Methodology Depending on the oncological pathology the following assisted reproductive technologies (ART) were used: conservative surgery of the reproductive organs in the early stages of disease, ovarian stimulation followed by cryopreservation techniques (of embryos, oocytes, ovarian cortex and semen), interoperation collecting of the ovarian cortex for the oocyte in-vitro maturation (OTO-IVM).The exclusion criteria were a high extension of the oncological process, poor oncological prognosis, menopausal ovarian reserve.Results Since March 2021 in N.N. Petrov NMRC of oncology in were consulted 370 primary patients: 314 women (85%) and 56 men (15%). The oncological disease's distribution was as follows: 31% (115 patients) reproductive system malignant tumors, 26% (96 patients) breast tumors, 15% (55 patients) with hemoblastoses, 10.2% (38 patients) bone and soft tissue tumors, 8.7% (32 patients) with germ cell tumors, 9.1% (34 patients) with tumors of other localizations, including brain tumors. The mean age of the consulted patients was 28.4 years (19 to 42 years). As part of the delayed motherhood program 60 ovarian stimulations followed by cryopreservation of oocytes and embryos were performed, 6 intraoperative collecting of the ovarian cortex for OTO-IVM were performed (in 3 cases oocytes cryopreservation was successful). More than 40 men were sent for semen cryopreservation, which is 71% of all consulted male patients. Conclusion The integration of fertility preservation technologies into the treatment of oncological patients demonstrates a high demand both among oncological patients and clinicians. An important aspect is the understanding that the leading role in the fertility preservation of oncological patients belongs to the oncological concilium, which must be carried out in a multidisciplinary way in specialised centers only.
Background: Cervical cancer affects 3,197 women in the UK, and 604000 women worldwide annually, with peak incidence seen between 30-34 years of age. For many, fertility-sparing surgery is an appealing option where possible. However, absence of large-scale data, along with a notable variation in reported outcomes in relevant studies may undermine future efforts for consistent evidence synthesis. Objectives: To systematically review the reported outcomes measured in studies that include women who underwent fertility-sparing surgery for cervical cancer and identify whether variation exists. Search Strategy: We searched MEDLINE, EMBASE, and CENTRAL from inception to February 2019. Selection Criteria: Randomised controlled trials, cohort and observational studies, and case studies of more than 10 participants from January 1990 to date. Data Collection and Analysis: Study characteristics and all reported treatment outcomes. Main results: 104 studies with a sum of 9535 participants were identified. Most studies reported on oncological outcomes (97/104), followed by fertility and pregnancy (86/104), post-operative complications (74/104), intra-operative complications (72/104), and quality of life (5). There were huge variation and heterogeneity in reported outcomes, with only 12% being good quality and 87% being of poor quality. Conclusions: There is significant heterogeneity in the reported outcomes. An agreed Core Outcome Set (COS) is necessary for future studies to effectively harmonise reported outcomes that are measurable and relevant to patients, clinicians, and researchers. This systematic review sets the groundwork for the development of a COS for fertility sparing surgery in cervical cancer. Funding: British Medical Association’s Strutt and Harper Grant.
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