Fertility preservation for young patients with cancer: who is at risk and what can be offered?

2005 ◽  
Vol 6 (4) ◽  
pp. 209-218 ◽  
Author(s):  
W Hamish B Wallace ◽  
Richard A Anderson ◽  
D Stewart Irvine
Keyword(s):  
At Risk ◽  
Fertility Preservation ◽  
Young Patients ◽  
Patients With Cancer

scholarly journals Genomic Consideration in Chemotherapy-Induced Ovarian Damage and Fertility Preservation

Genes ◽  
2021 ◽  
Vol 12 (10) ◽  
pp. 1525
Author(s):  
Seongmin Kim ◽  
Sanghoon Lee ◽  
Hyun-Tae Park ◽  
Jae-Yun Song ◽  
Tak Kim
Keyword(s):  
Fertility Preservation ◽  
Quality Care ◽  
Young Patients ◽  
Young Female ◽  
Patients With Cancer ◽  
Female Cancer Patients ◽  
Ovarian Damage ◽  
Prevention Methods ◽  
Gonadal Damage ◽  
Gene Alterations

Chemotherapy-induced ovarian damage and fertility preservation in young patients with cancer are emerging disciplines. The mechanism of treatment-related gonadal damage provides important information for targeting prevention methods. The genomic aspects of ovarian damage after chemotherapy are not fully understood. Several studies have demonstrated that gene alterations related to follicular apoptosis or accelerated follicle activation are related to ovarian insufficiency and susceptibility to ovarian damage following chemotherapy. This may accelerate follicular apoptosis and follicle reservoir utilization and damage the ovarian stroma via multiple molecular reactions after chemotherapy. This review highlights the importance of genomic considerations in chemotherapy-induced ovarian damage and multidisciplinary oncofertility strategies for providing high-quality care to young female cancer patients.

scholarly journals Follicle Rescue From Prepubertal Ovaries After Recent Treatment With Cyclophosphamide—An Experimental Culture System Using Mice to Achieve Mature Oocytes for Fertility Preservation

2021 ◽  
Vol 11 ◽  
Author(s):  
Xia Hao ◽  
Amandine Anastácio ◽  
Laia Viñals-Ribé ◽  
Ana Santamaria Lacuesta ◽  
Christina Diakaki ◽  
...  
Keyword(s):  
Fertility Preservation ◽  
Ovarian Tissue ◽  
Young Patients ◽  
Ovarian Tissue Cryopreservation ◽  
Ovarian Tissue Transplantation ◽  
Oocyte Competence ◽  
Patients With Cancer ◽  
Tissue Cryopreservation ◽  
Selection Of

Ovarian tissue cryopreservation is the only feasible method for fertility preservation in prepubertal girls that will undergo gonadotoxic chemotherapy. To date, the only clinical use of cryopreserved tissue is by a later tissue retransplantation to the patient. Clinical challenges in fertility preservation of very young patients with cancer include time constraints that do not allow to retrieve the tissue for cryopreservation before starting chemotherapy and the preclusion of future ovarian tissue transplantation due to the risk of reintroduction of malignant cells in patients with systemic diseases. To overcome these two challenges, we investigated using an experimental model the feasibility of retrieving secondary follicles from ovaries of prepubertal mice after cyclophosphamide (CPA) treatment in increasing doses of 50, 75, and 100 mg/kg. The follicles were thereafter cultured and matured in vitro. The main outcomes included the efficiency of the method in terms of obtained matured oocytes and the safety of these potentially fertility preservative procedures in terms of analyses of oocyte competence regarding normality of the spindle and chromosome configurations. Our findings demonstrated that it was feasible to isolate and culture secondary follicles and to obtain mature oocytes from prepubertal mice ovaries recently treated with CPA. The efficiency of this method was highly demonstrated in the 100 mg/kg CPA group, with near 90% follicle survival rate after 12 days’ culture, similarly to control. Around 80% of the follicles met the criteria to put into maturation, and more than 40% of them achieved metaphase II, with normal spindle and chromosome configurations observed. Suboptimal results were obtained in the 50 and 75 mg/kg CPA groups. These paradoxical findings towards CPA dose might probably reflect a more difficult selection of damaged growing follicles from ovaries recently treated with lower doses of CPA and a hampered ability to identify and discard those with reduced viability for the culture.

scholarly journals Fertility preservation in young patients with cancer

2015 ◽  
Vol 04 (03) ◽  
pp. 134-139 ◽  
Author(s):  
Virender Suhag ◽  
B. S. Sunita ◽  
Arti Sarin ◽  
A. K. Singh ◽  
Dashottar S.
Keyword(s):  
At Risk ◽  
Fertility Preservation ◽  
Ovarian Follicle ◽  
Reproductive Potential ◽  
Young Patients ◽  
Embryo Cryopreservation ◽  
Premature Menopause ◽  
High Dose ◽  
Future Fertility

AbstractInfertility can arise as a consequence of treatment of oncological conditions. The parallel and continued improvement in both the management of oncology and fertility cases in recent times has brought to the forefront the potential for fertility preservation in patients being treated for cancer. Many survivors will maintain their reproductive potential after the successful completion of treatment for cancer. However total body irradiation, radiation to the gonads, and certain high dose chemotherapy regimens can place women at risk for acute ovarian failure or premature menopause and men at risk for temporary or permanent azoospermia. Providing information about risk of infertility and possible interventions to maintain reproductive potential are critical for the adolescent and young adult population at the time of diagnosis. There are established means of preserving fertility before cancer treatment; specifically, sperm cryopreservation for men and in vitro fertilization and embryo cryopreservation for women. Several innovative techniques are being actively investigated, including oocyte and ovarian follicle cryopreservation, ovarian tissue transplantation, and in vitro follicle maturation, which may expand the number of fertility preservation choices for young cancer patients. Fertility preservation may also require some modification of cancer therapy; thus, patients’ wishes regarding future fertility and available fertility preservation alternatives should be discussed before initiation of therapy.

scholarly journals Gender-specific aspects related to type of fertility preservation strategies and access to fertility care

ESMO Open ◽  
2020 ◽  
Vol 5 (Suppl 4) ◽  
pp. e000771 ◽  
Author(s):  
Marta Perachino ◽  
Claudia Massarotti ◽  
Maria Grazia Razeti ◽  
Francesca Parisi ◽  
Luca Arecco ◽  
...  
Keyword(s):  
Fertility Preservation ◽  
Health Care Providers ◽  
Cancer Care ◽  
Safety Data ◽  
Young Patients ◽  
Ovarian Tissue Cryopreservation ◽  
Embryo Cryopreservation ◽  
Care Providers ◽  
Patients With Cancer ◽  
Age Related

Survivorship is an area of paramount importance to be addressed as early as possible after cancer diagnosis by all health care providers. On this regard, cancer care in young patients often poses several age-related considerations among which fertility and pregnancy-related issues have a crucial role. According to the available guidelines on the topic, all patients with cancer diagnosed during their reproductive years should be provided a proper oncofertility counselling before starting anticancer treatments. This is an important step in order to inform patients about the potential treatment-induced gonadotoxicity and the available strategies for fertility preservation so that they can be referred as early as possible to fertility specialists if potentially interested in these options.In this manuscript, we aim to provide an up to date overview on the available efficacy and safety data with the main strategies for fertility preservation in male and female cancer patients in order to help optimising the oncofertility counselling performed by healthcare providers involved in cancer care and dealing with young patients. In male patients with cancer, sperm cryopreservation is the standard technique for fertility preservation. Oocyte/embryo cryopreservation, ovarian tissue cryopreservation and temporary ovarian suppression with luteinising hormone-releasing hormone agonists during chemotherapy are the main options in female patients with cancer.A multidisciplinary management building a strong network between fertility and oncology/haematology units is crucial to properly address fertility care in all young patients with cancer, at both diagnosis and during oncologic follow-up. Discussing fertility and pregnancy-related issues with young patients with cancer has to be considered mandatory nowadays keeping in mind that returning to a normal life (including the possibility to have a family and to live with as few side effects as possible) should be considered an important ambition in cancer care in the 21st century .

Strategies for fertility preservation in young patients with cancer

2018 ◽  
Vol 1 (2) ◽  
pp. 86 ◽  
Author(s):  
Devika Gunasheela ◽  
Jyothi Menon ◽  
N Ashwin
Keyword(s):  
Fertility Preservation ◽  
Young Patients ◽  
Patients With Cancer

scholarly journals Molecular Mechanism and Prevention Strategy of Chemotherapy- and Radiotherapy-Induced Ovarian Damage

2021 ◽  
Vol 22 (14) ◽  
pp. 7484
Author(s):  
Seongmin Kim ◽  
Sung-Woo Kim ◽  
Soo-Jin Han ◽  
Sanghoon Lee ◽  
Hyun-Tae Park ◽  
...  
Keyword(s):  
Fertility Preservation ◽  
Radiation Treatment ◽  
Quality Care ◽  
Young Patients ◽  
Young Female ◽  
Clinical Value ◽  
Ovarian Toxicity ◽  
Patients With Cancer ◽  
Ovarian Damage ◽  
Molecular Pathophysiology

Fertility preservation is an emerging discipline, which is of substantial clinical value in the care of young patients with cancer. Chemotherapy and radiation may induce ovarian damage in prepubertal girls and young women. Although many studies have explored the mechanisms implicated in ovarian toxicity during cancer treatment, its molecular pathophysiology is not fully understood. Chemotherapy may accelerate follicular apoptosis and follicle reservoir utilization and damage the ovarian stroma via multiple molecular reactions. Oxidative stress and the radiosensitivity of oocytes are the main causes of gonadal damage after radiation treatment. Fertility preservation options can be differentiated by patient age, desire for conception, treatment regimen, socioeconomic status, and treatment duration. This review will help highlight the importance of multidisciplinary oncofertility strategies for providing high-quality care to young female cancer patients.

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