scholarly journals Ovarian tissue cryopreservation (OTC) in prepubertal girls and young women: an analysis of parents’ and patients’ decision-making

2018 ◽  
Vol 35 (4) ◽  
pp. 593-600 ◽  
Author(s):  
Chantae S. Sullivan-Pyke ◽  
Claire A. Carlson ◽  
Maureen Prewitt ◽  
Clarisa R. Gracia ◽  
Jill P. Ginsberg
Keyword(s):  
Decision Making ◽  
Young Women ◽  
Ovarian Tissue ◽  
Ovarian Tissue Cryopreservation ◽  
Tissue Cryopreservation ◽  
Prepubertal Girls

scholarly journals Methods for preserving fertility in young women suffering from cancer: some aspects of ovarian tissue cryopreservation

2012 ◽  
Vol 113 (03) ◽  
pp. 192-194 ◽  
Author(s):  
J. Zakova ◽  
M. Sedlackova ◽  
S. Polak ◽  
J. Dumkova ◽  
P. Ventruba ◽  
...  
Keyword(s):  
Young Women ◽  
Ovarian Tissue ◽  
Ovarian Tissue Cryopreservation ◽  
Tissue Cryopreservation

O-185 Evaluation of the decision-making process of girls with Turner syndrome and their parents considering ovarian tissue cryopreservation

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
S. Van der Coelen ◽  
M Schleedoorn ◽  
S Nadesapillai ◽  
R Peek ◽  
D Braat ◽  
...  
Keyword(s):  
Decision Making ◽  
Focus Group ◽  
Focus Groups ◽  
Turner Syndrome ◽  
Ovarian Tissue ◽  
Healthcare Providers ◽  
Ovarian Tissue Cryopreservation ◽  
Decision Making Process ◽  
Literature Research ◽  
Tissue Cryopreservation

Abstract Study question What are the experiences with the decision-making process of girls with Turner syndrome (TS) considering ovarian tissue cryopreservation (OTC), their parents and healthcare providers? Summary answer Offering a new option to preserve fertility in TS caused unrealistic hope leading to challenges for healthcare providers to fulfil the ideal of informed consent. What is known already Due to premature ovarian insufficiency, girls with TS have only a small chance of genetic offspring. OTC might increase these odds. Healthcare providers and scientist are still cautious in offering OTC to girls with TS because of the many uncertainties regarding OTC in this patient group. Hence, OTC is now offered to girls with TS between 2 and 18 years old in a research setting: the TurnerFertility study. Study design, size, duration A retrospective qualitative study consisting of a survey and focus groups. Within a year after counselling, families (n = 132) received a survey with 30 questions regarding their experiences with the decision-making process and also an invitation for a focus group. The focus groups were conducted between January and October 2019 and lasted 51-84 minutes. The topic lists were based on literature research and survey results. Results were analysed following a thematic analysis approach. Participants/materials, setting, methods This is a sub-study of the prospective intervention study within an academical medical centre. Focus groups were composed through purposive sampling. Focus group 1 (FG1) consisted of five gynaecologists involved in counselling, FG2 with seven paediatricians who referred girls for counselling, FG3 with nine parents of girls with TS between 2 and 12 years old and FG4 with three parents of girls with TS between 13 and 17 years old. Main results and the role of chance 90% of survey respondents appreciated counselling regarding fertility options and considered it an enrichment of existing healthcare. The individual consultation was rated as most contributing by 66% of the survey respondents, followed by the information meeting (37%) and decision aid (3%). The focus groups revealed that many had not discussed options for future parenthood with a healthcare provider before. Girls with TS and their parents indicated that the option of OTC raised hope for future genetic offspring, and at once made them feel like they had no choice but to take this chance. The small chance of success did not influence the decision for families who opted for OTC. Some parents who had to decide for their young daughter accepted OTC to give their daughter the option to decide herself whether to make use of the cryopreserved tissue later in life. Gynaecologists found it challenging to truly make families grasp a realistic perspective of OTC in TS and the associated mental and physical risks. Gynaecologists and paediatricians struggled with conflicting moral principles of non-maleficence against respect for autonomy: healthcare providers recognized the scientific relevance for the TS population, while it felt inconsistent with the disproportionate burden for some individual patients. Limitations, reasons for caution Because there was no validated survey for this topic in TS, we developed a survey based on literature research and experiences of a dedicated TS team. Among the survey responders and focus group participants a greater proportion decided for OTC compared to the overall counselled group (75% vs 60%). Wider implications of the findings This study gives insight in the issues to consider when implementing new technologies regarding fertility, in which parents have to decide for their child, where it is expected that anticipated decision regret plays a major role, or where healthcare providers experience conflicting duties as scientist and physician. Trial registration number not applicable

A critical evaluation of ovarian tissue cryopreservation and grafting as a strategy for preserving the human female germline

1997 ◽  
Vol 6 (3) ◽  
pp. 163-183 ◽  
Author(s):  
JM Shaw ◽  
KJ Dawson ◽  
AO Trounson
Keyword(s):  
Young Women ◽  
Ovarian Tissue ◽  
Critical Evaluation ◽  
Systemic Circulation ◽  
Ovarian Tissue Cryopreservation ◽  
Malignant Cells ◽  
Human Female ◽  
Embryo Freezing ◽  
Female Germline ◽  
Tissue Cryopreservation

Ovarian tissue freezing has been used successfully in animals and it has recently begun to be offered clinically to young women who have medical conditions with a high risk of sterility. Although no frozen human ovarian grafts have yet been returned to the donor and resulted in a pregnancy, there are many indications that this procedure should be feasible. Although live young have been derived from frozen grafts in several species, research should aim to make further improvements to the cryopreservation and grafting procedures to optimize follicle survival, and hence minimize the amount of tissue that needs to be collected, stored and returned. Ovarian tissue freezing, particular if used in combination with egg and embryo freezing, should allow a patient to safeguard their chance of becoming a parent later (Table 1). In cases where the patient has a systemic cancer or infection and malignant cells or viruses may be present in the systemic circulation and the gonadal tissue, ovarian tissue could be collected and frozen, but grafting is not currently recommended (Table 3).

Spontaneous Pregnancy and Fertility Preservation Program in Women Undergoing High Dose Chemotherapy for Hematological Malignancies.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1114-1114
Author(s):  
Izhar Hardan ◽  
Dror Meirow ◽  
Avichai Shimoni ◽  
Jacob Levron ◽  
Noga Shemtov ◽  
...  
Keyword(s):  
Fertility Preservation ◽  
Young Women ◽  
Ovarian Tissue ◽  
Young Patients ◽  
High Dose Chemotherapy ◽  
Ovarian Failure ◽  
Ovarian Tissue Cryopreservation ◽  
High Dose ◽  
Cryopreserved Ovarian Tissue ◽  
Tissue Cryopreservation

Abstract Loss of fertility is a major concern in young women undergoing high dose chemotherapy (HDT). Although it is generally accepted that therapy of the myeloabelative range is related with a high rate of fertility loss, we observed during the last years eight spontaneous pregnancies with normal deliveries in young women after bone marrow transplantation. Seven patients (pt’s) were with lymphoma and MM and were conditioned with BEAM regimen (n=6) and melphalan 200mg/sm (n=1) prior to an autologous SCT, while one patient had a secondary AML and underwent BEAM primed autologous SCT and Busulfex/FA primed allogeneic BMT. The median age at transplant of this group was 28y and median time from transplant to pregnancy was 25 months. More than 100 women of 18–40y.o were transplanted in our center during this period; however, obviously the fertility rate cannot be calculated as it is related with additional parameters including survival, post transplant complications and mainly patient’s preferences. Naturally we observed during the same period many young patients with ovarian failure post transplant, as well as one successful pregnancy from a cryopreserved embryo. Methods. We Therefore initiated in October 2000 a fertility preservation program in which all women of 18 – 40y.o were offered a pretransplant IVF with embryo preservation, and/or ovarian tissue cryopreservation (OTC), according to their clinical status. 651 pt’s were transplanted in our center in the last 44 months, of which 81 were women of 18–41y.o that were all enrolled in this program. Results. Seven pt’s of this group (8.6%) underwent IVF. The major causes of denying IVF were the need to delay BMT for more than clinically accepted, prolonged preexisting ovarian failure, lack of a suitable partner and patient’s preference. Seventeen pt’s (21%) underwent OTC. The major causes of denying OTC were patient’s preference (mainly due to no evidence of success with this method) and thrombocytopenia/neutropenia. During this period: One patient of this group was fertilized with her cryopreserved embryos 32 months after transplant and is at her 16 week of pregnancy. One patient underwent a successful transplantation of her cryopreserved ovarian tissue 2.5 years after HDC while in a documented ovarian failure, and gave birth to a healthy baby on June 2005. The OTC of this patient was performed after cis-platinum containing salvage therapy for relapsing NHL, prior to BEAM primed SCT, and immediately after a failure of hormonal stimulation for IVF. One patient underwent a cryopreserved ovarian tissue transplantation on July 2005 Conclusions: 1. Spontanous pregnancy after HDT, mainly at the younger age, is not a rare phenomenon. 2. Most young patients prior to HDT are not eligible for IVF. 3. Pretransplant ovarian tissue cryopreservation is a feasible tool in this set-up. The first success with this method is promising.

scholarly journals Fertility preservation for girls and young women with cancer: population-based validation of criteria for ovarian tissue cryopreservation

2014 ◽  
Vol 15 (10) ◽  
pp. 1129-1136 ◽  
Author(s):  
W Hamish B Wallace ◽  
Alice Grove Smith ◽  
Thomas W Kelsey ◽  
Angela E Edgar ◽  
Richard A Anderson
Keyword(s):  
Fertility Preservation ◽  
Young Women ◽  
Ovarian Tissue ◽  
Population Based ◽  
Ovarian Tissue Cryopreservation ◽  
Tissue Cryopreservation
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