The medical community has known for a very long time that chemotherapy is disruptive to reproductive function and that young women undergoing chemotherapy have a greater chance of entering early menopause. In the 1970s, two articles were published acknowledging these two issues: Depletion of Growing Follicles and Premature Menopause, indicating a growing awareness among the scientific community that fertility preservation needed to be addressed. Since then, we have seen a steady increase in fertility preservation programs across the United States and the world.
Over the last 30 years in the United Kingdom, the survival rate for young adults with cancer has increased dramatically resulting in the current statistic that 70% of young people with cancer will survive 5 years or more after their last treatment. In addition to that, the incidence of pediatric cancer has increased, requiring a closer examination of fertility impairments as a result of cancer treatment as well as preventative measures that can be performed prior to treatment to protect reproductive function. Over the last 10 years, publications in the UK addressing fertility preservation have more than doubled demonstrating a growing interest in this sub specialty, oncofertility.
A recent visitor to the Oncofertility Consortium, Dr. Richard Anderson, Professor of Clinical Reproductive Science at the University of Edinburgh, spoke at the Oncofertility Virtual Grand Rounds yesterday and discussed how the fertility preservation program at the Queens Medical Research Institute is administered. Similar to the Oncofertility Consortium, Dr. Anderson states that good colleagues from diverse backgrounds are needed to ensure that a program runs smoothly. A set of criteria is also needed to determine which individuals are good candidates for fertility preservation. This is especially important in Scotland, where the resources (i.e., number of fertility treatments available) are limited by the federal health system. A functioning registry, which requires an effort from both the provider and the patient, is required to keep the links of communication open to ensure that the tissue is being properly handled.
Currently, the fertility preservation program in the United Kingdom does not have an organization similar to the National Physicians Cooperative, which Dr. Anderson argued would only benefit the success of the program going forward. Through his visit we were able to share our experiences in this burgeoning field and gain insights into how we can work together on this intractable problem in an effort to address fertility preservation globally. A video of Dr. Anderson’s presentation entitled, “Fertility Perseveration: Where We Are, and How We Got Here,” is available now.