scholarly journals Fertility preservation options for children and adolescents with cancer

2017 ◽  
Vol 11 (1-2S) ◽  
pp. 97 ◽  
Author(s):  
Rodrigo L.P. Romao ◽  
Armando J. Lorenzo

Introduction: Cancer in children and adolescents has seen a stark rise in survival rates in the last decades; overall survival in excess of 80% can be reasonably expected for many newly diagnosed patients with malignancies in this age group. Survivorship has unfolded several specific issues faced by these patients, including fertility concerns. Hence, fertility preservation efforts have been discussed and undertaken with increased frequency.Methods: In this article, the authors provide a broad overview of the current recommendations surrounding fertility preservation in this patient population. Reasons to offer fertility preservation, target groups for interventions, and methods available based on age group and gender are discussed in detail.Results: The medical literature and patient advocates strongly support a discussion about fertility preservation at the time of diagnosis; the risk of infertility is real and parents and families wish to be informed about it. In postpubertal males, sperm-banking is relatively straightforward and should be attempted by most newly diagnosed patients, ideally before commencement of treatment. Cryopreservation of testicular tissue in higher-risk prepubertal males is feasible, but still experimental. Female fertility preservation is more complex, requires more invasive procedures, and can delay initiation of treatment due to the requirement for hormone stimulation of follicles prior to harvesting.Conclusions: Oncofertility initiatives in children and youth are still in their early days and will continue to expand; urologists should be prepared to offer counselling and interventions when appropriate to this growing vulnerable population.

PEDIATRICS ◽  
1992 ◽  
Vol 90 (1) ◽  
pp. 87-91 ◽  
Author(s):  
G. Bennett Humphrey ◽  
Chris M. J. Boon ◽  
G. F. E. Chiquit van Linden van den Heuvell ◽  
Harry B. M. van de Wiel

While there is no question that children dislike needles, there are very little data available on the occurrence of high levels of distress experienced by children undergoing routine venipunctures. To provide some insight into this problem, trained observers evaluated distress in 223 different children and adolescents undergoing this procedure. An observational distress scale of 1 to 5 was developed; 1 = calm, 2 = timid/nervous, 3 = serious distress, but still under control, 4 = serious distress with loss of control, and 5 = panic. We observed a strong relation between distress and age but not between distress and gender. During the actual venipuncture. half the subjects (113/223) were scored as having high levels of distress (3 or more). Our subjects were also grouped into three age ranges: toddlers; 2½ to 6 years, N = 70; preadolescents; 7 to 12 years, N = 55; and adolescents; 12 years and older, N = 98. The percent of subjects experiencing high levels of distress for each age group were: 83%, 51%, and 28%, respectively. We conclude that for venipunctures: 1) high levels of distress are common, and 2) age and not gender correlates with distress. Other correlations are discussed. Toddlers and pre-adolescents should be the targets for new interventions to reduce distress.


2017 ◽  
Author(s):  
Yan Li ◽  
Zhijun Li ◽  
Qing Sun ◽  
Mengying Wang ◽  
Meng Jiang ◽  
...  

Objective: In China, the obesity epidemic is truly national and childhood obesity prevalence has rapidly increased and is close to the developed countries. This study aimed to estimate the prevalence and temporal trends of overweight and obesity among children and adolescents in Jilin City, China (2011-2015). Methods: The data derived from the census on students’ constitution and health in 2011-2015 carried out by the Jilin CDC, Jilin City. 191191 children and adolescents aged 7-18 years were included in the present survey, of which 37549 in 2011 to 41564 in the 2015. The newly developed age- and gender-specific BMI cutoffs by the working group on obesity in China were used to define overweight and obesity in children and adolescents. Results: The mean of BMI (body mass index) was significantly increasing from 20.9 kg/m2 in 2011 to 21.5 kg/m2 in 2015 in all subjects. Overweight and Obesity prevalence of total students aged 7-18 years had a significantly increasing from 2012 to 2015 (P<0.001), from 16.0% and 13.1% to 17.1% and 17.1%. The minimum value of BMI and overweight and obesity prevalence in overall age group all presented in 2012. Boys and girls all showed the significant increase in overweight and obesity prevalence in every age group from 2012 to 2015 and boys higher than girls (P<0.001). Regardless of girls and boys, the most likely of children and adolescents being overweight and obesity had been observed in the youngest age and lowest school grade category. Conclusion: In summary, our results indicate that all the overweight and obesity prevalence among children and adolescents over the past 5 years were higher than the 2010 Chinese National Level and Chinese large coastal cities’ level and a significantly increase from 2011-2015. Obesity epidemic is serious, at least not optimistic among children and adolescents in Jilin, Northeast China.


2021 ◽  
Vol 03 (03) ◽  
pp. 94-100
Author(s):  
Jennifer K. Y. Ko ◽  
Kevin K.W. Lam ◽  
Heidi H.Y. Cheng ◽  
Man Wa Lui ◽  
Sofie S.F. Yung ◽  
...  

Background: Fertility preservation is increasingly important with improving cancer survival rates and the delay in childbearing in modern societies. The objective of our study was to review the experience of the fertility preservation programme in a tertiary-assisted reproduction unit in Hong Kong. Methods: This is a retrospective study involving men and women who were seen at a tertiary-assisted reproduction unit for fertility preservation counselling before gonadotoxic treatment from January 2005 to December 2020. Their medical records in paper and electronic forms were reviewed. Results: There were 75 consultations for female fertility preservation from 2010 to 2020 involving 72 women. Twenty women underwent 22 cycles of ovarian stimulation for oocyte or embryo cryopreservation, two of whom subsequently transported their oocytes abroad for further management and another two achieved natural conception. Additional four women who did not have oocyte or embryo cryopreservation achieved natural conception after cancer treatment. Eleven (15.2%) women were followed up at a reproductive endocrinology clinic after their cancer treatment. From 2005 to 2020, 265 men had sperm cryopreserved. Twenty-six (9.8%) came back to use the cryopreserved sperms, the wives of 13 (50.0%) of whom achieved an on-going pregnancy. Six of them transferred out and 40 discarded the cryopreserved sperms. Conclusions: There was generally an increasing number of patient consultations for fertility preservation in our Centre over the past decade but a consistently low rate of utilisation of cryopreserved gametes for both women and men. Post-cancer treatment fertility evaluation and monitoring was a major area of deficiency in Hong Kong. More structured post-cancer treatment fertility follow-up is needed.


2021 ◽  
Author(s):  
Natasha N. Frederick ◽  
James L. Klosky ◽  
Lillian R. Meacham ◽  
Gwendolyn P. Quinn ◽  
Joanne Frankel Kelvin ◽  
...  

PURPOSE Fertility preservation (FP) services are part of comprehensive care for those newly diagnosed with cancer. The capacity to offer these services to children and adolescents with cancer is unknown. METHODS A cross-sectional survey was sent to 220 Children's Oncology Group member institutions regarding institutional characteristics, structure and organization of FP services, and barriers to FP. Standard descriptive statistics were computed for all variables. The association between site-specific factors and selected outcomes was examined using multivariable logistic regression. RESULTS One hundred forty-four programs (65.5%) returned surveys. Fifty-three (36.8%) reported a designated FP individual or team. Sperm banking was offered at 135 (97.8%) institutions, and testicular tissue cryopreservation at 37 (27.0%). Oocyte and embryo cryopreservation were offered at 91 (67.9%) and 62 (46.6%) institutions, respectively; ovarian tissue cryopreservation was offered at 64 (47.8%) institutions. The presence of dedicated FP personnel was independently associated with the ability to offer oocyte or embryo cryopreservation (odds ratio [OR], 4.7; 95% CI, 1.7 to 13.5), ovarian tissue cryopreservation (OR, 2.7; 95% CI, 1.2 to 6.0), and testicular tissue cryopreservation (OR, 3.3; 95% CI, 1.4 to 97.8). Only 26 (18.1%) participating institutions offered all current nonexperimental FP interventions. Barriers included cost (70.9%), inadequate knowledge or training (60.7%), difficulty characterizing fertility risk (50.4%), inadequate staffing (45.5%), and logistics with reproductive specialties (38%-39%). CONCLUSION This study provides the most comprehensive view of the current landscape of FP infrastructure for children and adolescents with cancer and demonstrates that existing infrastructure is inadequate to offer comprehensive services to patients. We discuss modifiable factors to improve patient access to FP.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253144
Author(s):  
Gerrit Schwiertz ◽  
Julian Bauer ◽  
Thomas Muehlbauer

Background The Upper Quarter Y Balance test (YBT-UQ) is a field test for measuring shoulder mobility/stability. However, there is a lack of information regarding age- and sex-specific reference values for classifying the YBT-UQ performance of children and adolescents. Objective The aim was to investigate YBT-UQ performance in youth and to provide age- and sex-specific normative values. Method Six hundred and sixty-five persons (325 girls, 340 boys) aged between 10 and 17 years carried out the YBT-UQ test. Following this, maximum reach values, normalised in terms of arm length, were calculated for each arm (i.e., left and right) and reach direction (i.e., medial [MD], inferolateral [IL], superolateral [SL]), and the composite score (CS) per arm. Additionally, percentiles were displayed graphically and in tabular form, distinguished according to age and gender. Results In boys, those aged 14–15 years showed a higher achievement (e.g., MD direction) compared with both younger (12–13-year-olds) and older (16–17-year-olds) persons. In girls, differences related to age could only be observed for the IL direction and the CS, where the youngest age group (10–11-year-olds) achieved better results than the older groups. Sex-specific differences to the girls’ advantage could be observed in 12–13-year-olds (i.e., SL and CS), and to the boys’ advantage in 14–15-year-olds (i.e., for all reach directions) and 16–17-year-olds (i.e., IL and SL direction and CS). Further, curvilinear developments were observed with regard to the 10th, 50th, and 90th percentiles, and were more strongly marked in boys than in girls. Conclusions The obtained age- and sex-specific normative values for the YBT-UQ can be used by teachers, coaches, and therapists to classify the level of shoulder mobility/stability among 10–17 year-old children and adolescents.


2017 ◽  
Author(s):  
Yan Li ◽  
Zhijun Li ◽  
Qing Sun ◽  
Mengying Wang ◽  
Meng Jiang ◽  
...  

Objective: In China, the obesity epidemic is truly national and childhood obesity prevalence has rapidly increased and is close to the developed countries. This study aimed to estimate the prevalence and temporal trends of overweight and obesity among children and adolescents in Jilin City, China (2011-2015). Methods: The data derived from the census on students’ constitution and health in 2011-2015 carried out by the Jilin CDC, Jilin City. 191191 children and adolescents aged 7-18 years were included in the present survey, of which 37549 in 2011 to 41564 in the 2015. The newly developed age- and gender-specific BMI cutoffs by the working group on obesity in China were used to define overweight and obesity in children and adolescents. Results: The mean of BMI (body mass index) was significantly increasing from 20.9 kg/m2 in 2011 to 21.5 kg/m2 in 2015 in all subjects. Overweight and Obesity prevalence of total students aged 7-18 years had a significantly increasing from 2012 to 2015 (P<0.001), from 16.0% and 13.1% to 17.1% and 17.1%. The minimum value of BMI and overweight and obesity prevalence in overall age group all presented in 2012. Boys and girls all showed the significant increase in overweight and obesity prevalence in every age group from 2012 to 2015 and boys higher than girls (P<0.001). Regardless of girls and boys, the most likely of children and adolescents being overweight and obesity had been observed in the youngest age and lowest school grade category. Conclusion: In summary, our results indicate that all the overweight and obesity prevalence among children and adolescents over the past 5 years were higher than the 2010 Chinese National Level and Chinese large coastal cities’ level and a significantly increase from 2011-2015. Obesity epidemic is serious, at least not optimistic among children and adolescents in Jilin, Northeast China.


2011 ◽  
Vol 2 (3) ◽  
pp. 114-117 ◽  
Author(s):  
Korula George ◽  
Vaibhav Londhe ◽  
K Muthukumar

ABSTRACT Improvement in survival rates of cancer patients has lead to a shift in focus toward fertility issues, especially in young survivors. Male fertility preservation is well established. Embryo cryopreservation remains most successful female fertility preservation option. Other female fertility preservation procedures like oocyte/ovarian tissue cryopreservation either have limited efficacy or in experimental stages. We have highlighted not uncommon clinical scenarios where the fertility preservation option was exercised. There is an urgent need to spread awareness among clinicians and patients regarding the various available fertility preservation measures. Timely referral will help in improving the quality of life of cancer survivors.


2015 ◽  
Vol 14 (3) ◽  
pp. 153-162 ◽  
Author(s):  
Andrea Fischbach ◽  
Philipp W. Lichtenthaler ◽  
Nina Horstmann

Abstract. People believe women are more emotional than men but it remains unclear to what extent such emotion stereotypes affect leadership perceptions. Extending the think manager-think male paradigm ( Schein, 1973 ), we examined the similarity of emotion expression descriptions of women, men, and managers. In a field-based online experiment, 1,098 participants (male and female managers and employees) rated one of seven target groups on 17 emotions: men or women (in general, managers, or successful managers), or successful managers. Men in general are described as more similar to successful managers in emotion expression than are women in general. Only with the label manager or successful manager do women-successful manager similarities on emotion expression increase. These emotion stereotypes might hinder women’s leadership success.


2020 ◽  
Vol 22 (2) ◽  
pp. 99-103
Author(s):  
Md Fardhus ◽  
AMSM Sharfuzzaman ◽  
Md Nayeem Dewan ◽  
Md Abul Hossain ◽  
Ahmed Sami Al Hasan ◽  
...  

Aim: To compare Desarda’s versus Lichtenstein’s mesh repair in patients with unilateral, primary, reducible inguinal hernia in terms of mean operative time and seroma formation Methods: This randomized control trial conducted at Department of Surgery, Patuakhali Medical College & Hospital, Patuakhali. Eighty patients with unilateral, primary, reducible inguinal hernia were randomly distributed into two groups to undergo hernia repair i.e. Lichtenstein (L) and Desarda’s (D). Outcome was measured in terms of mean operative time and seroma formation. Seroma formation was defined as presence of enclosed cavity containing serous fluid determined by ultrasonography at 30th post-operative day. Results: Thirty three patients (41.25%) were above 50 years of age, whereas remaining 47 patients (58.75%) were below 50 years of age. Five patients (6.25%) were female and 75 patients(93.75%) were male. Seroma formation was 5% in Desarda’s group while 7.5% in Lichtenstein group (P> 0.05). Similarly difference in mean operative time was statistically non-significant. Seroma formation was common in older age group. There was no effect of smoking, obesity, operative time and gender on seroma formation. Conclusion: It is concluded that there is no difference in frequency of seroma formation and mean operative time in Desarda’s or Lichtenstein’s technique of hernia repair. Journal of Surgical Sciences (2018) Vol. 22 (2) : 99-103


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