小児，思春期・若年がん患者に対する妊孕性温存療法―現状と改善の取り組み―

Chemotherapy decreases fertility in childhood, adolescent and young adult (CAYA) cancer patients. We previously conducted a questionnaire survey of 275 otorhinolaryngologists to determine how they handled fertility issues in their patients. The number of physicians who had actually referred patients to an egg and sperm storage facility was only 17.5%, which was significantly lower than the number in other departments. Therefore, in order to raise awareness about fertility issues of their patients, we investigated the actual status of fertility care provided to patients in our department. Among 20 CAYA cancer patients who received chemotherapy at our department during the study period, only two had received explanations about fertility and only one had received oocyte preservation therapy. Based on these results, our department reviewed the explanatory documents provided to the patients prior to chemotherapy and strengthened cooperation with the department in charge of reproductive medicine. Although subsidy systems and regional reproductive health networks are gradually being established, it is important to make reforms at the departmental and physician levels in order to create an effective system.