Synopsis
Today, 80% of children treated for cancer will survive. However, a significant proportion of survivors are at risk of infertility, due to toxicity of their treatment. The Royal Children’s Hospital is a leader worldwide in promoting discussion of fertility issues at the time of treatment, and offering options that might be able to preserve fertility for the future. The standard and accepted options of egg or sperm collection are only possible for young people who have already gone through puberty, and may not always be appropriate in the context of a new cancer diagnosis and urgency to start treatment. More recently, surgical procedures to retrieve and store tissue from ovaries or testes have provided another option. These procedures can be done for pre-pubertal children, even when very young, as well as post-pubertal children.
What is the latest evidence for the likelihood that these procedures will be effective in allowing survivors of childhood cancer to have their own children in the future? Is it the same for boys and girls? And given the evidence so far, which patients should be offered the option of ovarian or testicular biopsy? This could depend on the level of infertility risk, or the probability of survival into adulthood, risks associated with the biopsy procedure, or other medical factors. Or perhaps the option should be available to all patients whose parents want it?
These questions will be addressed in this Grand Rounds, which forms part of 2nd National Oncofertility Summit, being held at The Royal Children’s Hospital.
Speakers
Professor Richard Anderson is Elsie Inglis Professor of Clinical Reproductive Science and Head of Obstetrics and Gynaecology at The University of Edinburgh. He has an international reputation in developing strategies for fertility preservation in children undergoing cancer therapy. Prof Anderson developed the Edinburgh selection criteria for cryopreservation of ovarian tissue in girls and young women. Richard will go through the latest evidence and discuss the current relevance of the Edinburgh selection criteria.
Professor Lynn Gillam is the Academic Director of the Children’s Bioethics Centre at RCH, and Professor of Health Ethics in the School of Population and Global Health at The University of Melbourne. Lynn provides policy advice and leads research into a range of issues in paediatric clinical ethics, and has been involved in over 200 ethics consultations over the past 12 years. With her colleagues, she developed the first clinical ethics framework for decisions around fertility preservation in children. Lynn will tackle the questions such as: what counts as needing fertility preservation? And: what if parents want a procedure when the child doesn’t “need” it?