Search

Your search keyword '"Breech, Lesley"' showing total 405 results
Start Over Author "Breech, Lesley"
405 results on '"Breech, Lesley"'

1. Diagnostic Performance of Magnetic Resonance Imaging for Pediatric Ovarian Neoplasms: A Multi-Institutional Review

Author

Bergus, Katherine C., Knaus, Maria E., Onwuka, Amanda J., Afrazi, Amin, Breech, Lesley, Corkum, Kristine S., Dillon, Patrick A., Ehrlich, Peter F., Fallat, Mary E., Fraser, Jason D., Gadepalli, Samir K., Grabowski, Julia E., Hertweck, S. Paige, Kabre, Rashmi, Lal, Dave R., Landman, Matthew P., Leys, Charles M., Mak, Grace Z., Markel, Troy A., Merchant, Naila, Overman, R. Elliott, Rademacher, Brooks L., Raiji, Manish T., Rymeski, Beth, Sato, Thomas T., Wright, Tiffany, Aldrink, Jennifer H., Hewitt, Geri D., Minneci, Peter C., and Deans, Katherine J.

Published
2024
Full Text
View/download PDF

3. A View from the past into our collective future: the oncofertility consortium vision statement.

Author

Woodruff, Teresa K, Ataman-Millhouse, Lauren, Acharya, Kelly S, Almeida-Santos, Teresa, Anazodo, Antoinette, Anderson, Richard A, Appiah, Leslie, Bader, Joy, Becktell, Kerri, Brannigan, Robert E, Breech, Lesley, Bourlon, Maria T, Bumbuliene, Žana, Burns, Karen, Campo-Engelstein, Lisa, Campos, Jacira R, Centola, Grace M, Chehin, Mauricio Barbour, Chen, Diane, De Vos, Michel, Duncan, Francesca E, El-Damen, Ahmed, Fair, Douglas, Famuyiwa, Yemi, Fechner, Patricia Y, Fontoura, Paula, Frias, Olivia, Gerkowicz, Sabrina A, Ginsberg, Jill, Gracia, Clarisa R, Goldman, Kara, Gomez-Lobo, Veronica, Hazelrigg, Brent, Hsieh, Michael H, Hoyos, Luis R, Hoyos-Martinez, Alfonso, Jach, Robert, Jassem, Jacek, Javed, Murid, Jayasinghe, Yasmin, Jeelani, Roohi, Jeruss, Jacqueline S, Kaul-Mahajan, Nalini, Keim-Malpass, Jessica, Ketterl, Tyler G, Khrouf, Mohamed, Kimelman, Dana, Kusuhara, Atsuko, Kutteh, William H, Laronda, Monica M, Lee, Jung Ryeol, Lehmann, Vicky, Letourneau, Joseph M, McGinnis, Lynda K, McMahon, Eileen, Meacham, Lillian R, Mijangos, Monserrat Fabiola Velez, Moravek, Molly, Nahata, Leena, Ogweno, George Moses, Orwig, Kyle E, Pavone, Mary Ellen, Peccatori, Fedro Alessandro, Pesce, Romina Ileana, Pulaski, Hanna, Quinn, Gwendolyn, Quintana, Ramiro, Quintana, Tomas, de Carvalho, Bruno Ramalho, Ramsey-Goldman, Rosalind, Reinecke, Joyce, Reis, Fernando M, Rios, Julie, Rhoton-Vlasak, Alice S, Rodriguez-Wallberg, Kenny A, Roeca, Cassandra, Rotz, Seth J, Rowell, Erin, Salama, Mahmoud, Saraf, Amanda J, Scarella, Anibal, Schafer-Kalkhoff, Tara, Schmidt, Deb, Senapati, Suneeta, Shah, Divya, Shikanov, Ariella, Shnorhavorian, Margarett, Skiles, Jodi L, Smith, James F, Smith, Kristin, Sobral, Fabio, Stimpert, Kyle, Su, H Irene, Sugimoto, Kouhei, Suzuki, Nao, Thakur, Mili, Victorson, David, Viale, Luz, Vitek, Wendy, and Wallace, W Hamish

Subjects
Fertility preservation, Oncofertility, cancer, Genetics, Paediatrics and Reproductive Medicine, Obstetrics & Reproductive Medicine
Abstract

PurposeToday, male and female adult and pediatric cancer patients, individuals transitioning between gender identities, and other individuals facing health extending but fertility limiting treatments can look forward to a fertile future. This is, in part, due to the work of members associated with the Oncofertility Consortium.MethodsThe Oncofertility Consortium is an international, interdisciplinary initiative originally designed to explore the urgent unmet need associated with the reproductive future of cancer survivors. As the strategies for fertility management were invented, developed or applied, the individuals for who the program offered hope, similarly expanded. As a community of practice, Consortium participants share information in an open and rapid manner to addresses the complex health care and quality-of-life issues of cancer, transgender and other patients. To ensure that the organization remains contemporary to the needs of the community, the field designed a fully inclusive mechanism for strategic planning and here present the findings of this process.ResultsThis interprofessional network of medical specialists, scientists, and scholars in the law, medical ethics, religious studies and other disciplines associated with human interventions, explore the relationships between health, disease, survivorship, treatment, gender and reproductive longevity.ConclusionThe goals are to continually integrate the best science in the service of the needs of patients and build a community of care that is ready for the challenges of the field in the future.

Published
2021

6. Recurrence Rates for Pediatric Benign Ovarian Neoplasms

Author

Knaus, Maria E., Onwuka, Amanda J., Abouelseoud, Naila M., Bergus, Katherine C., Breech, Lesley L., Brito, Katherine S., Dekonenko, Charlene, Hertweck, S. Paige, Hong, Helena Y., Menon, Seema, Merritt, Diane F., Schikler, Allegra G., Senapati, Nikki, Smith, Yolanda R., Strickland, Julie L., Truehart, Amber I., Minneci, Peter C., and Hewitt, Geri D.

Published
2023
Full Text
View/download PDF

7. Does presence of a VACTERL anomaly predict an associated gynecologic anomaly in females with anorectal malformations?: A Pediatric Colorectal and Pelvic Learning Consortium Study

Author

Ahmad, Hira, Wood, Richard J., Avansino, Jeffrey R., Calkins, Casey M., Dickie, Belinda Hsi, Durham, Megan M., Frischer, Jason, Fuller, Megan, Ralls, Matt, Reeder, Ron W., Rentea, Rebecca M., Rollins, Michael D., Saadai, Payam, Oelschlager, Anne-Marie E. Amies, Breech, Lesley L., Hewitt, Geri D., Kluivers, Kirsten, van Leeuwen, Kathleen D., and McCracken, Katherine A.

Published
2023
Full Text
View/download PDF

8. Failure of Operative Therapy after Ovarian-Sparing Surgery for Pediatric Benign Ovarian Neoplasms: A Retrospective Review

Author

Knaus, Maria E., Onwuka, Amanda J., Abouelseoud, Naila M., Breech, Lesley L., Brito, Katherine S., Dekonenko, Charlene, Hertweck, S. Paige, Hong, Helena Y., Lawrence, Amy E., Menon, Seema, Merritt, Diane F., Schikler, Allegra G., Senapati, Nikki, Smith, Yolanda R., Strickland, Julie L., Truehart, Amber I., Minneci, Peter C., and Hewitt, Geri D.

Published
2022
Full Text
View/download PDF

9. Multi-Institutional Review of the Preoperative Diagnostic Accuracy for Pediatric Ovarian Mature Cystic Teratomas

Author

Knaus, Maria E., Onwuka, Amanda J., Afrazi, Amin, Breech, Lesley, Corkum, Kristine S., Dillon, Patrick A., Ehrlich, Peter F., Fallat, Mary E., Fraser, Jason D., Gadepalli, Samir K., Grabowski, Julia E., Hertweck, S. Paige, Kabre, Rashmi, Lal, Dave R., Landman, Matthew P., Lawrence, Amy E., Leys, Charles M., Mak, Grace Z., Markel, Troy A., Merchan, Naila, Overman, R. Elliott, Rademacher, Brooks L., Raiji, Manish T., Rymeski, Beth, Sato, Thomas T., Scannel, Madeline, Schikler, Allegra G., Sujka, Joseph A., Wright, Tiffany, Aldrink, Jennifer H., Hewitt, Geri D., Minneci, Peter C., and Deans, Katherine J.

Published
2022
Full Text
View/download PDF

10. Laparoscopy versus laparotomy for pediatric ovarian dermoids

Author

Knaus, Maria E., Onwuka, Amanda J., Afrazi, Amin, Breech, Lesley, Corkum, Kristine S., Dillon, Patrick A., Ehrlich, Peter F., Fallat, Mary E., Fraser, Jason D., Gadepalli, Samir K., Grabowski, Julia E., Hertweck, S. Paige, Kabre, Rashmi, Lal, Dave R., Landman, Matthew P., Lawrence, Amy E., Leys, Charles M., Mak, Grace Z., Markel, Troy A., Merchant, Naila, Elliott Overman, R., Rademacher, Brooks L., Raiji, Manish T., Rymeski, Beth, Sato, Thomas T., Scannell, Madeline, Schikler, Allegra G., Sujka, Joseph A., Wright, Tiffany, Aldrink, Jennifer H., Hewitt, Geri D., Minneci, Peter C., and Deans, Katherine J.

Published
2022
Full Text
View/download PDF

11. Reduced-Intensity Conditioning Mitigates Risk for Primary Ovarian Insufficiency but Does Not Decrease Risk for Infertility in Pediatric and Young Adult Survivors of Hematopoietic Stem Cell Transplantation

Author

Bender, Jonathan D., Toro, Helen Oquendo-del, Benoit, Janie, Howell, Jonathan C., Badia, Priscila, Davies, Stella M., Grimley, Michael S., Jodele, Sonata, Phillips, Christine, Burns, Karen, Marsh, Rebecca, Nelson, Adam, Wallace, Gregory, Dandoy, Christopher E., Pate, Abigail, Strine, Andrew C., Frias, Olivia, Breech, Lesley, Rose, Susan R., Hoefgen, Holly, Khandelwal, Pooja, and Myers, Kasiani C.

Published
2022
Full Text
View/download PDF

21. Diagnostic Performance of Magnetic Resonance Imaging for Pediatric Ovarian Neoplasms: A Multi-Institutional Review

Author

Bergus, Katherine C., primary, Knaus, Maria E., additional, Onwuka, Amanda J., additional, Afrazi, Amin, additional, Breech, Lesley, additional, Corkum, Kristine S., additional, Dillon, Patrick A., additional, Ehrlich, Peter F., additional, Fallat, Mary E., additional, Fraser, Jason D., additional, Gadepalli, Samir K., additional, Grabowski, Julia E., additional, Hertweck, S. Paige, additional, Kabre, Rashmi, additional, Lal, Dave R., additional, Landman, Matthew P., additional, Leys, Charles M., additional, Mak, Grace Z., additional, Markel, Troy A., additional, Merchant, Naila, additional, Overman, R. Elliott, additional, Rademacher, Brooks L., additional, Raiji, Manish T., additional, Rymeski, Beth, additional, Sato, Thomas T., additional, Wright, Tiffany, additional, Aldrink, Jennifer H., additional, Hewitt, Geri D., additional, Minneci, Peter C., additional, and Deans, Katherine J., additional

Published
2023
Full Text
View/download PDF

27. Reducing Unnecessary Oophorectomies for Benign Ovarian Neoplasms in Pediatric Patients.

Author

Minneci, Peter C., Bergus, Katherine C., Lutz, Carley, Aldrink, Jennifer, Bence, Christina, Breech, Lesley, Dillon, Patrick A., Downard, Cynthia, Ehrlich, Peter F., Fallat, Mary, Fraser, Jason D., Grabowski, Julia, Helmrath, Michael, Hertweck, Paige, Hewitt, Geri, Hirschl, Ronald B., Kabre, Rashmi, Lal, Dave R., Landman, Matthew, and Leys, Charles

Subjects
CHILD patients, OVARIAN tumors, BENIGN tumors, OVARIAN cancer, CLINICAL trials, CHILDREN'S hospitals, PEDIATRIC surgery
Abstract

Key Points: Question: Can a consensus-based, preoperative risk stratification algorithm reduce unnecessary oophorectomies in pediatric and adolescent patients with benign ovarian disease? Findings: In this multi-institutional, pre/post interventional study that included 519 patients aged 21 years or younger with ovarian masses, the percentage of oophorectomies performed for benign disease decreased from 16.1% to 8.4% after implementation of a consensus-based preoperative risk stratification algorithm. Meaning: Managing pediatric and adolescent patients with ovarian masses using a consensus-based preoperative risk stratification algorithm can prevent unnecessary oophorectomies for benign disease. Importance: Although most ovarian masses in children and adolescents are benign, many are managed with oophorectomy, which may be unnecessary and can have lifelong negative effects on health. Objective: To evaluate the ability of a consensus-based preoperative risk stratification algorithm to discriminate between benign and malignant ovarian pathology and decrease unnecessary oophorectomies. Design, Setting, and Participants: Pre/post interventional study of a risk stratification algorithm in patients aged 6 to 21 years undergoing surgery for an ovarian mass in an inpatient setting in 11 children's hospitals in the United States between August 2018 and January 2021, with 1-year follow-up. Intervention: Implementation of a consensus-based, preoperative risk stratification algorithm with 6 months of preintervention assessment, 6 months of intervention adoption, and 18 months of intervention. The intervention adoption cohort was excluded from statistical comparisons. Main Outcomes and Measures: Unnecessary oophorectomies, defined as oophorectomy for a benign ovarian neoplasm based on final pathology or mass resolution. Results: A total of 519 patients with a median age of 15.1 (IQR, 13.0-16.8) years were included in 3 phases: 96 in the preintervention phase (median age, 15.4 [IQR, 13.4-17.2] years; 11.5% non-Hispanic Black; 68.8% non-Hispanic White); 105 in the adoption phase; and 318 in the intervention phase (median age, 15.0 [IQR, 12.9-16.6)] years; 13.8% non-Hispanic Black; 53.5% non-Hispanic White). Benign disease was present in 93 (96.9%) in the preintervention cohort and 298 (93.7%) in the intervention cohort. The percentage of unnecessary oophorectomies decreased from 16.1% (15/93) preintervention to 8.4% (25/298) during the intervention (absolute reduction, 7.7% [95% CI, 0.4%-15.9%]; P =.03). Algorithm test performance for identifying benign lesions in the intervention cohort resulted in a sensitivity of 91.6% (95% CI, 88.5%-94.8%), a specificity of 90.0% (95% CI, 76.9%-100%), a positive predictive value of 99.3% (95% CI, 98.3%-100%), and a negative predictive value of 41.9% (95% CI, 27.1%-56.6%). The proportion of misclassification in the intervention phase (malignant disease treated with ovary-sparing surgery) was 0.7%. Algorithm adherence during the intervention phase was 95.0%, with fidelity of 81.8%. Conclusions and Relevance: Unnecessary oophorectomies decreased with use of a preoperative risk stratification algorithm to identify lesions with a high likelihood of benign pathology that are appropriate for ovary-sparing surgery. Adoption of this algorithm might prevent unnecessary oophorectomy during adolescence and its lifelong consequences. Further studies are needed to determine barriers to algorithm adherence. This pre/post interventional study assesses the ability of a preoperative risk stratification algorithm to identify lesions with a high likelihood of benign pathology that are appropriate for ovary-sparing surgery among pediatric patients with an ovarian mass. [ABSTRACT FROM AUTHOR]

Published
2023
Full Text
View/download PDF

34. Does presence of a VACTERL anomaly predict an associated gynecologic anomaly in females with anorectal malformations?: A pediatric colorectal and pelvic learning consortium study

Author

Ahmad, Hira, primary, Wood, Richard J., additional, Avansino, Jeffrey R., additional, Calkins, Casey M., additional, Dickie, Belinda Hsi, additional, Durham, Megan M., additional, Frischer, Jason, additional, Fuller, Megan, additional, Ralls, Matt, additional, Reeder, Ron W., additional, Rentea, Rebecca M., additional, Rollins, Michael D., additional, Saadai, Payam, additional, Oelschlager, Anne-Marie E. Amies, additional, Breech, Lesley L., additional, Hewitt, Geri D., additional, Kluivers, Kirsten, additional, van Leeuwen, Kathleen D., additional, and McCracken, Katherine A., additional

Published
2022
Full Text
View/download PDF

39. A View from the past into our collective future: the oncofertility consortium vision statement.

Author

UCL - SSS/IREC/GYNE - Pôle de Gynécologie, UCL - (SLuc) Service de gynécologie et d'andrologie, Woodruff, Teresa K, Ataman-Millhouse, Lauren, Acharya, Kelly S, Almeida-Santos, Teresa, Anazodo, Antoinette, Anderson, Richard A, Appiah, Leslie, Bader, Joy, Becktell, Kerri, Brannigan, Robert E, Breech, Lesley, Bourlon, Maria T, Bumbuliene, Žana, Burns, Karen, Campo-Engelstein, Lisa, Campos, Jacira R, Centola, Grace M, Chehin, Mauricio Barbour, Chen, Diane, De Vos, Michel, Duncan, Francesca E, El-Damen, Ahmed, Fair, Douglas, Famuyiwa, Yemi, Fechner, Patricia Y, Fontoura, Paula, Frias, Olivia, Gerkowicz, Sabrina A, Ginsberg, Jill, Gracia, Clarisa R, Goldman, Kara, Gomez-Lobo, Veronica, Hazelrigg, Brent, Hsieh, Michael H, Hoyos, Luis R, Hoyos-Martinez, Alfonso, Jach, Robert, Jassem, Jacek, Javed, Murid, Jayasinghe, Yasmin, Jeelani, Roohi, Jeruss, Jacqueline S, Kaul-Mahajan, Nalini, Keim-Malpass, Jessica, Ketterl, Tyler G, Khrouf, Mohamed, Kimelman, Dana, Kusuhara, Atsuko, Kutteh, William H, Laronda, Monica M, Lee, Jung Ryeol, Lehmann, Vicky, Letourneau, Joseph M, McGinnis, Lynda K, McMahon, Eileen, Meacham, Lillian R, Mijangos, Monserrat Fabiola Velez, Moravek, Molly, Nahata, Leena, Ogweno, George Moses, Orwig, Kyle E, Pavone, Mary Ellen, Peccatori, Fedro Alessandro, Pesce, Romina Ileana, Pulaski, Hanna, Quinn, Gwendolyn, Quintana, Ramiro, Quintana, Tomas, de Carvalho, Bruno Ramalho, Ramsey-Goldman, Rosalind, Reinecke, Joyce, Reis, Fernando M, Rios, Julie, Rhoton-Vlasak, Alice S, Rodriguez-Wallberg, Kenny A, Roeca, Cassandra, Rotz, Seth J, Rowell, Erin, Salama, Mahmoud, Saraf, Amanda J, Scarella, Anibal, Schafer-Kalkhoff, Tara, Schmidt, Deb, Senapati, Suneeta, Shah, Divya, Shikanov, Ariella, Shnorhavorian, Margarett, Skiles, Jodi L, Smith, James F, Smith, Kristin, Sobral, Fabio, Stimpert, Kyle, Su, H Irene, Sugimoto, Kouhei, Suzuki, Nao, Thakur, Mili, Victorson, David, Viale, Luz, Vitek, Wendy, Wallace, W Hamish, Wartella, Ellen A, Westphal, Lynn M, Whiteside, Stacy, Wilcox, Lea H, Wyns, Christine, Xiao, Shuo, Xu, Jing, Zelinski, Mary, UCL - SSS/IREC/GYNE - Pôle de Gynécologie, UCL - (SLuc) Service de gynécologie et d'andrologie, Woodruff, Teresa K, Ataman-Millhouse, Lauren, Acharya, Kelly S, Almeida-Santos, Teresa, Anazodo, Antoinette, Anderson, Richard A, Appiah, Leslie, Bader, Joy, Becktell, Kerri, Brannigan, Robert E, Breech, Lesley, Bourlon, Maria T, Bumbuliene, Žana, Burns, Karen, Campo-Engelstein, Lisa, Campos, Jacira R, Centola, Grace M, Chehin, Mauricio Barbour, Chen, Diane, De Vos, Michel, Duncan, Francesca E, El-Damen, Ahmed, Fair, Douglas, Famuyiwa, Yemi, Fechner, Patricia Y, Fontoura, Paula, Frias, Olivia, Gerkowicz, Sabrina A, Ginsberg, Jill, Gracia, Clarisa R, Goldman, Kara, Gomez-Lobo, Veronica, Hazelrigg, Brent, Hsieh, Michael H, Hoyos, Luis R, Hoyos-Martinez, Alfonso, Jach, Robert, Jassem, Jacek, Javed, Murid, Jayasinghe, Yasmin, Jeelani, Roohi, Jeruss, Jacqueline S, Kaul-Mahajan, Nalini, Keim-Malpass, Jessica, Ketterl, Tyler G, Khrouf, Mohamed, Kimelman, Dana, Kusuhara, Atsuko, Kutteh, William H, Laronda, Monica M, Lee, Jung Ryeol, Lehmann, Vicky, Letourneau, Joseph M, McGinnis, Lynda K, McMahon, Eileen, Meacham, Lillian R, Mijangos, Monserrat Fabiola Velez, Moravek, Molly, Nahata, Leena, Ogweno, George Moses, Orwig, Kyle E, Pavone, Mary Ellen, Peccatori, Fedro Alessandro, Pesce, Romina Ileana, Pulaski, Hanna, Quinn, Gwendolyn, Quintana, Ramiro, Quintana, Tomas, de Carvalho, Bruno Ramalho, Ramsey-Goldman, Rosalind, Reinecke, Joyce, Reis, Fernando M, Rios, Julie, Rhoton-Vlasak, Alice S, Rodriguez-Wallberg, Kenny A, Roeca, Cassandra, Rotz, Seth J, Rowell, Erin, Salama, Mahmoud, Saraf, Amanda J, Scarella, Anibal, Schafer-Kalkhoff, Tara, Schmidt, Deb, Senapati, Suneeta, Shah, Divya, Shikanov, Ariella, Shnorhavorian, Margarett, Skiles, Jodi L, Smith, James F, Smith, Kristin, Sobral, Fabio, Stimpert, Kyle, Su, H Irene, Sugimoto, Kouhei, Suzuki, Nao, Thakur, Mili, Victorson, David, Viale, Luz, Vitek, Wendy, Wallace, W Hamish, Wartella, Ellen A, Westphal, Lynn M, Whiteside, Stacy, Wilcox, Lea H, Wyns, Christine, Xiao, Shuo, Xu, Jing, and Zelinski, Mary

Abstract

Today, male and female adult and pediatric cancer patients, individuals transitioning between gender identities, and other individuals facing health extending but fertility limiting treatments can look forward to a fertile future. This is, in part, due to the work of members associated with the Oncofertility Consortium. The Oncofertility Consortium is an international, interdisciplinary initiative originally designed to explore the urgent unmet need associated with the reproductive future of cancer survivors. As the strategies for fertility management were invented, developed or applied, the individuals for who the program offered hope, similarly expanded. As a community of practice, Consortium participants share information in an open and rapid manner to addresses the complex health care and quality-of-life issues of cancer, transgender and other patients. To ensure that the organization remains contemporary to the needs of the community, the field designed a fully inclusive mechanism for strategic planning and here present the findings of this process. This interprofessional network of medical specialists, scientists, and scholars in the law, medical ethics, religious studies and other disciplines associated with human interventions, explore the relationships between health, disease, survivorship, treatment, gender and reproductive longevity. The goals are to continually integrate the best science in the service of the needs of patients and build a community of care that is ready for the challenges of the field in the future.

Published
2021

40. Levonorgestrel Intrauterine Device Use for Medical Indications in Nulliparous Adolescents and Young Adults.

Author

Schwartz, Beth I, Alexander, Morgan, Breech, Lesley L, Schwartz, Beth I, Alexander, Morgan, and Breech, Lesley L

Abstract

PURPOSE: Intrauterine devices (IUDs) are highly effective at preventing pregnancy. Levonorgestrel (LNG) IUDs also have beneficial effects on menstrual bleeding and abdominal and pelvic pain. Although there are increasing data on use of IUDs for contraception in adolescents and for medical indications in adults, there are extremely limited data on LNG IUD use for medical indications in adolescents. Our objective is to describe the characteristics and experiences of LNG IUD use in nulliparous adolescents and young women using IUDs for medical indications. METHODS: We conducted a retrospective chart review of all nulliparous patients aged 22 years and younger who underwent LNG IUD insertion at a tertiary care children's hospital between July 1, 2004 and June 30, 2014 primarily for noncontraceptive indications. Descriptive statistical analysis was performed. RESULTS: We identified 231 LNG IUDs placed in 219 nulliparous women for medical indications during this time period. Mean patient age was 16.8 years (±2.2). Only 41% reported ever being sexually active. IUD continuation rate at 1 year was 86%. The amenorrhea rate at 1 year was 51%. Approximately 80% of women reported improvements in menstrual bleeding and abdominal and pelvic pain. Side effects and complications were low. CONCLUSIONS: This study provides evidence that LNG IUDs are effective, well-tolerated, and safe menstrual management options in young nulliparous women, including younger adolescents and those who have never been sexually active. This method is an excellent first-line therapy option for adolescents and young women for both contraceptive and noncontraceptive indications, regardless of age, parity, or sexual activity.

Published
2021

43. Reduced-Intensity Conditioning Mitigates Risk for Primary Ovarian Insufficiency but Does Not Decrease Risk for Infertility in Pediatric and Young Adult Survivors of Hematopoietic Stem Cell Transplantation

Author

Bender, Jonathan D., Oquendo-del Toro, Helen, Benoit, Janie, Howell, Jonathan C., Badia, Priscila, Davies, Stella M., Grimley, Michael S., Jodele, Sonata, Phillips, Christine, Burns, Karen, Marsh, Rebecca, Nelson, Adam, Wallace, Gregory, Dandoy, Christopher E., Pate, Abigail, Strine, Andrew C., Frias, Olivia, Breech, Lesley, Rose, Susan R., Hoefgen, Holly, Khandelwal, Pooja, and Myers, Kasiani C.

Abstract

Hematopoietic stem cell transplantation (HSCT) is a curative therapy for many pediatric malignant and nonmalignant conditions. Gonadal insufficiency or infertility is present in almost all HSCT survivors who received a myeloablative conditioning (MAC) regimen. Reduced-intensity conditioning (RIC) regimens are being increasingly used in medically fragile patients or in patients with nonmalignant diagnoses to limit the toxicities associated with HSCT; however, the short-term and long-term gonadal toxicity of RIC regimens in pediatric and young adult survivors remains unknown. In this study, we compared the prevalence of gonadal insufficiency and infertility among pubertal and postpubertal pediatric and young adult survivors of HSCT who received a RIC regimen versus those who received a MAC regimen. Twenty-three females (RIC, n = 8; MAC, n = 15) and 35 males (RIC, n = 19; MAC, n = 16) were included in this single-center, retrospective cross-sectional study. Eligible patients were those with available laboratory results who were ≥1 year post-HSCT, age <40 years, and pubertal or postpubertal as assessed by an endocrinologist. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and anti-Müllerian hormone (AMH) levels were measured in females, and FSH, LH, total testosterone, and inhibin B (InhB) levels were measured in males. Twenty-one males (RIC, n = 11; MAC, n = 10) underwent semen analysis through a separate consent. Parametric and nonparametric analyses were undertaken to compare the RIC and MAC groups. Female patients who received RIC were less likely than those who received MAC to develop primary ovarian insufficiency, as demonstrated by elevated FSH (P = .02) and low estradiol (P = .01) or elevated LH (P = .09). Most females in the RIC (75%) and MAC (93%) groups had low AMH levels, indicating low or absent ovarian reserve, with no significant difference between the groups (P = .53). In males, there were no significant differences between the 2 groups in the prevalence of abnormal FSH, LH, testosterone, or InhB levels. Ten of 11 RIC males (91%) and 10 of 10 MAC males (100%) had azoospermia or oligospermia, at a median time to semen analysis from HSCT of 3.7 years (range, 1.3 to 12.2 years). RIC may pose less risk than MAC for primary ovarian insufficiency among female survivors of HSCT; however, both female and male recipients of either RIC or MAC regimens are at high risk for infertility. In the largest reported series of semen analyses of pediatric and young adult male recipients of RIC, azoospermia or oligospermia was found in nearly all (91%) RIC survivors. All patients undergoing HSCT should receive counseling about the high risk of gonadal toxicity, and efforts should be made to preserve fertility in patients undergoing either RIC or MAC.

Published
2023
Full Text
View/download PDF

47. Ethical quandaries in gamete-embryo cryopreservation related to oncofertility.

Author

Ayensu-Coker, Leslie, Essig, Ellen, Breech, Lesley L., and Lindheim, Steven

Subjects
Posthumous conception -- Laws, regulations and rules, Cancer survivors -- Laws, regulations and rules, Advance directives (Medicine) -- Laws, regulations and rules, Cryopreservation of organs, tissues, etc. -- Ethical aspects, Frozen human embryos -- Laws, regulations and rules, Government regulation
Abstract

Cancer rates in men and women of reproductive age have continued to increase in recent years; however, therapy has dramatically decreased the mortality rates. Since 1990, the prevalence of cancer [...]

Published
2013

50. Contributors

Author

Amin, Raouf S., primary, Barzman, Drew H., additional, Biro, Frank M., additional, Braverman, Paula K., additional, Breech, Lesley L., additional, Britto, Maria T., additional, Byars, Kelly C., additional, Catallozzi, Marina, additional, Crosby, Paul R., additional, Daniels, Stephen R., additional, Dorn, Lorah D., additional, Ebert, James R., additional, Engel, Carol, additional, Ewing, Reginald S., additional, Ginsburg, Kenneth R., additional, Hergenroeder, Albert C., additional, Hershey, Andrew D., additional, Heyman, Richard B., additional, Hillard, Paula J. Adams, additional, Huppert, Jill S., additional, Inge, Thomas H., additional, Kabbouche, Marielle A., additional, Kahn, Jessica A., additional, Karacostas, Velissarios, additional, Kollar, Linda M., additional, Kraus, Christopher E., additional, Lehmann, Corinne, additional, Mitan, Laurie A.P., additional, Mullins, Tanya Kowalczyk, additional, Orr, Donald P., additional, Rauh, Joseph L., additional, Schneider, Giselle, additional, Slap, Gail B., additional, Sorter, Michael T., additional, Spigarelli, Michael G., additional, Steinegger, Cathleen M., additional, Tosh, Aneesh K., additional, Urbina, Elaine M., additional, Vogel, Daniel A., additional, Webb, Thomas S., additional, Wolraich, Mark L., additional, Zidenberg, Nichole, additional, and Zucker, Michele L., additional

Published
2008
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results