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: William H Kutteh[Show abstract] [Hide abstract]
ABSTRACT: The desire to reproduce is one of the strongest human instincts. Many men and women in our society may experience situations that compromise their future fertility. The past several decades have seen an explosion of technologies that have changed the historical limitations regarding fertility preservation. This review offers an overview of the state of the art within fertility preservation including surgical and medical interventions and therapies that necessitate the need for cryopreservation of eggs, sperm, and embryos. The review also addresses the psychological consequences of banking/not banking materials among patients in need of fertility preservation, particularly in the oncofertility context. Copyright © 2015 Elsevier Inc. All rights reserved.Obstetrics and Gynecology Clinics of North America 03/2015; 42(1):39-54. DOI:10.1016/j.ogc.2014.09.004 · 1.40 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). DOI:10.1586/eog.12.15
[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