O-278 Medical and ethical perspectives of performing ovarian stimulation and oocyte cryopreservation for fertility preservation (FP) in adolescents: 5 years’ experience from a tertiary centre

Abstract Study question What are the medical and ethical challenges of performing ovarian stimulation oocyte cryopreservation in adolescents what barriers to provision? Summary answer Oocyte for benign malignant indications is associated with unique challenges. known already An improvement childhood cancer survival, increased transgender care conditions such as haemoglobinopathies requiring stem cell transplant have led higher representation adolescent birth-registered females FP clinics. has complexities, both physical (pubertal stage, diagnosis) psychological (accepting diagnosis, processing information, decision-making). Concerns relate reliability AMH adolescents, anticipated response quality. Counselling consenting young people their families about fertility decisions, often alongside receiving a life-changing an ethically complex area. Assessing capacity consent not straightforward. We report our clinical experience. design, size, duration This was retrospective, observational cohort study 26 aged 13 18 years who underwent specialist unit preservation between 2018 2022. The primary outcome yield, secondary outcomes included complications drop-out rate. Participants/materials, setting, methods post-pubertal were referred high risk gonadotoxicity from treatment commenced cryopreservation. Data retrieved prospectively managed database. noted demographic data, reserve, method monitoring, route egg collection. Documentation on counselling conversations maturity records. Main results role chance There total 29 cycles performed years. Indications malignancy 62% (16/26), immunological disorders 19% (5/26), gender reassignment 8% (2/26), recurrent cyst surgery (2/26) haematological disease 4% (1/26). youngest 10 months at time Minimum menarche 11 months. 23% (6/26) had previously received chemotherapy. 2.8-37 pmol/L AFC 2-36. correlated well majority. Random-start 54% (14/26) dual 12% (3/26). Number cryopreserved oocytes 3-45 number MII 3-35. Ultrasound monitoring transabdominally 88% (23/26) transvaginally Egg collection all cases this cohort, comprising varying ethnicities. All proceeded completion. no any cycle, including 42% (11/26) malignancy. counselled association family member obtain informed consent. assessed able comprehend discussions. Limitations, reasons caution limited data adolescents. Further studies expanding findings needed support clinicians perform population. remain regarding aneuploidy rates age group compared women 20s. Livebirth needed. Wider implications largest case series date. Post-pubertal can undergo Transvaginal accepted procedure when appropriately. Clinician experience, correct setting funding enable permissive environment Trial registration N/A