Practical Workings of a Pediatric and Adolescent Fertility Preservation Program, from Consults to Care Models (003)

In recent years, there has been increased emphasis on fertility preservation (FP) in pediatric hematology/oncology centers. The growing population of cancer patients and patients receiving hematopoietic cell transplants (HCTs) for nonmalignant diseases (e.g., sickle cell disease) has resulted in more patients expressing interest in FP information and interventions at Children’s Healthcare of Atlanta (CHOA).

The FP team at CHOA has accommodated this demand with efforts in several areas of focus:

  • Create and train a core FP team of varied specialties (endocrinology, oncology, psychology) and varied disciplines (physician, PhD, PNP, RNs) to oversee the work of the program.
  • Give focused FP education to new RNs joining the hematology/oncology service line.
  • Build a library of FP patient education resources in print, online, and video formats.
  • Develop models of care that optimize provider time and ensure top-of-license practice for each team member through nurse navigation and innovative assignments of urgency levels.
  • FP consult volumes have consistently increased year-over-year, increasing from 87 in 2016 to 181 in 2020, meaning more patients and families are now getting timely information about infertility risk based on planned treatment and, if possible, being given the opportunity to make a decision about preserving fertility.

Even those who may not wish to preserve fertility are granted a bit of control and decisional satisfaction in the midst of a tumultuous time. The team is also counseling in survivorship about possible infertility as a late effect and offering fertility status assessments or interventions, if applicable. These strategies have expedited FP referrals and consults for those who have short timelines before treatment. They have been impactful in enabling us to reach our growing population of oncology patients and patients with noncancer conditions who might benefit from fertility-focused education, intervention, and follow-up care, both before and after bone marrow transplant.

James Ludemann, BSN RN OCN CPHON®

Megan Pruett, MSN CPNP

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