scholarly journals Cryopreservation Options to Preserve Fertility in Female Cancer Patients: Available Clinical Practice and Investigational Strategies from the Oncology Guidelines Point of View

2021 ◽  
Author(s):  
Leila Mirzaeian ◽  
Haniyeh Rafipour ◽  
Saadeh Hashemi ◽  
Sara Zabihzadeh ◽  
Saeid Amanpour
Keyword(s):  
Cancer Patients ◽  
Fertility Preservation ◽  
Clinical Oncology ◽  
Ovarian Tissue ◽  
Point Of View ◽  
Reproductive Age ◽  
Ovarian Tissue Cryopreservation ◽  
Female Cancer Patients ◽  
Restoration Strategies ◽  
Oncology Practice

In recent years, advances in cancer treatment have improved the survival rate of cancer patients significantly. However, destructive damage to ovaries due to the therapies or cancer itself can cause different degrees of infertility in women of reproductive age that can affect their quality of life seriously. In this study, fertility cryopreservation options for female cancer patients in oncology guidelines were reviewed. Cryopreservation methods have a long history in reproductive biology and oncology. However, embryo and oocyte cryopreservation were the eligible restoration strategies in clinical oncology practice. Ovarian tissue cryopreservation (OTC) is the latest option recommended for fertility preservation in pre-pubertal and adult patients who cannot delay their treatment or in whom taking IVF hormones may have adverse effects on their cancer. Reports show that frozen-thawed ovarian tissue transplantation has led to more than 130 live births so far in patients, most of whom were cancer patients. Although OTC is indeed generally recognized as an investigational method, it is recommended in some important guidelines, such as ASCO 2018. Therefore, based on many clinical pieces of evidence , it is predicted that the investigational label will soon be removed, and OTC might be considered as one of the main fertility preservation options for female cancer patients in clinical oncology practice.

scholarly journals Advances in the Treatment and Prevention of Chemotherapy-Induced Ovarian Toxicity

2020 ◽  
Vol 21 (20) ◽  
pp. 7792
Author(s):  
Hyun-Woong Cho ◽  
Sanghoon Lee ◽  
Kyung-Jin Min ◽  
Jin Hwa Hong ◽  
Jae Yun Song ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Fertility Preservation ◽  
Ovarian Tissue ◽  
Alkylating Agents ◽  
Survival Rates ◽  
Chemotherapeutic Agents ◽  
Reproductive Age ◽  
Experimental Techniques ◽  
Ovarian Tissue Cryopreservation

Due to improvements in chemotherapeutic agents, cancer treatment efficacy and cancer patient survival rates have greatly improved, but unfortunately gonadal damage remains a major complication. Gonadotoxic chemotherapy, including alkylating agents during reproductive age, can lead to iatrogenic premature ovarian insufficiency (POI), and loss of fertility. In recent years, the demand for fertility preservation has increased dramatically among female cancer patients. Currently, embryo and oocyte cryopreservation are the only established options for fertility preservation in women. However, there is growing evidence for other experimental techniques including ovarian tissue cryopreservation, oocyte in vitro maturation, artificial ovaries, stem cell technologies, and ovarian suppression. To prevent fertility loss in women with cancer, individualized fertility preservation options including established and experimental techniques that take into consideration the patient’s age, marital status, chemotherapy regimen, and the possibility of treatment delay should be provided. In addition, effective multidisciplinary oncofertility strategies that involve a highly skilled and experienced oncofertility team consisting of medical oncologists, gynecologists, reproductive biologists, surgical oncologists, patient care coordinators, and research scientists are necessary to provide cancer patients with high-quality care.

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 The role of gonadotropin-releasing hormone agonists in female fertility preservation

2021 ◽  
Vol 48 (1) ◽  
pp. 11-26
Author(s):  
Jae Hoon Lee ◽  
Young Sik Choi
Keyword(s):  
Cancer Patients ◽  
Fertility Preservation ◽  
Young Women ◽  
Large Scale ◽  
Ovarian Tissue ◽  
Gonadotropin Releasing Hormone ◽  
Ovarian Tissue Cryopreservation ◽  
Breast Cancer Patients ◽  
Ovarian Suppression ◽  
Releasing Hormone

Advances in anticancer treatments have resulted in increasing survival rates among cancer patients. Accordingly, the quality of life after treatment, particularly the preservation of fertility, has gradually emerged as an essential consideration. Cryopreservation of embryos or unfertilized oocytes has been considered as the standard method of fertility preservation among young women facing gonadotoxic chemotherapy. Other methods, including ovarian suppression and ovarian tissue cryopreservation, have been considered experimental. Recent large-scale randomized controlled trials have demonstrated that temporary ovarian suppression using gonadotropin-releasing hormone agonists (GnRHa) during chemotherapy is beneficial for preventing chemotherapy-induced premature ovarian insufficiency in breast cancer patients. It should also be emphasized that GnRHa use during chemotherapy does not replace established fertility preservation methods. All young women facing gonadotoxic chemotherapy should be counseled about and offered various options for fertility preservation, including both GnRHa use and cryopreservation of embryos, oocytes, and/or ovarian tissue.

Our act on fertility preservation for young breast cancer patients in our single institute.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 109-109 ◽  
Author(s):  
Yasuyuki Kojima ◽  
Kyoko Tsuchiya ◽  
Chie Nishijima ◽  
Nao Suzuki ◽  
Koichiro Tsugawa
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Fertility Preservation ◽  
Reproductive Age ◽  
Ovarian Tissue Cryopreservation ◽  
Embryo Cryopreservation ◽  
Newly Diagnosed ◽  
Breast Cancer Patients ◽  
Er Positive ◽  
Young Breast Cancer

109 Background: Along with increasing number of newly diagnosed Japanese breast cancer patients, the number of breast cancer survivors in reproductive age is also increasing. Among newly diagnosed Japanese breast cancer patients, 3182(6.6%) are under age 40 in 2011, which was 1610 in 2006. In our institute, we have been cooperating with gynecologists and providing fertility preservation program since 2010. Our aim is to access our team management, clinical impact and outcome of fertility preservation among young breast cancer patients in our institute. Methods: A patient, 1)without distant metastasis, 2)systemic chemotherapy and/or hormonal therapy planned, 3)within reproductive age and 4)willing to preserve fertility, will be referred to oncofertility clinic. Chart review was done retrospectively. Results: Ninety-five patients had consultation to the oncofertility clinic between April 2010 and April 2015. The average age at consultation was 34.1(range 22-44). Almost all patient had invasive cancer; cStage0:4%, cStageI:31%, cStageII:53%, cStageIII:11%. Fifty-five percent had estrogen receptor (ER) positive/HER2 negative, 31% had ER positive/HER2positive, 2% had ER negative/HER2 positive and 12% had ER negative/HER2 negative breast cancer. Forty-five had counseling without any procedure, 22 underwent ovarian tissue cryopreservation, 17 underwent embryo cryopreservation and 8 underwent oocyte cryopreservation. Because observation period is still short, we haven’t had any case that got pregnant or delivered, yet. Conclusions: The number of patient who choose to underwent fertility preservation is increasing. We have actually started facing proposition, when we shall lay aside adjuvant therapy and let them plan to be conceived. Taking risk into account, we are now evaluating the safety of cancer treatment and outcome of each procedure which undergone multidisciplinary deliberate decision-making process.

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