I work inpatient with adult acute leukemia and so we have a wide range of ages for our patients. I have received very minimal training in regards to fertility because the reality is that our patients often can not wait until their next period and then an additional 14 days after that before starting chemotherapy. In addition, many of our patients have extremely low platelets and so the thought of a needle biopsy during the acute setting would be risky. We have done emergent procedures before but it would be up to the comfortability of the physician doing the procedure to do a biopsy given the risk of bleeding. I appreciated this video, because it will help me feel more comfortable addressing this difficult subject with our female population. Still, it would be nice to see how these discussions take place with these type of patients, rather than just solid tumors.
This is most definitely an area of concern for the leukemia patients as the severity of the presentation will not allow the medical team to wait to discuss preservation at the time of therapy initiation.
@Ryasuda – Thank you for bring up this concern. Working in the pediatric setting, we care for many patients with leukemia. Often times due to the need to begin therapy right away, the risk for infertility and fertility preservation options are not discussed prior to starting treatmen.
The risk for bleeding is also more of a concern for this population than for solid tumors. I too would like to see an example or article of how to address fertility preservation options for women diagnosed with leukemia that addresses the difficulty in delaying cancer therapy or even the potential to complete fertility preservation procedures after treatment is started, and the risk for bleeding during and after procedures.