UPTAKE OF FERTILITY PRESERVATION IN ADOLESCENTS AND YOUNG ADULTS WITH A HISTORY OF OVARIAN GERM CELL AND SEX CORD STROMAL TUMORS

Objective: The objective of this study was to identify how many adolescents and young adults with history of ovarian germ cell or sex cord stromal tumors utilize fertility preservation (FP). Cancer treatments including chemotherapy, radiation, and surgery can impact future fertility. Providing FP counseling helps cancer patients make informed decisions regarding their reproductive health. Studying the FP uptake rate in patients with ovarian germ cell and sex cord stromal tumors can help clarify and enhance current counseling practices. Design: Retrospective cohort study of patients aged 12 – 35 with a diagnosis of ovarian germ cell or sex cord stromal tumor who were seen at University of Colorado Anschutz Medical Campus and/or Children’s Hospital Colorado from July 2013 to June 2023 Methods: Descriptive statistics were performed utilizing the Kruskal-Wallis rank-sum test, Fisher’s exact test, Wilcoxon rank-sum test, and Pearson’s Chi-squared test. Results: Seventy-three patients met inclusion criteria. The majority of participants were white (61%), had private insurance (63%), and were nulligravid (58%). Most patients (89%) underwent FP. Of those who utilized FP, 80% used fertility-sparing surgery only, while 20% also utilized other forms of FP including ovarian suppression or oocyte cryopreservation. There were no significant differences in the race, insurance status, and cancer stage of patients who received or did not receive fertility counseling from a provider. Patients who used FP were younger (p=0.024) and more likely to be nulligravida (p<0.001). Conclusion: Adolescents and young adults diagnosed with ovarian germ cell or sex cord stromal tumors demonstrate a high rate of FP utilization, with the majority undergoing fertility-sparing surgery as their sole approach. Younger age and nulligravid status were the strongest predictors of FP use, which suggests that reproductive intent and life stage play a role in patients’ decision-making and/or provider counseling. Overall, the use of non-surgical FP options was minimal, suggesting a potential need for more comprehensive counseling on available FP methods.