Building a Pediatric Fertility Preservation Program.

e17546 Background: Pediatric cancer patients are at risk of infertility based on their therapy. Many patients have questions about fertility regardless of risk, yet few pediatric centers have an oncofertility program. Of the 60 centers in the Oncofertility Consortium’s National Physician Collaborative, 9 are pediatric programs. In Sept 2013 we began our current Fertility Consult Service (FCS) model. We discuss risk of infertility and fertility preservation (FP) options. This includes sperm banking (SB) or testicular tissue cryopreservation (TTC) for males; oocyte/embryo freezing, or ovarian tissue cryopreservation (OTC) for females. We identified a Fertility Navigator (FN) to serve as a point of contact and coordinate services. This project looks at the ability of our program to identify patients and provide FP services. Methods: Patients new to the Division of Oncology at CCHMC were eligible. There was no age restriction. Patients were excluded for the following reasons: surgical resection, observation, palliative treatment, Phase I treatment, or second opinion/consult only; previous fertility consult / intervention; family declination. The oncology team care manager notified the FN at the time of diagnosis to initiate the consult. Patients were also identified through weekly oncology team meetings. Once a consult was requested the team saw the patient, reviewed options, and coordinated FP follow-up. Results: From Sept 2013 through Dec 2014 the FCS identified 350 patients new to the Division of Oncology. 183 were ineligible for a fertility consult (34 surgical resection, 50 observation, 22 palliative treatment, 11 Phase I, 49 second opinion, 14 previous consult / intervention, 2 declined, 1 died). Of the 167 eligible patients, 122 (73%) were seen by FCS. Consult rates improved over time. 24 (non-malignant) pre-bone marrow transplant patients were also seen by FCS. A total of 29 patients proceeded with FP (14 SB, 13 OTC, 2 TTC). Conclusions: Our FN-driven model is an effective approach to a Pediatric FCS. Although the number of patients choosing FP is small, this demonstrates the need for fertility counseling in this population. The role of the FCS in pediatric oncology will increase as additional FP options become available for pre-pubertal patients.