Global Policies on Oncofertility

Table of Contents

Oncofertility: Global Strategies and Collaborations for Fertility Preservation in Cancer Patients

In recent years, there’s been a significant improvement in cancer survival rates, particularly among younger patients. This progress is largely attributed to advancements in cancer treatments. However, a critical concern for these survivors, both men and women, is the potential risk of infertility caused by cancer or its treatments.

The field of oncofertility, a term coined to define this emerging discipline, initially concentrated on addressing fertility issues in cancer patients. However, the scope has broadened to include nonmalignant diseases and iatrogenic causes of infertility. Conditions like GI diseases, rheumatologic disorders, β thalassemia, neurologic, renal, and gynecologic disorders, as well as metabolic diseases, are now recognized as potential threats to fertility. This expansion ensures that a wider range of patients facing reproductive challenges due to diseases or treatments can benefit from oncofertility research and clinical advances.

Globally, the OC’s influence extends to 19 countries, each contributing to a growing body of shared knowledge and practices in the field of oncofertility. The goal is to continue expanding these international collaborations, bringing together centers of excellence to strengthen the global oncofertility community. International partnerships, advocacy groups, governments, and other stakeholders are increasingly engaged to promote advancements in reproductive care for those affected by cancer and other fertility-threatening conditions.

By establishing a robust global network, the OC not only enhances the collaborative nature of the field but also supports the development of local consortia and fertility preservation networks worldwide. This international effort is crucial in addressing the diverse cultural and medical needs of young cancer patients and those with other fertility-threatening diseases, ensuring access to the latest in fertility preservation and reproductive care globally.

The OC’s model of global partnership underlines the importance of multidisciplinary collaboration among reproductive specialists to serve children, adolescents, and young adults facing cancer and other diseases that threaten fertility. Through this collaborative and inclusive approach, the OC continues to drive forward scientific research and clinical innovation, making significant strides in oncofertility care across the globe.

Advocating for Global Networks in Fostering Reproductive Health Care Standards

The era of globalization has significantly expanded the influence of research universities, marking notable successes in knowledge enhancement. In the realm of oncofertility, extending this network globally transcends geographical boundaries, fostering knowledge exchange and discovery. Such international collaborations in oncofertility not only enrich scientific understanding but also ensure equitable access to diverse expertise. This global interconnection accelerates research findings, shortens the journey from laboratory to clinical application, and increases the potential for groundbreaking discoveries in reproductive health.

Research highlights the positive impact of international collaborations and networking on scientific progress. These partnerships attract broader attention to key issues, lead to increased publication rates, and garner more support for both basic and clinical research. When scientific findings are shared globally, the audience and influence of this research expand, enhancing its potential to significantly impact future patient care in reproductive health.

Recognizing the value of diverse networks, the Oncofertility Consortium (OC) diligently works to link local centers of excellence, building a robust global network of collaborators. This network, comprising partners who might not have interacted otherwise, bolsters clinical activities (like shared protocols and patient case studies), research efforts (sharing both successes and failures to expedite progress), and patient-focused initiatives (such as educational websites and patient decision tools). The OC’s facilitation of these interactions ensures a coordinated global effort in oncofertility research, paving the way for rapid clinical translation and the establishment of evidence-based reproductive health care standards.

Currently, numerous global partners contribute to the expanding oncofertility network. This article highlights six active partners who have made significant contributions to the field. These partners, engaged with the OC, have developed programs specifically tailored to meet the needs of patients in their respective countries. The OC provides foundational support, insights, and resources to these centers, enhancing fertility preservation research. In return, these global partners offer their unique perspectives, experiences, and scientific findings to the OC and the wider network, enriching the overall quality of patient care in the field of reproductive health.

Through its global partnerships, the OC exemplifies the power of collaborative networks in advancing reproductive health care standards. This model of international cooperation in oncofertility research and clinical practice not only fosters scientific innovation but also ensures that patients worldwide have access to the latest developments in fertility preservation and reproductive health care. As the network continues to grow, it stands as a testament to the transformative power of global collaboration in healthcare.

Advancements in Oncofertility Care and Research in Australasia

In the regions of Australia and New Zealand, there has been significant progress in integrating oncology and reproductive medicine. This integration is primarily through the development of specialized oncofertility services and dedicated research initiatives. These efforts aim to bridge the gaps between these two critical medical disciplines.

The Fertility Society of Australia, recognizing the need for collaboration between oncology and fertility specialists, established a special interest group in 2008. This group’s primary objectives are to foster collaborative research, enhance communication, and improve educational exchanges between cancer care and fertility treatment professionals.

2014 marked a significant milestone with the establishment of the Australasian Oncofertility Consortium (AOC). This consortium is dedicated to fostering interdisciplinary innovation in oncofertility across Australia and New Zealand. Its mission is to support and enhance the collaborative efforts of cancer and fertility specialists in the region, with a focus on improving oncofertility practices and services. In addition to this, the consortium has been proactive in engaging with consumer groups. This collaboration has led to the creation of over 30 resources on fertility preservation, sexual health, and sexual dysfunction. Furthermore, the consortium is in the process of developing e-learning tools for clinicians, expected to launch in the near future.

The efforts in Australasia exemplify a commitment to advancing oncofertility care and research. These developments not only benefit patients in Australia and New Zealand but also contribute valuable knowledge and best practices to the international oncofertility community.

Pioneering Fertility Preservation in Cancer Care: The Brazilian Oncofertility Consortium’s Journey

The Brazilian Oncofertility Consortium (BOC), also known as Rede Brasileira de Oncofertilidade, was established in 2012 to revolutionize cancer care by integrating fertility preservation. This network spans several key regions in Brazil, including Minas Gerais, São Paulo, Rio Grande do Sul, Ceará, the Federal District, and Bahia. The BOC has significantly raised awareness and sparked national discussions about fertility preservation options for cancer patients. It directs patients to leading assisted reproduction centers equipped with cutting-edge research protocols for the cryopreservation of semen, oocytes, embryos, and ovarian tissue. In addition to medical treatments, the BOC ensures that patients receive comprehensive psychological support to assist them in making informed decisions about their reproductive future.

A notable development in Fortaleza since 2014 is the introduction of innovative therapies for cancer treatment that prioritize the preservation of tissue function, specifically through ovarian tissue cryopreservation. Moreover, this region is conducting groundbreaking research in ovarian tissue reimplantation using animal models and assessing the effects of autografts on bone metabolism restoration.

The Brazilian Oncofertility Consortium’s efforts are not just limited to medical interventions. They are actively working to bridge the gap between oncology and reproductive medicine, ensuring that cancer patients are well-informed about their fertility preservation options and reproductive prospects. This comprehensive approach places Brazil at the forefront of oncofertility care, contributing to the global narrative of integrating fertility preservation into cancer treatment.

Europe’s FertiPROTEKT Network: A Beacon in Oncofertility Care and Research

In Europe, a significant stride in oncofertility care was initiated with the founding of the FertiPROTEKT network. Originating from the Departments for Gynecological Endocrinology and Reproductive Medicine at the Universities of Heidelberg and Bonn in Germany, FertiPROTEKT began its journey in May 2006. As of January 2014, FertiPROTEKT has seen remarkable growth, with approximately 100 centers across Germany, Austria, and Switzerland becoming part of its expansive network. Echoing the goals of the Oncofertility Consortium, FertiPROTEKT is dedicated to elevating the standard of patient care through the implementation of standardized protocols and rigorous quality control measures.

The network’s key achievements include the refinement of stimulation therapies administered before cytotoxic treatments, the innovative combination of ovarian stimulation with ovarian tissue cryopreservation, and the establishment of efficient overnight transportation systems for ovarian tissue. FertiPROTEKT’s members have conducted and analyzed around 60 ovarian tissue transplantations to date, showcasing the network’s commitment to advancing fertility preservation techniques.

The FertiPROTEKT network serves as a model of excellence in oncofertility, demonstrating the power of collaboration and innovation in addressing fertility preservation in cancer patients. Its approach, combining cutting-edge research, patient-centered care, and professional collaboration, positions it as a leading force in the field of oncofertility, not only in Europe but globally.

Advancing Oncofertility Care in Japan: The Journey of JSFP

In November 2012, Japan marked a significant milestone in oncofertility care with the establishment of the Japan Society for Fertility Preservation (JSFP), a nonprofit organization dedicated to enhancing the survival and quality of life of young cancer patients. One of the JSFP’s main objectives is to ensure timely and accurate information about fertility preservation options reaches young cancer patients.

An innovative approach of the JSFP has been the development of a healthcare coordination system designed to promptly provide fertility preservation information within local communities. Since its inception, similar healthcare networks have been established in various prefectures, including Okayama, Nagasaki, Fukuoka, and Okinawa, with the goal of achieving nationwide coverage.

The JSFP’s collaboration extends internationally, working closely with OC Japan and engaging in activities to expand oncofertility programs across Asia. This includes partnerships with the Korean Society for Fertility Preservation (KSFP) and the Fertility Preservation Society of India (FPI), underscoring the society’s commitment to advancing oncofertility care not only in Japan but throughout the Asian region.

Advancing Fertility Preservation in Portugal: The Role of the Portuguese Centre for Fertility Preservation

The Portuguese Centre for Fertility Preservation, established in 2010 at the Coimbra Hospital and University Centre, represents a pioneering initiative in Portugal’s healthcare landscape. This center was created to address the reproductive needs of patients undergoing potentially fertility-compromising treatments. While male fertility preservation has been available in various public institutions since the 1990s, the availability of female fertility preservation in Portuguese public practice was notably absent until the establishment of this center. It stands as the only center in Portugal offering comprehensive fertility preservation services to both men and women.

The center not only receives patient referrals from oncologists but also addresses the needs of those who seek consultation independently. A key objective is to enhance awareness among patients, health professionals, and the general public about the impact of cancer on fertility, available fertility preservation techniques, and the assembly of a supportive team for patient counseling and decision-making assistance.

Research is another critical component of the center’s work, focusing on the fertility preservation decision-making process, the impact of these decisions on individuals’ future adaptation, the effects of cancer treatments on reproductive function, and the development of new fertility preservation techniques. This network aims to facilitate multidisciplinary consultations, enabling patients and oncologists nationwide to make more informed and timely decisions about fertility preservation. Additionally, the center plans to produce and disseminate oncofertility decision aids targeted at the pediatric population and pediatricians and to establish protocols for the cryopreservation of ovarian and testicular tissues in prepubertal patients. These initiatives position the Portuguese Centre for Fertility Preservation at the forefront of fertility preservation in Portugal, significantly contributing to the field of oncofertility both nationally and internationally.

Enhancing Fertility Preservation in Korea: The Role of the Korean Society for Fertility Preservation

The Korean Society for Fertility Preservation (KSFP) was inaugurated in 2013, marking a significant development in the field of reproductive health in Korea. The society aims to foster collaboration between medical professionals specializing in reproductive medicine and oncology. The primary mission of KSFP is to assist patients undergoing treatments that potentially impact their fertility and reproductive functions. The society’s objectives encompass academic education, networking, advocacy, discussion, and the development of standardized protocols for fertility preservation. The overarching goal of this network is not only to enhance the quality of treatment but also to standardize the level of care and services across all institutions in Korea.

KSFP’s initiatives represent a comprehensive approach to fertility preservation, combining cutting-edge research, patient-focused care, and professional collaboration. These efforts place KSFP at the forefront of fertility preservation in Korea and contribute to the broader global narrative of integrating fertility preservation into healthcare for cancer patients and others facing fertility-threatening treatments.

Oncofertility in Turkey: An Emerging Field

In Turkey, the field of oncofertility is evolving, reflecting a growing awareness of the importance of fertility preservation in cancer patients. The integration of oncofertility into Turkish healthcare represents a significant advancement in both cancer care and reproductive medicine. This progress aligns with global trends, recognizing the need for comprehensive care strategies that address the fertility concerns of cancer survivors.

  1. Healthcare Landscape: Turkey’s healthcare system has undergone significant transformations over the years, aiming to provide more accessible and comprehensive care. The inclusion of oncofertility services into this system marks a vital step in offering holistic cancer treatment.
  2. Collaborative Efforts: Like many countries embracing oncofertility, Turkey has seen collaboration between oncologists, reproductive medicine specialists, and researchers. These interdisciplinary teams work together to provide the best possible care for patients facing fertility-threatening cancer treatments.
  3. Patient Awareness and Support: Efforts have been made in Turkey to raise awareness among cancer patients about the potential impact of treatments on fertility. Providing information and support regarding fertility preservation options has become an integral part of cancer care.
  4. Research and Development: Turkish medical researchers are contributing to the global body of knowledge in oncofertility. Research initiatives focus on developing and refining fertility preservation techniques and understanding the long-term effects of cancer treatments on reproductive health.
  5. Regulatory Environment: The legal and ethical framework in Turkey concerning fertility preservation and assisted reproductive technologies is evolving. This evolution reflects a broader understanding of the significance of fertility issues in cancer treatment and survivorship.
  6. Training and Education: There’s a growing emphasis on training healthcare professionals in Turkey about the nuances of oncofertility. This training ensures that doctors, nurses, and other healthcare workers can provide informed guidance to patients considering fertility preservation.
  7. Challenges and Opportunities: While oncofertility is gaining ground in Turkey, there are challenges, such as ensuring equitable access to fertility preservation services across different regions and socioeconomic groups. Overcoming these challenges presents opportunities for Turkey to enhance its healthcare offerings and improve quality of life for cancer survivors.

Future Prospects

As Turkey continues to develop its oncofertility capabilities, it is poised to become a key player in the regional landscape of fertility preservation. The country’s efforts to integrate oncofertility care into its healthcare system, coupled with a focus on research and collaborative practice, demonstrate a commitment to addressing the fertility needs of cancer patients comprehensively. This approach not only benefits Turkish patients but also contributes to the global advancement of oncofertility.

Overcoming Obstacles and Embracing Opportunities for Collaborative Growth in Oncofertility

Oncofertility, a field that integrates reproductive health with oncology, basic and clinical research, and spans across medical and social sciences, inherently depends on collaboration. The success of the global oncofertility initiative is propelled by the collective knowledge and experiences of all partners and stakeholders within the Oncofertility Consortium (OC), both nationally and internationally. While the journey is not without its challenges and barriers, such as the constraints of time and distance, these are often offset by the shared commitment and unity among team members.

One of the key obstacles encountered by the OC includes country-specific restrictions, such as regulations on embryo banking or the use of gestational carriers. These limitations can impede activities in certain regions, yet the shared understanding and experiences from other areas offer valuable insights and opportunities to navigate and overcome these local barriers.

The pathway to success in oncofertility is not one-size-fits-all. Due to various factors, strategies that work for one center might not be as effective for another. The OC’s triumph lies in its ability to motivate individuals and groups to take action and its collective dedication to serving people with iatrogenic fertility concerns. By facilitating access to a global network rich in knowledge, experience, and innovation, the OC enhances patient care at individual practices.

Communication and collaboration across disciplinary, institutional, and geographic boundaries are key strengths of the OC. Training the next generation of oncofertility professionals to embrace this multidisciplinary, multinational approach is crucial. Engaging all stakeholders, including those outside traditional institutional realms, ensures the continual rapid translation of scientific research into quality medical practice.

The OC’s approach of incorporating diverse scientific, cultural, ethical, and personal perspectives from new partners enriches oncofertility research and patient care. The most promising strategies for future success in oncofertility involve multifaceted approaches that connect different cultures, communities, and countries. By adopting an inclusive strategy in fertility preservation research and clinical care, the OC is set to continue building cohesive and highly effective communities of oncofertility practice, further advancing the field and improving patient outcomes worldwide.