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Inconsistencies in fertility preservation for young people with cancer in the UK
Archives of Disease in Childhood ( IF 4.3 ) Pub Date : 2022-03-01 , DOI: 10.1136/archdischild-2021-321873
Hannah L Newton 1, 2 , Helen M Picton 1 , Amanda Jane Friend 3, 4 , Catherine M Hayden 5 , Mark Brougham 6 , Rachel Cox 7 , Victoria Grandage 8 , Michelle Kwok-Williams 9 , Sheila Lane 10 , Rod Thomas Mitchell 11, 12 , Roderick Skinner 13, 14 , W Hamish Wallace 15, 16 , Daniel Yeomanson 17 , Adam W Glaser 4, 18 ,
Affiliation  

Objective To assess the utilisation of and funding structure for fertility preservation for children diagnosed with cancer in the UK. Design Survey of paediatric oncologists/haematologists. Questionnaires were sent electronically with reminder notifications to non-responders. Setting UK Paediatric Oncology Principal Treatment Centres (PTCs). Participants Paediatric oncologists/haematologists with an interest in the effects of treatment on fertility representing the 20 PTCs across the UK. Main outcome measures Referral practices, sources and length of funding for storage of gametes or gonadal tissue for children diagnosed with cancer in the preceding 12 months. Results Responses were received from 18 PTCs (90%) with responses to 98.3% of questions. All centres had referred patients for fertility preservation: ovarian tissue collection/storage 100% (n=18 centres), sperm banking 100% (n=17; one centre was excluded due to the age range of their patients), testicular tissue storage 83% (n=15), mature oocyte collection 35% (n=6; one centre was excluded due to the age range of their patients). All centres with knowledge of their funding source reported sperm cryopreservation was NHS funded. Only 60% (n=9) centres reported the same for mature oocyte storage. Of the centres aware of their funding source, half reported that ovarian and testicular tissue storage was funded by charitable sources; this increased in England compared with the rest of the UK. Conclusions Inequality exists in provision of fertility preservation for children with cancer across the UK. There is lack of formalised government funding to support international guidelines, with resultant geographical variation in care. Centralised funding of fertility preservation for children and young adults is needed alongside establishment of a national advisory panel to support all PTCs. All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article or uploaded as supplementary information.

中文翻译:

英国癌症患者的生育力保存不一致

目的 评估在英国被诊断患有癌症的儿童保留生育能力的使用情况和资金结构。儿科肿瘤学家/血液学家的设计调查。调查问卷以电子方式发送,并附有提醒通知给未答复者。设置英国儿科肿瘤学主要治疗中心 (PTC)。参与者 代表英国 20 个 PTC 的对治疗对生育能力的影响感兴趣的儿科肿瘤学家/血液学家。主要结果测量 过去 12 个月内被诊断患有癌症的儿童的配子或性腺组织储存的转诊实践、来源和资金期限。结果收到了 18 个 PTC (90%) 的回复,其中 98.3% 的问题得到了回复。所有中心都将患者转诊以保留生育能力:卵巢组织收集/储存 100%(n=18 个中心),精子库 100%(n=17;由于患者的年龄范围,一个中心被排除在外),睾丸组织储存 83%(n=15),成熟卵母细胞收集 35%(n=6;由于患者的年龄范围,一个中心被排除在外)。所有了解其资金来源的中心都报告说精子冷冻保存是由 NHS 资助的。只有 60% (n=9) 的中心报告了成熟卵母细胞储存的相同情况。在知道其资金来源的中心中,有一半报告说卵巢和睾丸组织储存是由慈善来源资助的;与英国其他地区相比,英格兰的这一数字有所增加。结论 在英国为患有癌症的儿童提供生育能力保护方面存在不平等。缺乏正式的政府资金来支持国际指导方针,从而导致护理的地域差异。需要为儿童和年轻人的生育力保护提供集中资金,同时建立一个国家咨询小组来支持所有 PTC。所有与研究相关的数据都包含在文章中或作为补充信息上传。所有与研究相关的数据都包含在文章中或作为补充信息上传。
更新日期:2022-02-18
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