© Springer International Publishing Switzerland 2017Teresa K. Woodruff and Yasmin C. Gosiengfiao (eds.)Pediatric and Adolescent Oncofertility10.1007/978-3-319-32973-4_20
20. Fertility Preservation in Japanese Children and Adolescents with Cancer
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
As the survival rate of pediatric and adolescent patients with cancer has shown marked improvement, the late effects of anticancer therapy on survivors of childhood/adolescent cancer have also been recognized as a critical issue in Japan. The Long-Term Follow-Up Guidelines for Survivors of Childhood and Adolescent Cancers were prepared by pediatric oncologists and endocrinologists with the aim of improving the management of various issues. Nevertheless, avoiding subfertility after anticancer therapy is still the responsibility of the individual treating pediatric oncologists who lack adequate coordination with reproductive medicine specialists. Thus, appropriate preventive measures for possible loss of fertility are often unavailable to young cancer survivors. Young patients with cancer may not receive any information about fertility after anticancer therapy. Also, follow-up for the primary disease is discontinued in quite a few patients, so that children and adolescents who survive cancer commonly face the crucial matter of infertility in adulthood without support.
In 2012, we established the Japan Society for Fertility Preservation (JSFP) (President: Nao Suzuki, MD, PhD) in order to promote measures for oncofertility in Japan. The JSFP holds a symposium every year, with the aim of promoting multidisciplinary coordination among medical and nonmedical professionals in the field of oncofertility. The JSFP has also established an Internet website to distribute the latest information concerning oncofertility. The JSFP initially developed a network based at Gifu University for oncofertility-related medical coordination that also involved the Gifu Prefectural Government (Gifu-Patients and Fertility Specialists established by Professor Kenichiro Morishige and Associate Professor Tatsuro Furui: GPOFs). Subsequently, regional oncofertility medical service coordination networks are being developed in many regions around Japan based on GPOFs, in order to provide coordinated and integrated medical care for oncofertility within a particular region. At a December 2014 meeting of the Cancer Control Promotion Council, which is the top Japanese organization for cancer control policies and programs, Dr. Suzuki provided a Statement of Opinion seeking national programs for fertility preservation in pediatric and adolescent patients with cancer. In May 2015, Dr. Suzuki and colleagues submitted a Letter of Request to Minister Shiozaki (the Minister of Health, Labour and Welfare) seeking the establishment of a clinical practice coordination system that will allow pediatric and adolescent patients with cancer to preserve the potential for future pregnancy and childbirth. Specifically, we made the following two suggestions: (1) the government should urgently launch projects for preservation of the reproductive function of young cancer patients and for the alleviation of physical and psychological distress due to loss of fertility, and (2) the government should take measures to establish a regional medical collaboration system among local governments, key hospitals, and community clinics that provides sustainable oncofertility services within each region.