Dados do Resumo

Título

FERTILITY PRESERVATION IN PATIENTS UNDERGOING ONCOHEMATOLOGICAL TREATMENT: NURSE NAVIGATOR APPROACH

Introdução

Fertility preservation must be addressed by the health team prior to oncological treatment, operationalizing the collection and conservation of gametes. It becomes a public health problem that impacts the quality of life of individuals of reproductive age. The nurse navigator must assess the individual's biopsychosocial condition, optimizing the planning of the treatment journey and understanding the associated infertility risks.

Objetivo

Describe the chemotherapy drugs with the greatest genotoxicity and the fertility preservation methods available.

Métodos

Integrative review of literature published in the PubMed and Cinahl databases in the last 5 years, using the descriptors fertility preservation, adolescents and young adults and oncology. Manual searches were also carried out. 56 articles were retrieved and 15 were critically analyzed to answer the initial question. The rest were discarded for not answering the initial question.

Resultados

The age range for teenagers and young adults is 15 to 35 years old. The genotoxic drugs classified as high risk are from the alkylating class, represented by cyclophosphamide, busulfan, chlorambucil, procarbazine, melphalan, ifosfamide and chlormethine. Intermediate risk medications are represented by platinums: doxorubicin, docetaxel and paclitaxel. Localized radiotherapy should also be considered with a high impact for infertility. There is no way to determine whether a patient will suffer from infertility. Fertility preservation is well established in male patients through sperm cryopreservation and testicular tissue preservation. In women, it is necessary to consider their menstrual cycle for gamete collection. The available techniques are: oocyte cryopreservation, ovarian tissue cryopreservation and in vitro fertilization for subsequent embryo implantation and drug ovarian suppression.

Conclusões

Most patients of childbearing age and undergoing oncohematological treatment want to receive information about fertility preservation, regardless of the decision to have offspring or not. Many factors can impact a patient's decision to discuss this issue with their doctor, such as lack of knowledge, personal and family values, and understanding of the long-term impacts of treatment. Most drugs classified as high and intermediate risk for genotoxicity are part of hematological treatment regimens.

Palavras Chave

fertility preservation; Patient navigation; Oncology Nursing