Because of an unexplained fever, a 15-year-old girl, Xingxing (pseudonym), was diagnosed with leukemia. However, Star's imminent bone marrow transplant would be a "nuclear blow" to her reproductive system.
Help, and save the seeds of hope! The Department of Reproductive Medicine of Renji Hospital, Shanghai Jiao Tong University School of Medicine, froze 11 mature eggs for Xingxing.
At present, the experts of the Department of Reproductive Medicine of Renji Hospital have established an effective evaluation and referral mechanism with oncologists from many hospitals to seize the time before the tumor and jointly preserve fertility.
Fertility preservation prior to bone marrow transplantation**.
Xingxing, 15 years old, was diagnosed with "chronic myeloid leukemia" at the Shanghai Children's Medical Center affiliated to Shanghai Jiao Tong University School of Medicine (hereinafter referred to as the "Children's Center") two years ago due to "fever of unknown cause". After more than 1 year of medication**, the disease control is not ideal. Chen Jing, chief physician of the Department of Hematology of the Pediatric Center, suggested that Xingxing should undergo a bone marrow transplant next**.
However, due to the need to use large doses of chemotherapy drugs to "evacuate" the patient in the early stage of bone marrow transplantation**, this process will be a "nuclear shock" to the reproductive system of the stars. Chemotherapy drugs can cause irreversible damage to the star's ovarian function, and it is likely that the fertility will be lost in adulthood.
Chen Jingtong Jiang Dapeng, chief physician of the general surgery department of the pediatric center focusing on child fertility preservation, fully evaluated, considering that the long-term survival situation after Xingxing bone marrow transplantation is relatively optimistic, and it is likely to face fertility problems after adult marriage, so it is recommended that Xingxing undergo fertility preservation before bone marrow transplantation**.
A plan was made to freeze 11 eggs for her.
Fortunately, Xingxing's condition is still acceptable, and there is still some time before the start of the bone marrow transplant, and the 15-year-old Xingxing already has normal menstrual periods, which provides conditions for Xingxing to hopefully preserve fertility through egg freezing. Xingxing was quickly referred to the fertility preservation team of the Department of Reproductive Medicine at Renji Hospital.
After further evaluation of ovarian reserve, Sun Yun, director of the Department of Reproductive Medicine of Renji Hospital, had an in-depth communication with Xingxing, alleviating their psychological burden, and formulating a fertility preservation program suitable for adolescents, and quickly starting ovulation induction for Xingxing**.
For pediatric cancer patients like Xingxing, perioperative safety is also a top priority. Before the egg retrieval operation, Niu Yichao, deputy chief physician of the fertility preservation team, discussed and formulated a detailed risk prevention and control plan for bleeding and infection.
In the end, the egg retrieval operation went smoothly, and 11 mature eggs were successfully frozen for Xingxing. After receiving a bone marrow transplant, Xingxing is expected to have a baby of his own in the future if his condition is in complete remission.
Renji Synergy Multidisciplinary Fertility has a special focus on pediatric oncology patients.
At present, the incidence of malignant tumors in children in China ranks second in the world, and the largest proportion is hematologic malignant tumors. Pediatric patients with hematologic cancers who can be transplanted with bone marrow** generally have a better prognosis. At present, the survival rate of children with malignant tumors is gradually improving, and the 5-year survival rate has exceeded 80%.
More and more children with malignant tumors are able to enter adulthood, and their long-term quality of life deserves attention. However, chemoradiotherapy, bone marrow transplantation in children, and surgery** can lead to reproductive failure or even complete loss of fertility in pediatric cancer patients in adulthood.
However, it is gratifying that at present, both oncology doctors and cancer patients, including the families of pediatric cancer patients, are gradually getting out of the misunderstanding of "saving life first, then giving birth". Oncologists and reproductive medicine doctors have established an effective referral mechanism to provide effective fertility assessment and preservation for patients who need fertility preservation in the first place.
Pediatric oncology patients are currently of particular interest to fertility preservation services. Parents of pediatric patients diagnosed with malignant tumors often only focus on the disease itself, and our pediatric oncologists provide timely fertility preservation advice and help to patients after fully assessing the patient's condition and expected survival rate. Sun Yun emphasized that there is a "time window" in front of the tumor in patients diagnosed with malignant tumors, and once it is missed, it will be difficult to take effective protective measures for the patient's reproductive function after starting tumor radiotherapy and chemotherapy.
For pediatric cancer patients who are referred to the Department of Reproductive Medicine of Renji Hospital, experts will provide a suitable fertility preservation plan according to the age, pubertal development, ovarian reserve and window time before the patient, without affecting the tumor, and start the fertility preservation process as soon as possible.
For pediatric cancer patients, fertility preservation methods include cryopreservation of gametes (eggs, sperm) and gonadal tissue (ovaries**). "Once the opportunity to preserve fertility before the tumor** is missed, there is little hope of solving the fertility problem after the irreversible damage to the gonadal tissue caused by the tumor radiotherapy and chemotherapy**. Sun Yun said frankly that if the little patients do not have enough time to induce ovulation like the stars**, or have not yet entered puberty, we can also freeze the ovarian tissue for them, and the subsequent fertility and endocrine function of the patient can also be restored.
*: Morning News.