Fertility Preservation for Cancer Patients: A Review

Abstract

Infertility can arise as a consequence of treatment of oncological conditions. The parallel and continued improvement in both the management of oncology and fertility cases in recent times has brought to the fore-front the potential for fertility preservation in patients being treated for cancer. Oncologists must be aware of situations where their treatment will affect fertility in patients who are being treated for cancer and they must also be aware of the pathways available for procedures such as cryopreservation of gametes and/or embryos. Improved cancer care associated with increased cure rates and long term survival, coupled with advances in fertility treatment means that it is now imperative that fertility preservation is considered as part of the care offered to these patients. This can only be approached within a multidisciplinary setting. There are obvious challenges that still remain to be resolved, especially in the area of fertility preservation in prepubertal patients. These include ethical issues, such as valid consent and research in the area of tissue retrieval, cryopreservation, and transplantation.

Ovarian Tissue Cryopreservation: Where Are We Now?

“…Autotransplantation of ovarian tissue to women who have suffered from systemic hematological malignancies is not condoned because of the high theoretical risk of retransmission of malignancy. Only women with cancer diagnosis associated with a negligible or no risk of ovarian metastasis should be considered for future autotransplantation [ 42 ].…”

Ovarian tissue and follicle transplantation as an option for fertility preservation

“…Currently, autotransplantation of ovarian tissue in women who have suffered from systemic hematological malignancies is not recommended because of the high risk of retransmission of malignancy. Only women with cancer diagnosis associated with a negligible or no risk of ovarian compromise should be considered for future autotransplantation (106).…”

Fertility Preservation in Gynecologic Cancers Patients

“…But increasing understanding of germ cell malignancies, borderline tumours of the ovary and epithelial tumors at stage IA grade I, has led to a more conservative approach to these neoplasms and often a single oophorectomy will be performed where in the past, a hysterectomy and/or bilateral oophorectomy would have been the treatment of choice. (10) It is unusual for vulvar carcinoma to be seen in the reproductive age group, and although it may have major psychosexual impact is unusual that surgical treatment impact upon fertility. In the case of early-stage vulvar cancer, the radical excision of the lesion and removing and examining one or two sentinel nodes in the groin and upper leg is an effective way to detect whether cancer has spread, but also results in fewer adverse side effects with great results and without being a posible cause of infertility.…”

“…In the case of early-stage vulvar cancer, the radical excision of the lesion and removing and examining one or two sentinel nodes in the groin and upper leg is an effective way to detect whether cancer has spread, but also results in fewer adverse side effects with great results and without being a posible cause of infertility. (10) 100 D. …”