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Fertility Preservation

Unit 6 Lesson 6

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Student Learning Outcomes

At the end of the lesson, students will be able to:

Describe treatment impact on future fertility

Discuss fertility preservation options

Discuss pediatric oncology clients' reproductive rights

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Introduction

Advances in pediatric cancer treatment have improved survival rates
Cancer treatments can have long-term effects on fertility
Understanding these effects is important for informed decision-making

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General Impact on Fertility

Chemotherapy and radiation can damage reproductive organs
Risk depends on:

Type and dose of treatment
Client's age
Cancer location

(Chen, et al., 2023; Kim et al., 2018.)

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Impact on Females

Chemotherapy can damage ovarian follicles
Radiation near ovaries or uterus can cause damage
High-dose alkylating agents increase risk of ovarian failure
Cranial radiation can disrupt hormone production

(Chen, et al., 2023; Kim et al., 2018.)

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Impact on Males

Chemotherapy can damage sperm-producing cells
Radiation near testes can cause damage
Alkylating agents increase risk of infertility
Cranial radiation can disrupt hormone production

(Chen et al., 2023.)

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Critical Thinking Question

A nurse is caring for a 14-year-old female client newly diagnosed with Hodgkin's lymphoma. The oncologist has recommended treatment with alkylating agents. What would be the nurse's most appropriate action regarding the client’s future fertility?

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Fertility Preservation: Females

Post-pubertal options:

Embryo cryopreservation

Freeze fertilized eggs

Oocyte cryopreservation

Freeze unfertilized eggs

Ovarian tissue cryopreservation

Freeze ovarian tissue for transplantation

Pre-pubertal option:

Ovarian tissue cryopreservation (experimental)

(Chen, et al., 2023; Kim et al., 2018.)

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Fertility Preservation: Males

Post-pubertal options:

Sperm cryopreservation

Freeze sperm samples

Testicular tissue cryopreservation

Freeze testicular tissue

Pre-pubertal option:

Testicular tissue cryopreservation (experimental)

(Chen et al., 2023.)

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Critical Thinking Question

A nurse is discussing fertility preservation options with a 16-year-old male client diagnosed with testicular cancer. Which option should the nurse primarily recommend for this client?

A) Testicular tissue cryopreservation

B) Sperm cryopreservation

C) Ovarian tissue cryopreservation

D) Embryo cryopreservation

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Reproductive Rights

Right to be informed about treatment impact on fertility
Age-appropriate discussions respecting values
Adequate time and support for decision-making
Decisions made in child's best interest
Equitable access to fertility preservation services

(Chen, et al., 2023; Kim et al., 2018.)

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Key Points to Remember

Cancer treatments can affect future fertility
Discuss fertility preservation before starting treatment
Consider age and developmental stage when discussing options
Respect client and family rights and values
Provide support throughout the decision-making process

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References

Chen, L., Dong, Z. & Chen, X. (2023). Fertility Preservation in Pediatric Healthcare: A Review. Frontiers in Endocrinology (Lausanne), 14:1147898. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10189781/

Kim, H., Kim, H. & Ku, S.Y. (2018). Fertility Preservation in Pediatric and Young Adult Female Cancer Patients. Annals of Pediatric Endocrinology and Metabolism, 23(2):70-74. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057020/

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