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Fertility preservation in pre-pubertal girls with cancer: the assessment of ovarian reserve

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Fertility preservation in pre-pubertal girls with cancer: the assessment of ovarian reserve

Abstract and Figures

Invited keynote presentation
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University*of*St*Andrews1
School*of*Computer*Science1
Fer$lity)preserva$on)in)pre0
pubertal)girls)with)cancer:)the)
assessment)of)ovarian)reserve!
ISFP 2015
Shanghai, PRC
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School*of*Computer*Science1
Colleagues & Competing Interests
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Overview
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School*of*Computer*Science1
EU Crude Death Rates – All Cancers
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School*of*Computer*Science1
EU Crude Death Rates – All Cancers
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School*of*Computer*Science1
Childhood Cancer Survival
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Late Effects
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School*of*Computer*Science1
Non-Growing Follicles
Ovarian reserve
Born with a population that declines until
menopause
NGFs are selected for maturation
Impossible to measure in vivo
Using current technologies
Populations are counted in vitro
Typically histological examination of stained
tissue
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NGFs – Wallace & Kelsey 2010
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NGFs – Wallace & Kelsey 2010
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NGFs – Wallace & Kelsey 2010
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School*of*Computer*Science1
NGFs – Wallace & Kelsey 2010
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School*of*Computer*Science1
NGF recruitment peaks at 14-15 years
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Anti-Müllerian Hormone
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An Age-Related Model of AMH
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Comparing AMH with ovarian activity
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Anti-Müllerian Hormone
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Using the models to assess infertility
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Predicting POI after radiotherapy
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Effective sterilizing doses
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Low risk (<20%)
Acute lymphoblastic leukaemia
Soft-tissue sarcoma: stage 1
Retinoblastoma
Wilms Tumour
Germ cell tumours (no radiotherapy)
Hodgkin lymphoma
Medium risk (20-80%)
Acute myeloblastic leukaemia
Hepatoblastoma
Osteosarcoma
Ewing's sarcoma: non metastatic
Soft tissue sarcoma
Neuroblastoma
Non- Hodgkins lymphoma
Hodgkin lymphoma (Alkylating agents)
High risk (>80%)
Total body irradiation
Localised radiotherapy
(pelvic/testis)
Chemotherapy for BMT
Hodgkin lymphoma (Pelvic RT)
Soft tissue sarcoma: stage IV
(metastatic)
Ewing's sarcoma: metastatic
Risk of infertility
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School*of*Computer*Science1
Criteria for Tissue Cryopreservation
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School*of*Computer*Science1
Offered)OTC))
Cumulative incidence of POI
Wallace WH et al., 2014 Lancet Oncology
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School*of*Computer*Science1
Fertility Risk Assessment
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Challenges
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School*of*Computer*Science1
Edinburgh Fertility Preservation
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www.ed.ac.uk/Edinburgh-fertility-preservation
@edinfertility
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School*of*Computer*Science1
Thank You
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