Fertility Preservation for Young Women with Rectal Cancer—A Combined Approach from One Referral Center
ABSTRACT BackgroundUp to 6% of women with colorectal cancer are diagnosed in the reproductive age and are at risk for premature ovarian failure
and infertility due to pelvic irradiation and chemotherapy.
Study DesignBetween 1997 and 2007, six women with rectal carcinoma were referred to the McGill Reproductive Center (Montreal, Canada)
for fertility preservation. Following resection of their primary tumor, they were scheduled to undergo pelvic irradiation.
ResultsFive patients underwent laparoscopic ovarian lateral transposition before radiotherapy in order to relocate their ovaries
outside the radiation field. A concomitant ovarian wedge resection was performed for ovarian cryopreservation. In two of these
women, before dissecting the ovarian cortical tissue for cryopreservation, all visible follicles were aspirated. The sixth
patient who had had low anterior resection underwent hormonal ovarian stimulation followed by oocyte retrieval and embryo
ConclusionsFertility preservation in women with rectal cancer is feasible. This includes laparoscopic ovarian transposition and cryopreservation
of ovarian tissue, embryo, or oocyte.
- SourceAvailable from: onlinelibrary.wiley.com[Show abstract] [Hide abstract]
ABSTRACT: The improved survival rates among patients with haematological malignancies, such as lymphoma and leukaemia, are shifting areas of focus towards understanding and preventing treatment-induced sequelae. Of these, infertility is one of the most devastating consequences for patients with reproductive potential. The degree of treatment-induced gonadal dysfunction depends on age and gender-related differences, the type and dosage of chemotherapy used and the field and cumulative dose of abdomino-pelvic irradiation. There is also the interesting phenomenon of reduced pre-treatment fertility among male lymphoma patients. At present, the only established methods of fertility preservation are cryopreservation of sperm, oocytes and embryos, as well as gonadal shielding and transposition of ovaries during irradiation. Several other methods, such as cryopreservation and subsequent transplantation of gonadal tissue and the gonadoprotective role of hormonal suppression, are under investigation. Pre-pubertal patients present a unique constellation of fertility considerations, especially as embryo and sperm cryopreservation are not applicable to this age group.British Journal of Haematology 03/2011; 153(3):291-308. · 4.94 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Fertility preservation (FP) was developed with the explicit purpose of helping young women and men overcome complications of infertility associated with cancer-related treatments. Currently, no databases in the USA follow cancer or noncancer patients who undergo FP. Hence, the number and demographics of women and men who seek these services, as well as the efficacy, benefits, risks, success rates and quality of care of FP are unknown. Two feasibility studies on young women seeking FP in southern California are discussed. In addition, barriers, funding, a needs assessment, and approaches to establishing and evaluating a database are presented. A FP database would provide oncologists, reproductive endocrinologists and other medical specialists with an invaluable resource for evidence-based decisions; a foundation of knowledge that could alleviate patients’ fears so that they can make informed decisions; public health surveillance; and research opportunities.Expert Review of Obstetrics & Gynecology 01/2014; 7(3).
- [Show abstract] [Hide abstract]
ABSTRACT: Background. Advances in the diagnosis and treatment of malignancies in girls and young women had significantly increased survival rates, but due to surgical removal of ovaries, potentially sterilizing radiotherapy or chemotherapy, is often the result of this treatment premature ovarian failure, infertility and premature menopause. The degree of ovarian damage depends on gonadotoxicity of chemotherapeutic agent and radiation dose, while surgical removal of ovaries results in definitive loss of ovarian function. Recently, with the purpose of fertility preservation, on one side, less radical surgical procedures in early stages of cancer are performed and on the other side, advanc in laboratory techniques in in vitro fertilization, enables cryopreservation of own genetic material Conclusions. While cryopreservation of embryos and oocytes is already established and successful procedure, ovarian transplantation remains, despite reports of livebirths following the transplantation, still at experimental stage. The indication for fertility preservation should take into account type of cancer, prognosis of the disease, age (≤38 let), planned therapy, such as type of surgical procedure, gonadotoxicity of chemotherapeutic agens and irradiation dose, therefore cooperation of oncologists, reproductive gynecologists and embryologists is mandatory, because each indication must be carefully taken into consideration.Zdravniški vestnik 10/2011; 80:762-70. · 0.17 Impact Factor