Female Fertility Cryopreservation Outcomes in Childhood Cancer: A Systematic Review

Infographic · May 2024 · 2 min read

In brief

Systematic review of 612 pediatric cancer patients across 7 countries found that while ovarian tissue cryopreservation is feasible, only 6% underwent transplantation, with 33% achieving pregnancy and 67% live birth rate. Study highlights critical need for long-term outcomes data in prepubertal patients to standardize fertility preservation recommendations.

OTC successfully performed in 501 pediatric cancer patients; 6% later underwent ovarian tissue transplantation with 33% achieving pregnancy
Live birth rate of 67% among pediatric cancer survivors who became pregnant after ovarian tissue transplantation
Long-term outcome data for pediatric OTC remains limited; most studies focus on adult patients in high-income countries
Hematological malignancies (81%) and CNS tumors (56%) are most common cancers requiring fertility preservation consideration
Standardized fertility preservation guidelines needed for pediatric cancer patients across all income levels globally

Written by the GCMD Library team from the infographic.

A horizontal flow diagram with a red sidebar on the left containing study metadata (St. Jude USA, systematic review, 2004-2022). The main panel shows a female figure icon followed by four stages connected by teal arrows: ovarian tissue collection and cryopreservation, tissue transplantation, pregnancy, and live birth. Each stage displays outcome statistics with simplified anatomical illustrations.

New infographic by Dr. Jose Campos & the Chilean Society of pediatric Surgery

"Female Fertility Cryopreservation Outcomes in Childhood Cancer: A Systematic Review"

Authors: Srinithya R. Gillipelli, Luca Pio, Paul D. Losty, Abdelhafeez H. Abdelhafeez

Full article: https://gcmd.co/3QNpBML

Background and aims

As survival rates in childhood cancer progress significantly, health outcomes in adulthood are pivotal to quality of life (QoL). Female patients undergoing chemotherapy and radiation for childhood cancer may experience adverse effects such as gonadotoxicity-related ovarian insufficiency. Ovarian tissue cryopreservation (OTC) is well studied in adults, but has only recently started to be explored in an effort to preserve fertility in young patients with childhood cancer. This systematic review aims to critically highlight contemporary outcomes of cryopreservation in female pediatric cancer patients.

Methods

A systematic search was conducted in PubMed, Embase, and Web of Science databases to identify English-language full text articles and abstracts published between 2004 and 2022 describing cryopreservation among female children (0–21 years old) with cancer. Abstracts and full-text articles were screened for inclusion. Subsequently, data from eligible studies was extracted and analyzed. Descriptive statistics were utilized to estimate overall outcomes of cryopreservation.

Results

Of 104 abstracts and 34 full-text articles, 12 studies were included. Data was collected from 7 world countries and involved some 612 pediatric and adolescent patients with malignant disease. Most common cancers included hematological malignant disease (81%), CNS nervous system malignant tumors (56%), and sarcomas (39%). Of the 6 studies with full reporting, OTC was undertaken in 501 patients, and 5.9% (30/501) of these patients underwent ovarian tissue transplantation (OTT). After OTT, 27 patients desired pregnancy and 33% (9/27) became pregnant. Six of these 9 patients (67%) had live births.

Conclusions

Preliminary analysis showed that OTC has been successfully performed but not yet studied thoroughly in pediatric cancer patients in a longitudinal manner. This study has further shown that cryopreservation outcomes are mainly reported among adult patients living in high income countries, demonstrating a crucial need for long-term outcome studies focused on pediatric and prepuberal OTC, subsequent OTT, and potential pregnancy. This work is considered critical to aid standardize recommendations of fertility preservation in childhood cancer patients and to better inform the efficacy of these procedures to benefit patients in world nations of all fiscal income levels.

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