established within the next decade. Unravelling the complex mechanisms of activation and suppression of follicle growth will not only expand the care of thousands of women diagnosed with cancer, but also inform the care of millions of women confronted with reduced reproductive fitness because of ageing.
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Fertility Preservation for Oncological Reasons
Encyclopedia of Reproduction, 2014Co-Authors: Atsuko Kusuhara, Teresa K. WoodruffAbstract:With the recent decrease in cancer mortality rates due to better treatment options, more cancer patients can now contemplate parenthood. Yet despite improved treatment methods, certain cancer treatment regimens can compromise Fertility. To address this, recent Fertility Preservation methods, including ovary cryoPreservation, have aimed to preserve Fertility in patients preparing to undergo cancer treatment. Although this Preservation process is complex and intensive, oncoFertility Preservation methods have demonstrated much potential. Currently, Fertility Preservation methods are offered to adults, adolescents and pre-pubertal children, and in so doing, give the possibility of future parenthood to many affected by cancer.
Ralph R. Kazer - One of the best experts on this subject based on the ideXlab platform.
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Psychological Counseling of Female Fertility Preservation Patients
Journal of Psychosocial Oncology, 2015Co-Authors: Angela K. Lawson, Mary Ellen Pavone, Susan C. Klock, J. Hirshfeld-cytron, Kristin Smith, Ralph R. KazerAbstract:Young cancer patients are increasingly interested in preserving their Fertility prior to undergoing gonadotoxic therapies. Although the medical safety and treatment protocols for Fertility Preservation have been well documented, limited research has addressed the emotional issues that arise in Fertility Preservation patients. We briefly review the literature on the psychosocial issues in adult female Fertility Preservation treatment and describe our experiences within this patient population. Our findings suggest that several important issues to be addressed during the psychological counseling of adult female Fertility Preservation patients include: (1) preexisting psychological distress in patients undergoing treatment, (2) choice of Fertility Preservation strategy in the face of an uncertain relationship future, (3) decision making regarding use of third-party reproduction (e.g., sperm/egg donation, gestational surrogacy), (4) treatment expectations regarding pregnancy and miscarriage, (5) ethical issue...
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Fertility Preservation for female cancer patients early clinical experience
Fertility and Sterility, 2010Co-Authors: Susan C. Klock, John X Zhang, Ralph R. KazerAbstract:Objective To characterize the early experience of a clinical program designed to provide strategies for Fertility Preservation to female cancer patients about to undergo chemotherapy or radiation therapy. Design Retrospective chart review; case–control study. Setting Academic medical center. Patient(s) Sixty-five female cancer patients and 57 age-matched inFertility patients. Intervention Enrollment in a program for Fertility Preservation. Main Outcome Measure(s) Choice of active participation, Fertility Preservation option selection, clinical outcomes of patients undergoing oocyte retrieval, attitudes regarding embryo disposition. Result(s) Of 65 patients referred to the program, 18 declined to undergo embryo, oocyte, or tissue cryoPreservation. Six were found not to be eligible for medical reasons. Of the remaining 41 patients, 35 chose to cryopreserve embryos, four chose to cryopreserve oocytes, and two chose to undergo ovarian tissue freezing. Fewer oocytes were recovered from the embryo cryoPreservation group when compared with an age-matched control group, but the mean number of zygotes generated was similar. Attitudes regarding embryo disposition were different between the two groups. No serious clinical sequelae resulted from participation. Conclusion(s) Fertility Preservation techniques employing available technology may provide safe and practical options to female cancer patients facing chemotherapy or radiation therapy. A significant number of otherwise appropriate participants decline active management. Cancer patients display different attitudes regarding embryo disposition when compared with inFertility patients without cancer.
Gwendolyn P Quinn - One of the best experts on this subject based on the ideXlab platform.
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clinical guide to Fertility Preservation in hematopoietic cell transplant recipients
Bone Marrow Transplantation, 2014Co-Authors: Sarita Joshi, Bipin N Savani, Eric J Chow, M Gilleece, Jorg Halter, David A Jacobsohn, Joseph Pidala, Gwendolyn P Quinn, J Y Cahn, Ann A JakubowskiAbstract:With broadening indications, more options for hematopoietic cell transplantation (HCT) and improvement in survival, the number of long-term HCT survivors is expected to increase steadily. InFertility is a frequent problem that long-term HCT survivors and their partners face and it can negatively impact on the quality of life. The most optimal time to address Fertility issues is before the onset of therapy for the underlying disease; however, Fertility Preservation should also be addressed before HCT in all children and patients of reproductive age, with referral to a reproductive specialist for patients interested in Fertility Preservation. In vitro fertilization (IVF) and embryo cryoPreservation, oocyte cryoPreservation and ovarian tissue banking are acceptable methods for Fertility Preservation in adult women/pubertal females. Sperm banking is the preferred method for adult men/pubertal males. Frequent barriers to Fertility Preservation in HCT recipients may include the perception of lack of time to preserve Fertility given an urgency to move ahead with transplant, lack of patient–physician discussion because of several factors (for example, time constraints, lack of knowledge), inadequate access to reproductive specialists, and costs and lack of insurance coverage for Fertility Preservation. There is a need to raise awareness in the medical community about Fertility Preservation in HCT recipients.
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barriers to Fertility Preservation among pediatric oncologists
Patient Education and Counseling, 2008Co-Authors: Susan T Vadaparampil, Gwendolyn P Quinn, Lindsey M King, Crystal Wilson, Michael L NiederAbstract:Abstract Objective : Limited research has been conducted on the extent to which Fertility Preservation is discussed by pediatric oncologists with patients and less is known about the discussion content. This study sought to examine factors that may influence the discussion with pediatric cancer patients and families. Methods : Qualitative data were collected using open-ended, in-depth interviews with 24 pediatric oncologists in Florida at 13 children's cancer centers, representing 87% of the centers in the state. Results : Providers practiced between 0.5 and 35 years, treated most types of pediatric cancers, and most were board certified in pediatric hematology/oncology. The main factors associated with a discussion of Fertility Preservation options were: (1) physician factors that contribute to communication issues with FP discussion (e.g., awareness and sense of comfort in discussing issues, perceptions of the priority); (2) parent factors (e.g., receptiveness and cultural background); (3) patient factors (e.g., receptiveness and age); and (4) institutional factors (e.g., referral sites and practice guidelines). Conclusions : Pediatric oncologists may benefit from education about Fertility Preservation options for pediatric cancer patients, particularly females. Practice implications : Training on how to address parents’ and patients’ emotions, culture, and other factors may also promote the discussion. Although guidelines have been established, barriers related to availability and affordability of resources must also be addressed.
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patient physician communication barriers regarding Fertility Preservation among newly diagnosed cancer patients
Social Science & Medicine, 2008Co-Authors: Gwendolyn P Quinn, Susan T Vadaparampil, Bethany A Bellellison, Clement K Gwede, Terrance L AlbrechtAbstract:With cancer survival rates increasing, new directions have focused on issues of survivorship, with an intense focus on quality of life. One area gaining increased attention is Fertility Preservation and future parenthood among cancer survivors. Although medical options for Fertility Preservation exist, most are not well understood by physicians, patients and family members, and are not readily accessible to patients and their health care providers. This paper discusses the current difficulties in communicating information about Fertility Preservation in the United States. Physician level of knowledge about Fertility Preservation, attitudes and comfort level with the topics, patient preferences, and financial and practice barriers may serve as obstacles in the communication process. Social, interaction and behavioral research studies are well poised to address the communication barriers and provide possible solutions to problems in understanding Fertility Preservation, for patients, family members and health care providers alike.
Susan T Vadaparampil - One of the best experts on this subject based on the ideXlab platform.
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barriers to Fertility Preservation among pediatric oncologists
Patient Education and Counseling, 2008Co-Authors: Susan T Vadaparampil, Gwendolyn P Quinn, Lindsey M King, Crystal Wilson, Michael L NiederAbstract:Abstract Objective : Limited research has been conducted on the extent to which Fertility Preservation is discussed by pediatric oncologists with patients and less is known about the discussion content. This study sought to examine factors that may influence the discussion with pediatric cancer patients and families. Methods : Qualitative data were collected using open-ended, in-depth interviews with 24 pediatric oncologists in Florida at 13 children's cancer centers, representing 87% of the centers in the state. Results : Providers practiced between 0.5 and 35 years, treated most types of pediatric cancers, and most were board certified in pediatric hematology/oncology. The main factors associated with a discussion of Fertility Preservation options were: (1) physician factors that contribute to communication issues with FP discussion (e.g., awareness and sense of comfort in discussing issues, perceptions of the priority); (2) parent factors (e.g., receptiveness and cultural background); (3) patient factors (e.g., receptiveness and age); and (4) institutional factors (e.g., referral sites and practice guidelines). Conclusions : Pediatric oncologists may benefit from education about Fertility Preservation options for pediatric cancer patients, particularly females. Practice implications : Training on how to address parents’ and patients’ emotions, culture, and other factors may also promote the discussion. Although guidelines have been established, barriers related to availability and affordability of resources must also be addressed.
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patient physician communication barriers regarding Fertility Preservation among newly diagnosed cancer patients
Social Science & Medicine, 2008Co-Authors: Gwendolyn P Quinn, Susan T Vadaparampil, Bethany A Bellellison, Clement K Gwede, Terrance L AlbrechtAbstract:With cancer survival rates increasing, new directions have focused on issues of survivorship, with an intense focus on quality of life. One area gaining increased attention is Fertility Preservation and future parenthood among cancer survivors. Although medical options for Fertility Preservation exist, most are not well understood by physicians, patients and family members, and are not readily accessible to patients and their health care providers. This paper discusses the current difficulties in communicating information about Fertility Preservation in the United States. Physician level of knowledge about Fertility Preservation, attitudes and comfort level with the topics, patient preferences, and financial and practice barriers may serve as obstacles in the communication process. Social, interaction and behavioral research studies are well poised to address the communication barriers and provide possible solutions to problems in understanding Fertility Preservation, for patients, family members and health care providers alike.