Fertility Preservation in the Age of Assisted Reproductive Technologies

2015 ◽  
Vol 42 (1) ◽  
pp. 39-54 ◽  
Author(s):  
Paul R. Brezina ◽  
William H. Kutteh ◽  
Amelia P. Bailey ◽  
Jianchi Ding ◽  
Raymond W. Ke ◽  
...  
2015 ◽  
Vol 22 (4) ◽  
pp. 294 ◽  
Author(s):  
J. Roberts ◽  
R. Ronn ◽  
N. Tallon ◽  
H. Holzer

BackgroundAdvancements in the treatments for cancer and autoimmune and other hematologic conditionscontinue to improve survival and cure rates. Despite those changes, various gonadotoxic agents and other treatments can still compromise the future fertility of many women. Progress in medical and surgical reproductive technologies has helped to offset the reproductive consequences of the use of gonadotoxic therapies, and allows for future fertility and normal pregnancy.Methods A review of the literature was performed to outline the pathophysiology of gonadotoxicity from various treatments. The success of fertility preservation, fertility sparing, and cryopreservation options are reviewed. Barriers and facilitators to referral and oncofertility treatment in Canada are also outlined.ResultsAccording to the quality of the evidence, recommendations are made for fertility assessment, patient referral, cryopreservation, and other assisted reproductive technologies.ConclusionsTo ensure ongoing fertility in women undergoing gonadotoxic treatments, assisted reproductive technologies can be combined with a multidisciplinary approach to patient assessment and referral. 


2021 ◽  
Vol 10 (8) ◽  
pp. 1650
Author(s):  
Kenny A. Rodriguez-Wallberg ◽  
Xia Hao ◽  
Anna Marklund ◽  
Gry Johansen ◽  
Birgit Borgström ◽  
...  

Fertility preservation is a novel clinical discipline aiming to protect the fertility potential of young adults and children at risk of infertility. The field is evolving quickly, enriched by advances in assisted reproductive technologies and cryopreservation methods, in addition to surgical developments. The best-characterized target group for fertility preservation is the patient population diagnosed with cancer at a young age since the bulk of the data indicates that the gonadotoxicity inherent to most cancer treatments induces iatrogenic infertility. Since improvements in cancer therapy have resulted in increasing numbers of long-term survivors, survivorship issues and the negative impact of infertility on the quality of life have come to the front line. These facts are reflected in an increasing number of scientific publications referring to clinical medicine and research in the field of fertility preservation. Cryopreservation of gametes, embryos, and gonadal tissue has achieved quality standards for clinical use, with the retrieval of gonadal tissue for cryopreservation being currently the only method feasible in prepubertal children. Additionally, the indications for fertility preservation beyond cancer are also increasing since a number of benign diseases and chronic conditions either require gonadotoxic treatments or are associated with premature follicle depletion. There are many remaining challenges, and current research encompasses clinical health care and caring sciences, ethics, societal, epidemiological, experimental studies, etc.


2020 ◽  
pp. 345-349 ◽  
Author(s):  
Alexandra S. Rashedi ◽  
Saskia F. de Roo ◽  
Lauren M. Ataman ◽  
Maxwell E. Edmonds ◽  
Adelino Amaral Silva ◽  
...  

Purpose In the accompanying article, “Survey of Fertility Preservation Options Available to Patients With Cancer Around the Globe,” we showed that specific fertility preservation services may not be offered at various sites around the world because of cultural and legal barriers. We assessed global and regional experiences as well as the legal status of third-party reproduction and adoption to serve as a comprehensive international data set and resource for groups that wish to begin oncofertility interventions. Methods We provide data on the legalities of third-party assisted reproductive technologies and other family-building options in the 28 oncofertility-practicing countries surveyed. Results We found regional and country differences that will be important in the development of tailored resources for physicians and for patient brochures that are sensitive to these local restrictions and cultural norms. Conclusion Because many patients first consult Web-based materials, the formal assessment of the availability of these options provides members of the global oncofertility community with data to which they might otherwise not have ready access to better serve their patients.


GYNECOLOGY ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. 110-116
Author(s):  
Galina E. Chernukha ◽  
Madina R. Dumanovskaya ◽  
Lilia M. Ilina

Aim. To review the most recent literature regarding the modern management of women with ovarian endometriosis and no desire for immediate pregnancy but wanted fertility preservation in future. Materials and methods. The analysis of latest publications on this topic has been carried out. Results. Ovarian endometriosis is associated with infertility due to several factors including potential gonadotoxic effect per se and ovarian reserve decline after surgical treatment. Medical treatment is the first-line therapeutic option for patients with pelvic pain and no desire for immediate pregnancy in absence indications for the urgent surgery, for prevention disease progression. Postoperative long-term medical therapy has been effective in the prevention of endometrioma recurrence, repeated surgery, additional ovarian reserve decline and preserve fertility in future. Conclusion. Ovarian endometriosis management should be individualized according to the patients intentions and priorities. Long-term progestins most appropriate therapy for fertility preservation in women prior to performing surgery or provide assisted reproductive technologies, if needed.


Endocrinology ◽  
2020 ◽  
Vol 161 (3) ◽  
Author(s):  
Molly B Moravek ◽  
Hadrian M Kinnear ◽  
Jenny George ◽  
Jourdin Batchelor ◽  
Ariella Shikanov ◽  
...  

Abstract Studies show that a subset of transgender men desire children; however, there is a paucity of literature on the effect of gender-affirming testosterone therapy on reproductive function. In this manuscript, we will review the process of gender-affirming hormone therapy for transgender men and what is known about ovarian and uterine consequences of testosterone exposure in transgender men; draw parallels with existing animal models of androgen exposure; summarize the existing literature on parenting experiences and desires in transgender people; discuss considerations for assisted reproductive technologies and fertility preservation; and identify gaps in the literature and opportunities for further research.


Somatechnics ◽  
2015 ◽  
Vol 5 (1) ◽  
pp. 88-103 ◽  
Author(s):  
Kalindi Vora

This paper provides an analysis of how cultural notions of the body and kinship conveyed through Western medical technologies and practices in Assisted Reproductive Technologies (ART) bring together India's colonial history and its economic development through outsourcing, globalisation and instrumentalised notions of the reproductive body in transnational commercial surrogacy. Essential to this industry is the concept of the disembodied uterus that has arisen in scientific and medical practice, which allows for the logic of the ‘gestational carrier’ as a functional role in ART practices, and therefore in transnational medical fertility travel to India. Highlighting the instrumentalisation of the uterus as an alienable component of a body and subject – and therefore of women's bodies in surrogacy – helps elucidate some of the material and political stakes that accompany the growth of the fertility travel industry in India, where histories of privilege and difference converge. I conclude that the metaphors we use to structure our understanding of bodies and body parts impact how we imagine appropriate roles for people and their bodies in ways that are still deeply entangled with imperial histories of science, and these histories shape the contemporary disparities found in access to medical and legal protections among participants in transnational surrogacy arrangements.


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