Ovarian Tissue Cryopreservation in Pediatric Centers Across the United States: Practice Patterns and Barriers.

IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Journal of pediatric and adolescent gynecology Pub Date : 2024-11-16 DOI:10.1016/j.jpag.2024.11.002
Chelsea A Kebodeaux, Megan Pruett, Veronica Gomez-Lobo, Leena Nahata, Amanda J Saraf, Holly R Hoefgen
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Abstract

Study objective: Evaluate practice patterns in ovarian tissue cryopreservation (OTC) provision.

Methods: United States providers practicing or developing OTC at pediatric programs were invited to participate in a survey disseminated via the Oncofertility Consortium.

Results: Twenty-seven programs representing a wide geographic area responded, largely representing academic institutions (85.2%). Of these, 21 (77.4%) performed OTC at their facility, the majority for oncology patients receiving gonadotoxic therapy, relapsed patients and non-oncologic patients receiving gonadotoxic therapy (95.7, 87.0, 82.6% respectively). OTC procedures were most commonly performed by pediatric gynecology surgeons (71.4%) via laparoscopic oophorectomy (90.5%) using a heat-based method (55.0%) for dissection. Most centers used an outside compensated service (50%) or a reproductive endocrinology group (45%) for processing tissue. Many (13, 61.9%) performed OTC as standard of care and 7 utilized an IRB for data collection. Of the 8 centers whose OTC programs are in the planning or early stages, frequently identified barriers were lack of priority within their medical team or institution (5/8), lack of protected time (3/8), and lack of funding (3/8).

Conclusions: OTC is commonly offered to oncology patients receiving highly gonadotoxic therapy with pediatric gynecologists frequently involved in counseling and performing OTC. Variability exists in offering OTC to other patient populations, as well as in research practices, surgical technique and processing. Institutions continue to face barriers in offering OTC when necessary resources are not prioritized by leadership.

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全美儿科中心的卵巢组织冷冻:实践模式和障碍。
研究目的评估提供卵巢组织冷冻保存(OTC)的实践模式:方法:邀请在儿科项目中开展或发展 OTC 的美国医疗机构参与通过肿瘤不孕不育联盟(Oncofertility Consortium)发布的一项调查:结果:代表广泛地理区域的 27 个项目做出了回应,其中大部分代表学术机构(85.2%)。其中,21 个项目(77.4%)在其机构内实施了 OTC,大部分用于接受性腺毒性治疗的肿瘤患者、复发患者和接受性腺毒性治疗的非肿瘤患者(分别为 95.7%、87.0% 和 82.6%)。最常见的 OTC 手术是由儿科妇科医生(71.4%)通过腹腔镜输卵管切除术(90.5%)使用热敷法(55.0%)进行剥离。大多数中心使用外部有偿服务(50%)或生殖内分泌小组(45%)处理组织。许多中心(13 个,61.9%)将 OTC 作为标准护理,7 个中心利用 IRB 收集数据。在OTC项目处于规划或早期阶段的8个中心中,经常发现的障碍是医疗团队或机构缺乏优先权(5/8)、缺乏受保护的时间(3/8)和缺乏资金(3/8):结论:为接受高性腺毒性治疗的肿瘤患者提供 OTC 是一种普遍现象,儿科妇科医生经常参与咨询和实施 OTC。在为其他患者群体提供 OTC 方面存在差异,在研究实践、手术技术和处理方面也存在差异。如果领导层没有优先考虑必要的资源,医疗机构在提供 OTC 方面就会继续面临障碍。
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来源期刊
CiteScore
3.90
自引率
11.10%
发文量
251
审稿时长
57 days
期刊介绍: Journal of Pediatric and Adolescent Gynecology includes all aspects of clinical and basic science research in pediatric and adolescent gynecology. The Journal draws on expertise from a variety of disciplines including pediatrics, obstetrics and gynecology, reproduction and gynecology, reproductive and pediatric endocrinology, genetics, and molecular biology. The Journal of Pediatric and Adolescent Gynecology features original studies, review articles, book and literature reviews, letters to the editor, and communications in brief. It is an essential resource for the libraries of OB/GYN specialists, as well as pediatricians and primary care physicians.
期刊最新文献
Effect of Lifestyle Modifications on Polycystic Ovary Syndrome in Predominantly Young Adults: A Systematic Review. Menstrual Suppression in Gender Diverse Youth: What's Most Important to Patients? Gonadal Tumors in Individuals with Turner Syndrome and Y-Chromosome Mosaicism: A Retrospective Multisite Study. Ovarian Tissue Cryopreservation in Pediatric Centers Across the United States: Practice Patterns and Barriers. Co-occurrence of Unicornuate Uterus with Non-Communicating Functioning Rudimentary Horn and VACTERL Association - A Case Report.
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