The protection and preservation of fertility is particularly important for patients with
tumor diseases prior to cell-damaging therapies, especially in pediatric oncology and
during stem cell transplantation.
Fertility preservation in CAYA (Children, Adolescents, and Young Adults) remains a topic
that receives limited attention in everyday clinical practice. While it has been
addressed in pediatric oncology for years, it is often inconsistently implemented in
daily ward routines and rarely adheres to clinical guidelines.
A rational strategy for fertility-preserving and endocrinological follow-up care should
consider not only the therapeutic modalities employed in light of the patient's
underlying disease but also the age and gender of the patient at the time of therapy.
The structured documentation of critical risk factors for the manifestation of
fertility-restricting endocrinological late effects, as well as precise longitudinal
documentation, are therefore of immediate importance in clinical patient care. They
ensure the quality of diagnostic and therapeutic processes and outcomes and enable both
retrospective and prospective scientific investigations.
The following key questions are central to this effort:
Can predictive factors or combined predictor variables for fertility disorders
during follow-up be developed based on detailed clinical and laboratory phenotyping
of patients before and after exposure to gonadotoxic therapies (e.g., therapeutic
exposures, endocrinological markers, anthropometric markers such as body
composition, genetic predispositions including risk SNPs and epigenetics)?
What unmet needs, concerns, and challenges regarding potential fertility impairments
exist in different CAYA age groups and their parents, and how do these unmet needs
affect the fertility-related quality of life of those affected?
How can current practices in fertility preservation and counseling for fertility
preservation be systematically captured, with the goal of improving clinical care
structures (healthcare research)?
These research questions will be addressed within the framework of a multimodal research
program, specifically through:
Development and implementation of a database for the structured collection of
therapy-related endocrinological, anthropometric, and laboratory parameters of
patients before and after oncological therapy (or stem cell transplantation), as
well as during follow-up care at the Department of Pediatrics and Adolescent
Medicine, University Medical Center Ulm, Germany.
Identification of predictors for fertility disorders:
Therapeutic exposures during primary and secondary therapy
Endocrinological markers
Anthropometric markers (body composition)
Genetic predispositions
Prospective evaluation of the prevalence and cumulative incidence of fertility
disorders in boys and girls during childhood and adolescence, including
endocrinological and metabolic late effects.
Documentation of medical interventions, such as fertility-preserving measures before
therapy, endocrinological treatments for late effects, and reproductive medical
measures to support future parenthood (e.g., ICSI, IVF, IUI, oocyte transfer, etc.).
Assessment of previous fertility-preservation measures and counseling efforts for
fertility preservation. The long-term goal is to improve the quality of patient care
in endocrinological follow-up, focusing on fertility-related parameters after
oncological diseases through the structured collection of relevant data.
Evaluation of fertility-related quality of life and informational needs at different
time points during the course of the disease.
FeProCAYA is a part of the collaborative research project FePro-Ulm
(https://www.uniklinik-ulm.de/frauenheilkunde-und-geburtshilfe/schwerpunkte/unifee/standa
rd-titel.html), which is funded by the German Federal Ministry of Education and Research
(BMBF). FePro-Ulm is an interdisciplinary junior scientists research center for fertility
protection and one of five German CERES Excellence Centers for reproductive health
(https://www.gesundheitsforschung-bmbf.de/de/interdisziplinaere-nachwuchszentren-fuer-rep
roduktive-gesundheit-16739.php).