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Regional differences affect access to fertility preservation for children with cancer

27 September 2021
Appeared in BioNews 1114

Young people with cancer in the UK face a postcode lottery leaving many at risk of missing out on the chance to have children. 

Researchers at the University of Leeds surveyed 20 paediatric oncology centres about whether their patients have access to fertility preservation services and how these treatments are funded. Their results, published in the Archives of Diseases in Childhood show the extent of variation in access to fertility preservation for children with cancer. 

Lead author Professor Adam Glaser, a paediatric oncologist at Leeds Teaching Hospital, said, 'Opting for fertility preservation is not a simple choice – it requires specialist oncofertility expertise and often involves a surgical procedure at the time of the cancer diagnosis. Additional uncertainties about funding puts extra strain on families at a very difficult time. Having consistent funding from a central source would at least remove one of the barriers that currently exist in some regions.'

In the UK, about 1800 children aged 0-14 years are diagnosed with cancer each year, but advances in cancer treatment mean that over 80 percent of them now recover. However, for around a fifth of survivors either their cancer, or the treatment they received for it, can cause significant damage to their reproductive organs and threaten their future fertility.

Of 18 centres that responded to the survey, all had referred patients for fertility preservation in the previous 12 months. Of these, every centre with appropriately aged patients had referred girls for ovarian tissue storage and boys for sperm banking. Testicular tissue storage was used by 15 centres and mature oocyte collection by six (one did not have patients old enough for this to be viable). 

All the centres reported that sperm freezing was NHS-funded, but only 60 percent reported the same for mature oocyte storage. For ovarian and testicular tissue cryopreservation – which is used in younger patients who have not gone through puberty – half of the centres reported that this was funded by charitable sources.

An NHS spokesperson told PlanetRadio 'Cancer survival rates for children have increased substantially thanks to greater awareness, better access to tests and more lifesaving NHS treatments and all children with cancer should be advised about their options for fertility preservation before treatment begins in line with guidelines set out by the National Institute for Health and Care Excellence.'

Sarah Norcross, director of the Progress Educational Trust (the charity that publishes BioNews) said 'The UK government needs to take immediate action to provide equitable access to fertility preservation services for this vulnerable patient group who may not have time to access treatment if it is not a clear and integral part of their treatment pathway.'

SOURCES & REFERENCES
Fund future fertility for childhood cancer patients fairly, say experts Category
University of Leeds |  21 September 2021
Inconsistencies in fertility preservation for young people with cancer in the UK
Archives of Disease in Childhood |  20 September 2021
Young cancer patients face 'inequality in fertility care'
Planet Radio |  22 September 2021
Young cancer patients in UK face ‘inequality of fertility provision’
Guardian |  20 September 2021
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