scholarly journals Fertility Preservation Programme in a Tertiary-Assisted Reproduction Unit in Hong Kong

2021 ◽  
Vol 03 (03) ◽  
pp. 94-100
Author(s):  
Jennifer K. Y. Ko ◽  
Kevin K.W. Lam ◽  
Heidi H.Y. Cheng ◽  
Man Wa Lui ◽  
Sofie S.F. Yung ◽  
...  
Keyword(s):  
Hong Kong ◽  
Cancer Treatment ◽  
Fertility Preservation ◽  
Assisted Reproduction ◽  
Cancer Survival ◽  
Survival Rates ◽  
Embryo Cryopreservation ◽  
Natural Conception ◽  
Female Fertility Preservation ◽  
Evaluation And Monitoring

Background: Fertility preservation is increasingly important with improving cancer survival rates and the delay in childbearing in modern societies. The objective of our study was to review the experience of the fertility preservation programme in a tertiary-assisted reproduction unit in Hong Kong. Methods: This is a retrospective study involving men and women who were seen at a tertiary-assisted reproduction unit for fertility preservation counselling before gonadotoxic treatment from January 2005 to December 2020. Their medical records in paper and electronic forms were reviewed. Results: There were 75 consultations for female fertility preservation from 2010 to 2020 involving 72 women. Twenty women underwent 22 cycles of ovarian stimulation for oocyte or embryo cryopreservation, two of whom subsequently transported their oocytes abroad for further management and another two achieved natural conception. Additional four women who did not have oocyte or embryo cryopreservation achieved natural conception after cancer treatment. Eleven (15.2%) women were followed up at a reproductive endocrinology clinic after their cancer treatment. From 2005 to 2020, 265 men had sperm cryopreserved. Twenty-six (9.8%) came back to use the cryopreserved sperms, the wives of 13 (50.0%) of whom achieved an on-going pregnancy. Six of them transferred out and 40 discarded the cryopreserved sperms. Conclusions: There was generally an increasing number of patient consultations for fertility preservation in our Centre over the past decade but a consistently low rate of utilisation of cryopreserved gametes for both women and men. Post-cancer treatment fertility evaluation and monitoring was a major area of deficiency in Hong Kong. More structured post-cancer treatment fertility follow-up is needed.

scholarly journals Fertility Preservation: A Case Series

2011 ◽  
Vol 2 (3) ◽  
pp. 114-117 ◽  
Author(s):  
Korula George ◽  
Vaibhav Londhe ◽  
K Muthukumar
Keyword(s):  
Fertility Preservation ◽  
Ovarian Tissue ◽  
Survival Rates ◽  
Case Series ◽  
Female Fertility ◽  
Ovarian Tissue Cryopreservation ◽  
Embryo Cryopreservation ◽  
Clinical Scenarios ◽  
Female Fertility Preservation ◽  
Improvement In Survival

ABSTRACT Improvement in survival rates of cancer patients has lead to a shift in focus toward fertility issues, especially in young survivors. Male fertility preservation is well established. Embryo cryopreservation remains most successful female fertility preservation option. Other female fertility preservation procedures like oocyte/ovarian tissue cryopreservation either have limited efficacy or in experimental stages. We have highlighted not uncommon clinical scenarios where the fertility preservation option was exercised. There is an urgent need to spread awareness among clinicians and patients regarding the various available fertility preservation measures. Timely referral will help in improving the quality of life of cancer survivors.

scholarly journals Current and Future Perspectives for Improving Ovarian Tissue Cryopreservation and Transplantation Outcomes for Cancer Patients

2021 ◽  
Author(s):  
Sanghoon Lee ◽  
Sinan Ozkavukcu ◽  
Seung-Yup Ku
Keyword(s):  
Cancer Treatment ◽  
Cancer Patients ◽  
Fertility Preservation ◽  
Cancer Survival ◽  
Ovarian Tissue ◽  
Survival Rates ◽  
Reproductive Age ◽  
Ovarian Tissue Cryopreservation ◽  
Tissue Cryopreservation ◽  
Transplantation Outcomes

AbstractAlthough advances in cancer treatment and early diagnosis have significantly improved cancer survival rates, cancer therapies can cause serious side effects, including ovarian failure and infertility, in women of reproductive age. Infertility following cancer treatment can have significant adverse effects on the quality of life. However, established methods for fertility preservation, including embryo or oocyte cryopreservation, are not always suitable for female cancer patients because of complicated individual conditions and treatment methods. Ovarian tissue cryopreservation and transplantation is a promising option for fertility preservation in pre-pubertal girls and adult patients with cancer who require immediate treatment, or who are not eligible to undergo ovarian stimulation. This review introduces various methods and strategies to improve ovarian tissue cryopreservation and transplantation outcomes, to help patients and clinicians choose the best option when considering the potential complexity of a patient’s situation. Effective multidisciplinary oncofertility strategies, involving the inclusion of a highly skilled and experienced oncofertility team that considers cryopreservation methods, thawing processes and devices, surgical procedures for transplantation, and advances in technologies, are necessary to provide high-quality care to a cancer patient.

scholarly journals Fertility Preservation in Female Cancer Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Chung-Hoon Kim ◽  
Gyun-Ho Jeon
Keyword(s):  
Cancer Patients ◽  
Fertility Preservation ◽  
Survival Rates ◽  
Young Patients ◽  
Gynecologic Surgery ◽  
Embryo Cryopreservation ◽  
Future Fertility ◽  
Female Cancer Patients ◽  
Gestational Surrogacy

With improved survival rates among cancer patients, fertility preservation is now being recognized as an issue of great importance. There are currently several methods of fertility preservation available in female cancer patients and the options and techniques via assisted reproduction and cryopreservation are increasing, but some are still experimental and continues to be evaluated. The established means of preserving fertility include embryo cryopreservation, gonadal shielding during radiation therapy, ovarian transposition, conservative gynecologic surgery such as radical trachelectomy, donor embryos/oocytes, gestational surrogacy, and adoption. The experimental methods include oocyte cryopreservation, ovarian cryopreservation and transplantation, in vitro maturation, and ovarian suppression. With advances in methods for the preservation of fertility, providing information about risk of infertility and possible options of fertility preservation to all young patients with cancer, and discussing future fertility with them should be also considered as one of the important parts of consultation at the time of cancer diagnosis.

scholarly journals Female Fertility Preservation through Stem Cell-based Ovarian Tissue Reconstitution In Vitro and Ovarian Regeneration In Vivo

2019 ◽  
Vol 13 ◽  
pp. 117955811984800 ◽  
Author(s):  
Taichi Akahori ◽  
Dori C Woods ◽  
Jonathan L Tilly
Keyword(s):  
Fertility Preservation ◽  
Ovarian Tissue ◽  
Mammalian Species ◽  
Reproductive Age ◽  
Embryo Cryopreservation ◽  
Novel Approach ◽  
Future Fertility ◽  
Female Fertility Preservation

Historically, approaches designed to offer women diagnosed with cancer the prospects of having a genetically matched child after completion of their cytotoxic treatments focused on the existing oocyte population as the sole resource available for clinical management of infertility. In this regard, elective oocyte and embryo cryopreservation, as well as autologous ovarian cortical tissue grafting posttreatment, have gained widespread support as options for young girls and reproductive-age women who are faced with cancer to consider. In addition, the use of ovarian protective therapies, including gonadotropin-releasing hormone agonists and sphingosine-1-phosphate analogs, has been put forth as an alternative way to preserve fertility by shielding existing oocytes in the ovaries in vivo from the side-effect damage caused by radiotherapy and many chemotherapeutic regimens. This viewpoint changed with the publication of now numerous reports that adult ovaries of many mammalian species, including humans, contain a rare population of oocyte-producing germ cells—referred to as female germline or oogonial stem cells (OSCs). This new line of study has fueled research into the prospects of generating new oocytes, rather than working with existing oocytes, as a novel approach to sustain or restore fertility in female cancer survivors. Here, we overview the history of work from laboratories around the world focused on improving our understanding of the biology of OSCs and how these cells may be used to reconstitute “artificial” ovarian tissue in vitro or to regenerate damaged ovarian tissue in vivo as future fertility-preservation options.

P–457 Emergency fertility preservation (FP) in female patients- utilisation rate of the stored eggs/embryos and pregnancy outcomes

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
V Balakumar ◽  
S C Khaw ◽  
P Milne ◽  
S Kini
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Survival Rate ◽  
Fertility Preservation ◽  
Young Women ◽  
Pregnancy Outcomes ◽  
Cancer Survival ◽  
Embryo Cryopreservation ◽  
Utilisation Rate ◽  
The Mean

Abstract Study question The aim of the study was to determine the percentage of patients returning to use their stored eggs/embryos following FP and their pregnancy outcomes. Summary answer The patient utilisation rate for eggs/embryos was 17% with a live birth rate of 59%. What is known already Fertility preservation is considered as a vital issue for individuals in the reproductive stage of life when their future fertility may be compromised. Increased cancer survival rate and advances in assisted reproductive techniques make this an essential service to offer to patients facing life limiting disease or long-term medical conditions.FP is important to improve the quality of life in cancer survivors. Study design, size, duration A retrospective analysis was performed over a period of ten years between January 2010 to December 2020 in our tertiary unit. A total of 75 patients who underwent FP were identified. Participants/materials, setting, methods Infertility database for embryology and andrology (IDEAS) was used for the data collection and analysis. Patient’s age, reasons for fertility preservation, type of benign/cancer condition, protocol used for controlled ovarian stimulation (COS), dose of the gonadotropins, number of eggs collected, number of eggs/embryos cryopreserved, duration between storage and fertility treatment, pregnancy outcomes were included in the analysis. Main results and the role of chance Seventy-five patients underwent FP during the 10-year study period. The mean age was 30 years (range 17–43). Seventy-two patients (96%) underwent treatment for oncological reasons and the rest (4%) were for gender transition and Crohn’s disease. The most common types of malignancies include breast cancer (36%), Hodgkin’s lymphoma (18%) and cervical cancer (15%). Ninety-two percentage of patients underwent COS with an antagonist cycle, with an average of 10.8 eggs collected. Recombinant follicle stimulating hormone (FSH) was used in 92% of the cycles and human menopausal gonadotropin (HMG) was used in 8%. Fifty-eight percentage were given a maximum dose of 300IU of gonadotropin. The mean yield of eggs was higher in patients with breast cancer (12.62) followed by Hodgkin’s (10.5) and cervical cancer (9.6). Majority (60%) had embryo cryopreservation (82% at blastocyst stage and 18% at day 3 cleavage stage) and the rest (40%) had egg cryopreservation. A total of 17% (12) of patients returned for treatment with a livebirth rate of 59% and miscarriage rate of 8%. One third of livebirths were achieved through surrogacy. The average duration between fertility preservation and return for treatment was 2.4 years. Limitations, reasons for caution During the last 5 years, there has been an increase in the number of young women requiring FP in our unit. These women may require a considerable amount of time to complete their oncological treatment before embarking on pregnancy using their stored eggs/embryos. Wider implications of the findings: As cancer survival rate improves, there will be a likely increase in the utilisation rate for follow up treatment among young women who had FP. The overall awareness of the gonadotoxic effect of cancer therapy and available fertility preservation options among both patients and clinicians needs to be increased. Trial registration number NA

scholarly journals Fertility preservation options for children and adolescents with cancer

2017 ◽  
Vol 11 (1-2S) ◽  
pp. 97 ◽  
Author(s):  
Rodrigo L.P. Romao ◽  
Armando J. Lorenzo
Keyword(s):  
Children And Adolescents ◽  
Fertility Preservation ◽  
Survival Rates ◽  
Testicular Tissue ◽  
Age Group ◽  
Newly Diagnosed ◽  
Target Groups ◽  
Patient Advocates ◽  
And Gender ◽  
Female Fertility Preservation

Introduction: Cancer in children and adolescents has seen a stark rise in survival rates in the last decades; overall survival in excess of 80% can be reasonably expected for many newly diagnosed patients with malignancies in this age group. Survivorship has unfolded several specific issues faced by these patients, including fertility concerns. Hence, fertility preservation efforts have been discussed and undertaken with increased frequency.Methods: In this article, the authors provide a broad overview of the current recommendations surrounding fertility preservation in this patient population. Reasons to offer fertility preservation, target groups for interventions, and methods available based on age group and gender are discussed in detail.Results: The medical literature and patient advocates strongly support a discussion about fertility preservation at the time of diagnosis; the risk of infertility is real and parents and families wish to be informed about it. In postpubertal males, sperm-banking is relatively straightforward and should be attempted by most newly diagnosed patients, ideally before commencement of treatment. Cryopreservation of testicular tissue in higher-risk prepubertal males is feasible, but still experimental. Female fertility preservation is more complex, requires more invasive procedures, and can delay initiation of treatment due to the requirement for hormone stimulation of follicles prior to harvesting.Conclusions: Oncofertility initiatives in children and youth are still in their early days and will continue to expand; urologists should be prepared to offer counselling and interventions when appropriate to this growing vulnerable population.

Physician Referral for Fertility Preservation in Oncology Patients: A National Study of Practice Behaviors

2009 ◽  
Vol 27 (35) ◽  
pp. 5952-5957 ◽  
Author(s):  
Gwendolyn P. Quinn ◽  
Susan T. Vadaparampil ◽  
Ji-Hyun Lee ◽  
Paul B. Jacobsen ◽  
Gerold Bepler ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Fertility Preservation ◽  
Cancer Survival ◽  
Survival Rates ◽  
The United States ◽  
National Study ◽  
Childbearing Age ◽  
Practice Behaviors ◽  
Patient Recall ◽  
American Society

Purpose Cancer survival rates are improving, and the focus is moving toward quality survival. Fertility is a key aspect of quality of life for cancer patients of childbearing age. Although cancer treatment may impair fertility, some patients may benefit from referral to a specialist before treatment. However, the majority of studies examining patient recall of discussion and referral for fertility preservation (FP) show that less than half receive this information. This study examined the referral practices of oncologists in the United States. Methods This study examined oncologists' referral practice patterns for FP among US physicians using the American Medical Association Physician Masterfile database. A 53-item survey was administered via mail and Internet to a stratified random sample of US physicians. Results Forty-seven percent of respondents routinely refer cancer patients of childbearing age to a reproductive endocrinologist. Referrals were more likely among female physicians (P = .004), those with favorable attitudes (P = .043), and those whose patients routinely ask about FP (odds ratio = 2.09; 95% CI, 1.31 to 3.33). Conclusion Less than half of US physicians are following the guidelines from the American Society of Clinical Oncology, which suggest that all patients of childbearing age should be informed about FP.

scholarly journals State of the Art in Fertility Preservation for Female Patients Prior to Oncologic Therapies

Medicina ◽  
2020 ◽  
Vol 56 (2) ◽  
pp. 89
Author(s):  
Călin Bogdan Chibelean ◽  
Răzvan-Cosmin Petca ◽  
Dan Cristian Radu ◽  
Aida Petca
Keyword(s):  
Fertility Preservation ◽  
Cancer Survival ◽  
Ovarian Function ◽  
Survival Rates ◽  
Modern Society ◽  
Medical Sciences ◽  
Medical Specialties ◽  
Oncologic Patients ◽  
Reproductive Life ◽  
Life Improvement

Quality of life improvement stands as one of the main goals of the medical sciences. Increasing cancer survival rates associated with better early detection and extended therapeutic options led to the specific modeling of patients’ choices, comprising aspects of reproductive life that correlated with the evolution of modern society, and requires better assessment. Of these, fertility preservation and ovarian function conservation for pre-menopause female oncologic patients pose a contemporary challenge due to procreation age advance in evolved societies and to the growing expectations regarding cancer treatment. Progress made in cell and tissue-freezing technologies brought hope and shed new light on the onco-fertility field. Additionally, crossing roads with general fertility and senescence studies proved highly beneficial due to the enlarged scope and better synergies and funding. We here strive to bring attention to this domain of care and to sensitize all medical specialties towards a more cohesive approach and to better communication among caregivers and patients.

scholarly journals Cancer, Fertility Preservation, and Future Pregnancy: A Comprehensive Review

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Michelle L. Matthews ◽  
Bradley S. Hurst ◽  
Paul B. Marshburn ◽  
Rebecca S. Usadi ◽  
Margaret A. Papadakis ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Fertility Preservation ◽  
Cancer Survival ◽  
Treatment Options ◽  
Recurrence Risk ◽  
Advantages And Disadvantages ◽  
Recent Advances ◽  
Future Pregnancy ◽  
Risk Of Cancer ◽  
The Impact

Given the increases in 5-year cancer survival and recent advances in fertility preserving technologies, an increasing number of women with cancer are presenting for discussion of fertility preserving options. This review will summarize the risk of infertility secondary to cancer treatment, available treatment options for fertility preservation, and techniques to reduce future risks for patients. Concerns that will be addressed include the risk of the medications and procedures, the potential delay in cancer treatment, likelihood of pregnancy complications, as well as the impact of future pregnancy on the recurrence risk of cancer. Recent advances in oocyte cryopreservation and ovarian stimulation protocols will be discussed. Healthcare providers need to be informed of available treatment options including the risks, advantages, and disadvantages of fertility preserving options to properly counsel patients.

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