FertiTOX®
A platform for gonadotoxicity of cancer therapies

Welcome

Cancer therapies can harm the gonads. In high risk situations fertility preservation treatments such as freezing of oocytes, ovarian tissue, sperm and testicular tissue might be required. However, data about the risks of specific cancer therapies and the necessity to perform fertility preservation treatments is very limited.

Therefore the platform FertiTOX® will be set up to present systematically reviewed published data on the gonadotoxicity as well as prospectively collected data, collected in 3 countries by around 60 centres in Germany, Switzerland and Austria, having started data collection in 2024. These centres mainly belong to the network FertiPROTEKT®. The platform will be set up in 2026.

Participating countries

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Participating centres

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Included patients

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Steeering Committee

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Prof. Dr. Michael von Wolff
Coordinator and FertiTOX Switzerland
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Prof. Dr. Ariane Germeyer
FertiTOX Germany
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PD Dr. Bettina Böttcher
FertiTOX Austria
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PD Dr. Verena Nordhoff
Embryology
President FertiPROTEKT
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Prof. Dr. Sonja Grunewald
Andrology
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Prof. Dr. Nicole Sänger
Politics and Societies
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Irene Marcu, PhD
REDCap registry
(Switzerland and Austria)
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REDCap registry
(Germany)

Study protocol and documents for the study

First, previously published data is systematically analysed regarding the gonadotoxicity of chemo and radiotherapies in cancer patients.

Second, a prospective cohort study is performed to collect the following data in the study registry REDCap: ovarian function is evaluated by analysing AMH, FSH, LH and E2 concentrations and testicular function by analysing sperm parameters and total testosterone, just before and 12-15 months after the end of the gonadotoxic therapy (short term fertility). These fertility parameters, as well as the history of conceptions, will be collected 5 and 10 years after gonadotoxic therapies (long term fertility).

Furthermore, proportion of patients undergoing fertility preserving methods, efficacy and satisfaction with these methods will be analysed.

Third, the data will be merged to create the internet based data platform FertiTOX. The platform will be structured according to the ICD classification of cancer diseases and will be easily accessible using a specific App.

A description of the study has been submitted and will be found in the website menu “Papers published”.

Material such as paper versions of the REDCap study registry can also be downloaded (see PDF files below):

  • REDCap registry: Documentation in females before gonadotoxic therapy
  • REDCap registry: Documentation in males before gonadotoxic therapy
  • REDCap registry: Documentation in females 12-15 months after the end of gonadotoxic therapy
  • REDCap registry: Documentation in males 12-15 months after the end of gonadotoxic therapy

The paper versions can be used in the outpatient clinic to collect data to be added to the registry later.

Compact version

Compact paper versions in German of the REDCap study registry can also be downloaded (see PDF files below):

  • REDCap registry: Documentation in females before gonadotoxic therapy
  • REDCap registry: Documentation in males before gonadotoxic therapy
  • Disease list (ICD-10 coded, in English)

The English, French and Italian versions will be posted shortly.

Participating Centres

The restrospective data analysis is performed in the fertility centre in Inselspital Bern, Switzerland. Data for the prospective cohort study are collected in 15 centres in Germany, 21 centres in Switzerland and 1 centre in Austria. The complete list of the participating centres can be downloaded here.

Other centres are invited to contribute to the study if the study is accepted by their local ethical committee and if they add their data to the study registry. In case of interest, please contact the coordinator Michael von Wolff.

Sponsors

Several sponsors have provided financial support 2023 to 2028.

The project is mainly sponsored by public foundations such as the “Swiss cancer league” with a grant of CHF 349.000,-  (Grant number KLS-5650-08-2022) and “Deutsche Krebshilfe” with a grant of Euro: 393.600,- (Grant number 70115917).

The project is also financially supported by some companies.

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Deutsche Krebshilfe
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Theramex Switzerland GmbH
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Ferring Pharmaceuticals SA

Papers and Abstracts published and submitted

In this section we will upload all papers which have been submitted and published as a result of the project FertiTOX.

FertiTOX PROTOCOL
Evaluation of gonadotoxicity of cancer therapies to improve counselling of patients regarding fertility and fertility preservation measures: Protocol for a retrospective systematic data analysis and a prospective cohort study

Published in JMIR Res Protoc. 2024, this paper describes the project "FertiTOX".
Type of cancer
Type of study
Estimated overall risk/prevalence of infertility (95% CI)
Download paper
Bone cancer
Systematic review
Females: 5 – 13%
Males: 52 – 89%

"A systematic review of the gonadotoxicity of osteosarcoma and Ewing's sarcoma chemotherapies in postpubertal females and males"
Susanna Weidlinger, Satu Graber, Irina Bratschi, Janna Pape, Attila Kollár, Tanya Karrer, Michael von Wolff

Published in J Adolesc Young Adult Oncol. 2022
PDF download here
PubMed link

Soft tissue sarcoma
Systematic review
Females: 71%
Males: 60%

"Systematic review of the gonadotoxicity and risk of infertility of soft tissue sarcoma chemotherapies in pre- and postpubertal females and males"
Marcel Steinmann, Anita Rietschin, Flavia Pagano, Tanya Karrer, Attila Kollár, Susanna Weidlinger, Michael von Wolff

Published in J Adolesc Young Adult Oncol. 2024
PDF download here
PubMed link

Testicular cancer
Systematic review and meta-analysis
14% (9 – 21%)

"Oncological treatments have limited effects on the fertility prognosis in testicular cancer: A systematic review and meta-analysis"
Janna Pape, Jancy Fernando, Dimitrios Megaritis, Susanna Weidlinger, Angela Vidal, Frédéric D Birkhäuser, Tanya Karrer, Michael von Wolff

Published in Andrology. 2024
PDF download here
PubMed link

Central nervous system cancer
Systematic review and meta-analysis
20% (10 – 34%)

"Long-term effects on fertility after treatment of childhood, adolescents & young adults’ central nervous system cancer: A systematic review and meta-analysis"
Janna Pape, Tanya Gudzheva, Beeler Danijela, Susanna Weidlinger, Angela Vidal, Rhoikos Furtwängler, Tanya Karrer, Michael von Wolff

In Press
Manuscript download here

Bone marrow transplantation
Systematic review and meta-analysis
Females: 65% (58 – 71%)
Males: 41% (32 – 51%)

"Impact on fertility outcomes in survivors after hematopoietic stem cell transplantation for benign and malignant hematologic disorders: A systematic review and meta-analysis"
Angela Vidal, Cristina Bora, Andrea Jarisch, Janna Pape, Susanna Weidlinger, Tanya Karrer , Michael von Wolff

In Review
Manuscript download here

Colorectal cancer
Systematic review and meta-analysis
Females: 27% (11 – 54%)
Males: 18% (13 – 26%)

"Long-term effects on gonadal function after treatment of colorectal cancer: A systematic review and meta-analysis"
Christiane Anthon, Angela Vidal, Eva Piccand, Hanna Hecker, Janna Pape, Susanna Weidlinger, Marko Kornmann, Tanya Karrer, Michael von Wolff

In Review
Manuscript download here

Breast cancer
Meta-analysis
?
End of 2024
Hodgkin lymphoma
Meta-analysis
?
End of 2024
Non-Hodgkin's lymphoma
Meta-analysis
?
End of 2024
Leukaemia
Meta-analysis
?
End of 2024

Meetings

The PDF file versions of the online presentation meetings can be downloaded here.

The PDF files of our Steering Committee meetings can be downloaded here.

Contact us

The project has been initiated and is coordinated by Michael von Wolff.
The representative and contact person for Germany is Ariane Germeyer, for Switzerland Michael von Wolff and for Austria Bettina Böttcher.

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Prof. Michael von Wolff
University Women's Hospital
Friedbühlstrasse 19 
CH-3010 Bern
Switzerland
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Prof. Ariane Germeyer
University Women's Hospital
Im Neuenheimer Feld 672 
69120 Heidelberg
Germany
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PD Dr. Bettina Böttcher
Medical University of Innsbruck
Anichstraße 35
A-6020 Innsbruck
Austria