Article

Fertility reservation in female patients

Ankara University School of Medicine, Ankara, Turkey and The Center for Reproductive Medicine and Infertility, Department of Obstetrics and Gynecology, Joan and Sanford I. Weill Medical College of Cornell University, New York, NY 10021, USA.
Human Reproduction Update (Impact Factor: 8.66). 01/2004; 10(3):251-66. DOI: 10.1093/humupd/dmh021
Source: PubMed

ABSTRACT In the USA alone, >650 000 women will be afflicted by cancer in 2003, and 8% of these cases will be aged <40 years. Due to improvements in cancer therapy, cure rates of both adult and childhood cancers increased significantly over the past three decades. However, long-term consequences of cancer therapy and impact on quality of life are now being recognized. One of the major sequelae of cytotoxic chemotherapy is gonadal failure. Cytotoxic chemotherapy and/or radiotherapy are not only used to treat malignant diseases, but also non-malignant systemic conditions. Upon reviewing the extent and mechanism of gonadal damage due to chemo-/radiotherapy, this article discusses indications and the wide range of methods of fertility preservation in a comprehensive manner. All current, emerging, experimental as well as controversial approaches are reviewed. A comprehensive algorithm to manage fertility preservation through an individualized approach is presented.

1 Follower
 · 
99 Views
  • Source
    • "Most of the available data for ovarian failure after chemotherapy, is based on leukaemias, lymphomas, Hodgkin's disease, and on some solid tumors such as breast cancer. However, there is an increasing number of patients with no malignancy who are being treated successfully with chemotherapy due to autoimmune diseases, such as systemic erythematosus lupus, rheumatoid arthritis as well as some hematological diseases [1] [3] [4] [5]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Cancer prevalence is high, and of importance to cancer sufferers is the long term survival and normal activities resumption. Moreover, pregnancy is drawing interest for preserving ovarian reserves in post-chemotherapy affected women, especially of younger ages. The gonadotoxic effect of cancer treatment, involves mechanisms that are not fully understood, mainly due to the variety of molecular pathways triggered once therapeutic agents applied. Reported rates of premature ovarian failure after the treatment effect and the application of various treatment protocols, differ extensively due to the protocol itself but also due to the age of treated patients. Several options for preserving ovarian reserves are currently employed in the clinique, such as ovarian transposition, embryos cryopreservation and the use of gonadotropin-releasing hormone (GnRH) and its agonists/antagonists, but most of them are still under investigation. This paper reviews these methods and the molecular mechanisms that are possibly involved in the action of agents such as GnRH.
    Clinical and experimental obstetrics & gynecology 08/2015; XLII(4). DOI:10.12891/ceog1878.2015 · 0.36 Impact Factor
  • Source
    • "Most of the available data for ovarian failure after chemotherapy, is based on leukaemias, lymphomas, Hodgkin's disease, and on some solid tumors such as breast cancer. However, there is an increasing number of patients with no malignancy who are being treated successfully with chemotherapy due to autoimmune diseases, such as systemic erythematosus lupus, rheumatoid arthritis as well as some hematological diseases [1] [3] [4] [5]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Cancer prevalence is high, and of importance to cancer sufferers is the long term survival and normal activities resumption. Moreover, pregnancy is drawing interest for preserving ovarian reserves in post-chemotherapy affected women, especially of younger ages. The gonadotoxic effect of cancer treatment, involves mechanisms that are not fully understood, mainly due to the variety of molecular pathways triggered once therapeutic agents applied. Reported rates of premature ovarian failure after the treatment effect and the application of various treatment protocols, differ extensively due to the protocol itself but also due to the age of treated patients. Several options for preserving ovarian reserves are currently employed in the clinique, such as ovarian transposition, embryos cryopreservation and the use of gonadotropin-releasing hormone (GnRH) and its agonists/antagonists, but most of them are still under investigation. This paper reviews these methods and the molecular mechanisms that are possibly involved in the action of agents such as GnRH.
    Clinical and experimental obstetrics & gynecology 08/2015; XLII(4). DOI:10.12891/ceog1878.2015 · 0.36 Impact Factor
  • Source
    • "Chemotherapy may cause a loss of fertility due to premature ovarian failure [1] [2], and it has been well documented that this failure can be immediate [3] [4]. Alkylating agents such as cyclophosphamide (CTX) are a mainstay of chemotherapy regimens used to treat cancer and autoimmune diseases; however, CTX treatment can lead to impaired fertility or ovarian failure as a result of follicular destruction [5] [6]. Previous studies have shown that follicular decline in the CTX-treated ovaries occurred in a dosedependent manner, and apoptotic changes in granulosa and theca cells have been identified as the mechanism leading to the follicle loss [7] [8]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The adverse effects of the anti-cancer agent cyclophosphamide (CTX) on follicular growth and ovarian angiogenesis were investigated in mice. CTX treatment irreversibly induced a loss of follicles through apoptosis and decreased microvascularization of the corpora lutea and follicles in a dose-dependent manner. Our findings demonstrated that CTX adversely affected the ovaries indicating the need to support an awareness of fertility preservation before chemotherapy is initiated.
    Reproductive biology 09/2014; 14(3). DOI:10.1016/j.repbio.2014.04.007 · 1.05 Impact Factor
Show more

Preview

Download
4 Downloads