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Clinical guide to fertility preservation in hematopoietic cell transplant recipients

Bone Marrow Transplantation volume 49, pages 477–484 (2014)Cite this article

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Abstract

With broadening indications, more options for hematopoietic cell transplantation (HCT) and improvement in survival, the number of long-term HCT survivors is expected to increase steadily. Infertility is a frequent problem that long-term HCT survivors and their partners face and it can negatively impact on the quality of life. The most optimal time to address fertility issues is before the onset of therapy for the underlying disease; however, fertility preservation should also be addressed before HCT in all children and patients of reproductive age, with referral to a reproductive specialist for patients interested in fertility preservation. In vitro fertilization (IVF) and embryo cryopreservation, oocyte cryopreservation and ovarian tissue banking are acceptable methods for fertility preservation in adult women/pubertal females. Sperm banking is the preferred method for adult men/pubertal males. Frequent barriers to fertility preservation in HCT recipients may include the perception of lack of time to preserve fertility given an urgency to move ahead with transplant, lack of patient–physician discussion because of several factors (for example, time constraints, lack of knowledge), inadequate access to reproductive specialists, and costs and lack of insurance coverage for fertility preservation. There is a need to raise awareness in the medical community about fertility preservation in HCT recipients.

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Acknowledgements

The CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID); a Grant/Cooperative Agreement 5U01HL069294 from NHLBI and NCI; a contract HHSH234200637015C with Health Resources and Services Administration (HRSA/DHHS); two Grants N00014-06-1-0704 and N00014-08-1-0058 from the Office of Naval Research; and grants from Allos, Inc., Amgen, Inc., Angioblast, anonymous donation to the Medical College of Wisconsin, Ariad, Be the Match Foundation, Blue Cross and Blue Shield Association, Buchanan Family Foundation, CaridianBCT, Celgene Corporation, CellGenix, GmbH, Children’s Leukemia Research Association, Fresenius-Biotech North America, Inc., Gamida Cell Teva Joint Venture Ltd., Genentech, Inc., Genzyme Corporation, GlaxoSmithKline, HistoGenetics, Inc., Kiadis Pharma, The Leukemia & Lymphoma Society, The Medical College of Wisconsin, Merck & Co, Inc., Millennium: The Takeda Oncology Co., Milliman USA, Inc., Miltenyi Biotec, Inc., National Marrow Donor Program, Optum Healthcare Solutions, Inc., Osiris Therapeutics, Inc., Otsuka America Pharmaceutical, Inc., RemedyMD, Sanofi, Seattle Genetics, Sigma-Tau Pharmaceuticals, Soligenix, Inc., StemCyte, A Global Cord Blood Therapeutics Co., Stemsoft Software, Inc., Swedish Orphan Biovitrum, Tarix Pharmaceuticals, Teva Neuroscience, Inc., THERAKOS, Inc. and Wellpoint, Inc. P Stratton is supported by the Intramural Program of the National Institutes of Child Health and Human Development.

Author information

Author notes

  1. S Joshi and B N Savani: S Joshi and BN Savani are co-first authors in this study.

Authors and Affiliations

  1. Nationwide Children’s Hospital, Columbus, OH, USA

    S Joshi

  2. Vanderbilt University Medical Center, Nashville, TN, USA

    B N Savani

  3. Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    E J Chow & M L Sorror

  4. Department of Haematology, St. James’s University Hospital, Leeds, UK

    M H Gilleece

  5. Division of Hematology, University Hospital Basel, Basel, Switzerland

    J Halter

  6. Division of Blood and Marrow Transplantation, Children’s National Medical Center, Washington, DC, USA

    D A Jacobsohn

  7. Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, FL, USA

    J Pidala

  8. Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA

    G P Quinn

  9. Department of Hematology, University Hospital, Grenoble, France

    J-Y Cahn

  10. Division of Hematologic Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    A A Jakubowski

  11. Center for Cancer and Blood Disorders, Children’s National Medical Center, Washington, DC, USA

    N R Kamani

  12. Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH, USA

    H M Lazarus

  13. Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA

    J D Rizzo

  14. University Hospital Maastricht, Maastricht, The Netherlands

    H C Schouten

  15. Hopital Saint Louis, Paris, France

    G Socie

  16. Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA

    P Stratton

  17. Department of Pediatrics, Uniformed Services University, Bethesda, MD, USA

    A B Warwick

  18. Bone Marrow Transplant, Shands HealthCare, University of Florida, Gainesville, FL, USA

    J R Wingard

  19. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    A W Loren

  20. Center for International Blood and Marrow Transplant Research, National Marrow Donor Program, Minneapolis, MN, USA

    N S Majhail

Authors
  1. S Joshi
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  2. B N Savani
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  3. E J Chow
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  4. M H Gilleece
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  5. J Halter
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  6. D A Jacobsohn
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  7. J Pidala
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  8. G P Quinn
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  9. J-Y Cahn
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  10. A A Jakubowski
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  11. N R Kamani
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  12. H M Lazarus
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  13. J D Rizzo
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  14. H C Schouten
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  15. G Socie
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  16. P Stratton
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  17. M L Sorror
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  18. A B Warwick
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  19. J R Wingard
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  20. A W Loren
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  21. N S Majhail
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Corresponding author

Correspondence to N S Majhail.

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Competing interests

The authors declare no competing financial interests.

Additional information

Author Contributions

NSM had full access to all of the data in the study and had final responsibility for the integrity of the data, the accuracy of the data analysis and the responsibility for the decision to submit for publication. The concept for this review was prepared by SJ, BNS, EJC, MHG, JH, DAJ, JP, GPQ, AWL and NSM. All authors contributed to the preparation and writing of this review and critically revised the manuscript. All authors have reviewed and approved the final version of the manuscript.

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Joshi, S., Savani, B., Chow, E. et al. Clinical guide to fertility preservation in hematopoietic cell transplant recipients. Bone Marrow Transplant 49, 477–484 (2014). https://doi.org/10.1038/bmt.2013.211

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  • DOI: https://doi.org/10.1038/bmt.2013.211

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