Oncofertility: A Global Perspective

Christi Sodano from the Medill School of Journalism brings us the following insight on the global needs in fertility preservation for young patients. Read her first blog post.

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By Christi Sodano-

No longer just an old person’s disease, cancer among young people is increasingly prevalent. And while the growing field of oncofertility is gaining steam here in the U.S., more education and coordinated efforts are required to provide global awareness of the issues that young cancer patients face.

One of the main problems patients around the world often encounter is the lack of education or awareness among oncologists about new treatments and possibilities in the world of oncofertility.

Doctors are often concerned that delaying cancer treatment for fertility preservation procedures will harm the patient, said Dr. Melissa Hudson, director of the Cancer Survivorship division at St. Jude Children’s research hospital.

“Our perception as oncologists is that almost all options are still investigational. Because of this, fertility preservation is not really a priority. Those feelings can be easily transmitted to the patient,” she said.

However, she notes that especially in the cases of children with less aggressive cancers, a brief delay could be okay. It may only take a few days to harvest ovarian tissue that could enable an otherwise sterile young girl to have children later in life, something that is not widely accepted.

While physician education is ideal, patient awareness could ultimately solve this problem.

Many times patients go to their doctors after reading something in the media regarding oncofertility and that is how they learn about treatment options, said Johan Smitz, a fertility specialist and laboratory head at UZ Brussels.

“It all starts by educating the profession about the huge growth reproductive medicine has had over the last 30 years,” Smitz said.

Doctors now routinely take ovarian tissue samples and oocytes and freeze them as a method of preserving fertility. “I think it is now 17 live-births resulting from tissue culture,” said Prof. Teresa Woodruff, Ph.D., of Northwestern University’s Feinberg School of Medicine and  founder of the Oncofertility Consortium.

But awareness alone will not be enough to overcome the international barriers facing oncofertility. Coordinating national efforts is key in addressing this problem, Smitz said.

“There are approximately 1.4 million people in the world that will have a fertility threatening treatment. And globally, everyone needs to be aware that fertility preservation is a problem,” Woodruff said.

In some European countries, funding is largely dependent on publishing papers that impact the field of research.

“[In Belgium], the government provides funding for four years and they expect to see a lot of output from that, but the problem is, putting gonadal tissue in culture requires long-term research because it can take months to grow one mature, human oocyte,” Smitz said.

In an effort to address this issue and better coordinate research efforts, the European Society for Human Reproductive Embryology partnered with America’s Oncofertility Consortium to share information across borders.

Despite these efforts, one thing is clear, more research and awareness are required before fertility preservation becomes a mainstream global effort for cancer patients.