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2014 ; 3
(4
): 144-152
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Critical Review of Clinical Practice Guidelines for Fertility Preservation in
Teenagers and Young Adults with Cancer
#MMPMID25538859
Jakes AD
; Marec-Berard P
; Phillips RS
; Stark DP
J Adolesc Young Adult Oncol
2014[Dec]; 3
(4
): 144-152
PMID25538859
show ga
Purpose: The 5-year survival of teenagers and young adults (TYAs; 13-24 years
old) with cancer has continued to rise, but as a result more patients experience
late effects of treatment, such as infertility. Advice regarding fertility
preservation in relation to cancer is provided in numerous clinical practice
guidelines, but the rigor of their development is unclear. Methods: A systematic
search was undertaken for clinical practice guidelines regarding fertility
preservation in TYAs with cancer. All guidelines were reviewed according to the
Appraisal of Guidelines for Research and Evaluation (AGREE-II) criteria. Five out
of 13 identified guidelines scored over 75% in the "rigor of development" section
and were further appraised. Content, scope, and consistencies between
recommendations were also examined. Results: All five of the reviewed guidelines
encouraged oncologists to have discussions with their patients about potential
fertility issues associated with treatment and available fertility preservation
methods. The cryopreservation of sperm, oocytes, and embryos were all recommended
as first-line interventions in postpubertal patients. Recommendations surrounding
pre- or peripubescent adolescents were few, with many techniques only recommended
as part of a clinical trial. The risk of subfertility associated with different
treatment regimens was poorly described. Conclusions: The methodology and
development of guidelines describing fertility preservation in TYA cancer
patients varied greatly. Methodological quality did not clearly influence key
recommendations. Those involved with the development of guidelines are encouraged
to clearly define their development methods to allow users to be confident of the
quality.