Ovarian Tissue Cryopreservation in Pediatric Centers Across the United States: Practice Patterns and Barriers.

Abstract

Study objective: Evaluate practice patterns in ovarian tissue cryopreservation (OTC) provision.

Methods: United States providers practicing or developing OTC at pediatric programs were invited to participate in a survey disseminated via the Oncofertility Consortium.

Results: Twenty-seven programs representing a wide geographic area responded, largely representing academic institutions (85.2%). Of these, 21 (77.4%) performed OTC at their facility, the majority for oncology patients receiving gonadotoxic therapy, relapsed patients and non-oncologic patients receiving gonadotoxic therapy (95.7, 87.0, 82.6% respectively). OTC procedures were most commonly performed by pediatric gynecology surgeons (71.4%) via laparoscopic oophorectomy (90.5%) using a heat-based method (55.0%) for dissection. Most centers used an outside compensated service (50%) or a reproductive endocrinology group (45%) for processing tissue. Many (13, 61.9%) performed OTC as standard of care and 7 utilized an IRB for data collection. Of the 8 centers whose OTC programs are in the planning or early stages, frequently identified barriers were lack of priority within their medical team or institution (5/8), lack of protected time (3/8), and lack of funding (3/8).

Conclusions: OTC is commonly offered to oncology patients receiving highly gonadotoxic therapy with pediatric gynecologists frequently involved in counseling and performing OTC. Variability exists in offering OTC to other patient populations, as well as in research practices, surgical technique and processing. Institutions continue to face barriers in offering OTC when necessary resources are not prioritized by leadership.