Deciphering the Relationship Between Alcohol Consumption, Oropharyngeal Cancers, and Socioeconomic Determinants.

Hematopoietic stem cell transplantation (HSCT) is an established therapeutic modality for over 30 malignant and non-malignant conditions, with approximately 50,000 procedures performed worldwide each year []. With the long-term survival rate of HSCT recipients steadily improving [], preserving their quality of life, particularly ovarian function and fertility, has become a paramount concern for survivors. Unfortunately, the risk of infertility following the intensive conditioning regimens required for HSCT exceeds 80% [, ]. Ovarian failure following HSCT is notably more severe, occurs with higher frequency and earlier onset, and has a lower likelihood of recovery compared to other treatments []. This is starkly evidenced by large cohort studies showing that only 0.6% of women conceived post-HSCT [, ], underscoring the profound gonadotoxicity primarily associated with the intensity and types of conditioning []. For many young cancer survivors, the loss of fertility can be as devastating as the cancer diagnosis itself, profoundly impacting their quality of life and psychological well-being []. Premature ovarian insufficiency (POI), the most common late-effect complication of HSCT, profoundly impacts long-term quality of life. Only a small minority (<5%) of these patients experience transient ovarian function recovery after HSCT before progressing to early menopause []. The sequelae of POI and estrogen deficiency are extensive, encompassing vasomotor symptoms, neuropsychological disturbances, arthralgia, sexual dysfunction, and irreversible loss of reproductive capacity—all of which detrimentally affect quality of life. Furthermore, premature estrogen deprivation not only impedes the development of secondary sexual characteristics but also increases the long-term risk of osteoporosis, cardiovascular disease, and dementia, conditions frequently observed in this population []. Addressing this issue remains a critical unmet need during survivorship. In response, major professional societies, including the American Academy of Pediatrics [], the American Society of Clinical Oncology [], the Children’s Oncology Group (COG) [, ], and the American Society of Reproductive Medicine (ASRM) [], and the European Society of Human Reproduction and Embryology (ESHRE) [] unanimously recommend early discussions about fertility, irrespective of the risk profile, before treatment begins. Consequently, fertility preservation (FP) has emerged as a central component of contemporary cancer management, especially for women who wish to preserve childbearing and endocrine functions [, ].