title: Practices of pediatric oncology and hematology providers regarding fertility issues: a European survey.
abstract: BACKGROUND
  Fertility is impaired in many survivors of childhood cancer following treatment. Preservation of fertility after cancer has become a central survivorship concern. Nevertheless, several doctors, patients, and families do not discuss fertility and recommendations for fertility preservation in pediatrics are still lacking. Recommendations based on scientific evidence are needed and before their development we wanted to assess the practice patterns of fertility preservation in Europe.
  
  
  METHODS
  On behalf of the PanCare network, we sent a questionnaire to pediatric onco-hematology institutions across Europe. The survey consisted of 21 questions assessing their usual practices around fertility preservation.
  
  
  RESULTS
  One hundred ninety-eight institutional representatives across Europe received the survey and 68 (response rate 34.3%) responded. Pre-treatment fertility counseling was offered by 64 institutions. Counseling was done by a pediatric onco-hematologist in 52% (33/64) and in 32% (20/64) by a team. The majority of institutions (53%) lacked recommendations for fertility preservation. All 64 centers offered sperm banking; eight offered testicular tissue cryopreservation for pre-pubertal males. For females, the possibility of preserving ovarian tissue was offered by 40 institutions.
  
  
  CONCLUSIONS
  There is a high level of interest in fertility preservation among European centers responding to our survey. However, while most recommended sperm cryopreservation, many also recommended technologies whose efficacy has not been shown. There is an urgent need for evidence-based European recommendations for fertility preservation to help survivors deal with the stressful topic of fertility.
authors: Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors: Monica
authors: M
authors: Terenziani
authors: Marco
authors: M
authors: Spinelli
authors: Momcilo
authors: M
authors: Jankovic
authors: Edit
authors: E
authors: Bardi
authors: Lars
authors: L
authors: Hjorth
authors: Riccardo
authors: R
authors: Haupt
authors: Gisela
authors: G
authors: Michel
authors: Julianne
authors: J
authors: Byrne
mesh_terms: D002648:Child; D003376:Counseling; D005060:Europe; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000503:physiopathology*
keywords: childhood cancer survivors; fertility preservation; survey