Sexual and Reproductive Healthcare Following Gonadotoxic Treatment in Females at a Tertiary Pediatric Hospital.

STUDY OBJECTIVES: Recommendations from the Children's Oncology Group Long-Term Follow-Up (COG-LTFU) Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer emphasize the importance of reproductive health care, yet little is known regarding adherence to these recommendations and non-fertility related sexual and reproductive health (SRH) outcomes.

METHODS: Follow up of outcomes based on COG-LTFU Guidelines was assessed in female patients who underwent fertility preservation consultation before gonadotoxic therapy between 2016 and 2022 at a single institution and were at least 6 months from treatment completion.

RESULTS: We included 140 patients, with 2.7 years mean time from treatment completion. Eighty-six patients were 12 years or older, of whom sexual activity was recorded in 59 (68.7%), and 12/31 (38.7%) sexually active patients had sexual function assessment. The 57 (66.3%) patients at high risk of premature ovarian insufficiency (POI) at diagnosis were more likely than minimal risk counterparts (29, 33.7%) to have abnormal uterine bleeding (42.1% vs 17.2%, p= 0.03), be diagnosed with POI (29.8% vs 0%, p=0.01) and have sexual activity recorded (77.2% vs 51.7%, p=0.03). Of 17 patients with POI, 82.4% were on hormone replacement therapy and 58.8% had bone mineral density testing.

CONCLUSION: This study adds to limited literature regarding non-fertility related SRH outcomes after gonadotoxic therapy and illustrates opportunities to improve adherence to COG-LTFU Guidelines. Increased attention to SRH guidelines may increase detection and treatment of SRH conditions improving health and quality of life of female cancer survivors.