In this episode, Dr. Leslie Appiah, who is fellowship-trained in Pediatric and Adolescent Gynecology and is the Director of the Fertility Preservation Program at the University of Colorado, discusses oncofertility and fertility preservation.

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Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/KtEfCL

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SHOW NOTES

Dr. Appiah begins the episode by defining oncofertility as a multidisciplinary field that improves fertility and reproductive health outcomes for patients with cancer diagnoses. She emphasizes the growth of the field, with the term “oncofertility” being coined in 2009 by Dr. Teresa Woodruff at Northwestern University. Now, 13 states have legislation that mandates insurance providers to cover fertility services for patients with and without cancer.

The primary patient population that may benefit includes patients with a cancer diagnosis, although additional populations who may benefit, including patients with Sickle Cell Anemia undergoing bone marrow transplant, systemic lupus erythematosus using alkylator therapies, transgender populations undergoing gender-affirming treatments, and patients born with genetic conditions that may result in infertility (e.g., Turner Syndrome). The main agents that are harmful to fertility include alkylator and radiation therapies.

The physicians then transition to discuss fertility preservation, and Dr. Appiah highlights that it is the responsibility of medical providers to offer counseling for every patient who is at risk for infertility. She then describes types of fertility preservation, including sperm banking, testicular tissue preservation, egg freezing, and ovarian tissue cryopreservation. Dr. Appiah then shares 3 different procedures that are used for ovarian tissue cryopreservation, the most common approach begin a laparoscopic procedure to retrieve one ovary, which is then preserved and later transplanted back into the pelvic peritoneum once the patient has completed cancer therapies and is ready to start a family.

The episode concludes with Dr. Appiah shares future directions in the field of oncofertility, which includes streamlining the process for male patients, ensuring every state is able to allow fertility preservation services that are covered by insurance providers, optimizing the process of transplanting ovarian tissue, and utilizing ovarian tissues for hormone replacement.

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RESOURCES

ReproTech, Fertility Preservation:
https://www.reprotech.com/fertility-preservation-network/

Oncofertility Consortium:
https://oncofertility.msu.edu/about/

Alliance for Fertility Preservation, Fertility Scout:
https://www.allianceforfertilitypreservation.org/about-fertility-scout/