Objective: To elucidate through a systematic literature review the impact sperm DNA fragmentation has on embryos from assisted reproduction techniques. Data Source: Studies from the "PubMed", "Embase", and "BVS" databases were analyzed. Studies Selection: The articles selected in the review included: cohort and case-control studies that addressed the proposed theme, published between January 1, 2017, and January 31, 2022, in English, Portuguese, and Spanish. As inclusion criteria: cohort and case-control articles. As exclusion criteria: articles outside the scope of the research, review articles, case reports, articles using animal models, abstracts, letters to the editor, and articles found duplicates in the databases. Data Collection: Number of couples or cycles; age (men/ women); collection type; DNA damage (%); assisted reproduction activity and techniques. Data Synthesis: In in vitro fertilization, a reduction in fertilization rate, blastocyst rate, and embryo quality was observed. In addition to implantation and increased abortion rates in patients with high sperm DNA fragmentation. High rates of sperm DNA fragmentation in intracytoplasmic sperm injection led to reduced blastocyst production rate, embryo quality, implantation, and live birth rate, and in intrauterine insemination, a reduction in pregnancy rate. Conclusion: Sperm DNA fragmentation was a potential limiting factor for assisted reproduction techniques.

Objective To analyze the long-term effects of antineoplastic treatments on patient fertility. Selection of Studies The studies were selected through the New PubMed, Scielo and Lilacs databases along with references used for the creation of the present work. For the selection of studies, articles published between the periods from January 1, 2015 to April 6, 2020 in the English, Portuguese and Spanish languages were used. As inclusion criteria: cohort studies and studies conducted in vitro. As exclusion criteria: review articles, reported cases, studies that do not address thematic reproduction, studies that do not address the cancer theme, articles that used animals, articles that address the preservation of fertility and articles in duplicate in the bases. Data Collection The collected data included: age of the patient at the beginning of treatment, type of neoplasm, type of antineoplastic treatment, chemotherapy used, radiotherapy dosage, radiotherapy site, effect of antineoplastic agents on fertility and number of patients in the study. Data Synthesis Thirty studies were evaluated, antineoplastic chemotherapy agents and radiotherapy modulate serum hormone levels, reduces germ cell quantities and correlated with an increase in sterility rates. The effects mentioned occur in patients in the prepubertal and postpubertal age. Conclusion Antineoplastic treatments have cytotoxic effects on the germ cells leading to hormonal modulation, and pubertal status does not interfere with the cytotoxic action of therapies.

RESUMOA taxa de mulheres que estão recorrendo às técnicas de reprodução assistida para a concepção cresce a cada ano. Um dos fatores que ratifica esse aumento é o fato de as mulheres estarem postergando a primeira gestação para depois dos 30 anos, logo quando inicia um acentuado declínio na fertilidade, outro fator que causa infertilidade são as neoplasias. Uma das soluções para preservação da fertilidade em pacientes com neoplasias e para preservação social é a criopreservação tecido ovariano (CTO). O objetivo deste artigo é identificar, por meio da revisão da literatura, a utilização do método de CTO como uma alternativa terapêutica para a preservação da fertilidade feminina. Foram selecionados artigos experimentais em inglês, português e espanhol nos bancos de dados PubMed, Cochrane Library e ScienceDirect, que realizaram a criopreservação de tecido ovariano entre 2014 e 2019. De 38 artigos selecionados, 18 com 1.332 pacientes relataram 199 gestações e 164 nascidos vivos. Dos 18 artigos, 88,8% foi reimplantado de maneira ortotópica e 11,1% heterotópica. Assim, CTO pode ser utilizada em pacientes pré e póspúberes, não necessita de parceiros nem de estimulação ovariana, existindo grandes possibilidades de restauração endócrina e gravidez natural. Palavras-chave:Criopreservação. Tecido ovariano. Transplante. Preservação da fertilidade. Oncofertilidade. ABSTRACTThe rate of women who are using assisted reproduction techniques for conception grows every year. One of the factors that confirms this increase is the fact that women are postponing their first pregnancy until after the age of 30, just when a sharp decline in fertility starts, another factor that causes infertility is neoplasms. One of the solutions for preserving fertility in patients with cancer and for social preservation is the cryopreservation of ovarian tissue (CTO). The purpose of this article is to identify, through a literature review, the use of the CTO method as a therapeutic alternative for the preservation of female fertility. Experimental articles in English, Portuguese and Spanish were selected from the PubMed, Cochrane Library and ScienceDirect databases, which performed the cryopreservation of ovarian tissue between 2014 and 2019. Of 38 selected articles, 18 with 1,332 patients reported 199 pregnancies and 164 live births. Of the 18 articles, 88.8% were re-implanted in an orthotopic manner and 11.1% heterotopic. Thus, CTO can be used in pre-and postpubertal patients, does not require partners or ovarian stimulation, with great possibilities for endocrine restoration and natural pregnancy.

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Background: More women, and especially those younger than 14 years, have reported their first sexual intercourse as coerced. These age groups need to be targeted for interventions to delay sexual debut and prevent sexual coercion. This study sought to compare the prevalence of sexual debut (SD) in adolescents under 14 years old before and after the implementation of the Statutory Rape Law in Brazil.Methods: We conducted a retrospective analysis of medical records of 591 pregnant adolescents aged 10-18 years served at teaching maternity hospital of Brazil's National Health System (Sistema Único de Saúde -SUS). Sociodemographic data and information on clinical history of SD were collected.Results: The prevalence rate of SD under 14 years of age was 26% in 2006 versus 48.5% in 2016 (p<0.001). In 2006, the median age of the partner was 19 years versus 17 years in 2016 (p=0.001).Conclusions: The prevalence of early sexual debut was significantly higher 7 years after the implementation of the Statutory Rape law as compared to 3 years prior.

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