Fertility Preservation in Female Patients with Breast Cancer – a Current Overview

Guenther, Veronika; Alkatout, İbrahim; Junkers, Wiebe; Bauerschlag, Dirk; Maass, Nicolaì; Otte, Sebastian

doi:10.1055/s-0043-119543

Cited by 5 publications

(5 citation statements)

References 47 publications

(94 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…At present, the cooperation between practices and university hospitals is not sufficient 13 . Clear concepts and networks would have to be created to ensure the successful continued existence of reproductive medicine in Germany 17 , 18 . In addition, the infrastructure of the university centres must be adequately remunerated.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Can a University Reproductive Medicine Centre Be Financed Under the Pre-Existing General Conditions in Germany?

Hildebrandt

Oversohl

Dittrich

et al. 2019

Geburtshilfe Frauenheilkd

View full text Add to dashboard Cite

Background Reduced resources for financing healthcare services are available to the German health system. For this reason, demographic development represents one of the greatest challenges for the German health system. Reproductive medicine can offer potential solutions and counteract the ageing of the population through an increase in the birth rate. Most reproductive medical treatments take place in private centres. For the development of new, innovative therapeutic approaches, continuing education and scientific advancement, university centres are essential. Materials and Methods Using multistage contribution margin accounting, IVF and ICSI treatments at the University Fertility Centre Franken (UFF) were investigated in 2012. The cost situation from the perspective of the patient couple and the statutory payer were contrasted with the cost and revenue situation of the service provider as a university reproductive medicine centre. Results The costs for the patient couple for an IVF treatment cycle were 538.71 € and for an ICSI cycle, 700.07 €. For the payer, the costs, including the university flat rate (194.80 €) to be paid, amount to 733.51 € for an IVF cycle and 894.87 € for an ICSI cycle. The payments of the patient couple and the payer were added and this yielded total costs of 1272.22 € and 1594.94 €. The University Fertility Centre Franken, as a part of the Department of Gynaecology of the Erlangen University Hospital, incurred costs of 1364.47 € for an IVF treatment cycle and 1423.48 € for an ICSI treatment cycle. In addition, the OB/GYN clinic had to pay the university hospital a flat general expense rate of 14.9% of the income. There was thus a loss for the department of gynaecology of 281.81 € for an IVF cycle and 66.19 € for an ICSI cycle. Discussion From the perspective of a university reproductive medicine centre, IVF and ICSI treatments currently cannot be performed in a cost-covering manner. At the same time, a reproductive medicine treatment cycle represents a significant financial burden on the patient couple due to only partial cost coverage by most statutory health insurance funds. This therefore demonstrates a need for action in health policy to revise and, in the interest of the patient couples, reproductive medicine centres and, not least of all, in the interest of society, to improve existing cost absorption policies and thus also benefit from this as a society over the long term.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Eine ausreichende Kooperation der Praxen und der Universitätskliniken besteht derzeit nicht 13 . Klare Konzepte und Netzwerke müssen geschaffen werden, um ein erfolgreiches Weiterbestehen der Reproduktionsmedizin in Deutschland zu sichern 17 , 18 . Des Weiteren muss die Infrastruktur der universitären Zentren adäquat entlohnt werden.…”

Section: Diskussionunclassified

Can a University Reproductive Medicine Centre Be Financed Under the Pre-Existing General Conditions in Germany?

Hildebrandt

Oversohl

Dittrich

et al. 2019

Geburtshilfe Frauenheilkd

View full text Add to dashboard Cite

show abstract

“…Fertility preservation is an emerging field that encompasses a range of fertility therapies for women facing circumstances that threaten their future reproductive outcomes. Consequently, the assessment of ovarian reserve has become an important aspect of fertility preservation strategies [1,2].…”

Section: Zusammenfassungmentioning

confidence: 99%

Is There a Need to Alter the Timing of Anti-Müllerian Hormone Measurement During the Menstrual Cycle?

Görkem

Toğrul

2019

Geburtshilfe Frauenheilkd

View full text Add to dashboard Cite

Introduction There are numerous conflicting studies which have addressed the question whether the measurement of anti-Müllerian hormone (AMH) concentrations should be done at a certain time during the menstrual cycle. We aimed to investigate AMH fluctuations during the follicular and luteal phases of the menstrual cycle and to determine whether AMH variations, if present, might influence the clinical utility of ovarian reserve markers. Materials and Methods A total of 257 infertile women eligible for inclusion were categorized into three groups based on their total antral follicle count: 1. hypo-response group (< 7 follicles, n = 66), 2. normo-response group (7 – 19 follicles, n = 98), and 3. hyper-response group (> 19 follicles, n = 93). Results Mean follicular AMH levels were elevated compared to levels in the luteal phase in all response groups (p < 0.001). There were significant and strong positive correlations between follicular and luteal AMH levels in all response groups (Spearmanʼs r = 0.822, r = 0.836, and r = 0.899, respectively; p < 0.001 for all groups). Fisherʼs Z-test comparisons of these correlations in all response groups demonstrated that there was no statistically significant difference (Z = 0.277, Z = − 1.001, and Z = − 1.425, respectively; p < 0.001). Conclusion We found that serum AMH levels in the follicular phase were higher than those in the luteal phase in all three response groups. In current practice, fluctuations in serum AMH concentrations are not large enough to alter the timing of AMH measurements during the menstrual cycle. The issue is important for the assessment of ovarian reserve in infertile women with AMH levels near to the cut-off value.

show abstract

“…A high antral count is very important for the success of this method. Success rates of IVM are much lower compared to standard IVF, it is more expensive and technically more demanding (26,27).…”

Section: Fertility Preservaton Optionsmentioning

confidence: 99%

Management of young women with early breast cancer – focus on fertility preservation

2019

View full text Add to dashboard Cite

Management of young women with breast cancer is complex and has several particularities, one of which is fertility preservation, a very important quality of life issue for young breast cancer survivors. Chemotherapy can be gonadotoxic and signifi cantly reduce woman`s reproductive potential and cause premature ovarian insuffi ciency while endocrine therapy requires a delay of pregnancy and indirectly aff ects fertility. Therefore every woman of reproductive age diagnosed with breast cancer should be informed about potential gonadotoxic eff ect of cancer treatment, the risk of premature ovarian insuffi ciency and associated symptoms, available fertility preservation methods, delay of cancer treatment and chances of subsequent pregnancy. If interested in fertility preservation breast cancer patients should be referred as early as possible to a reproductive specialist to further discuss the risk of infertility and available fertility preservation options. Currently established methods for fertility preservation are embryo and oocyte cryopreservation, while ovarian tissue cryopreservation, cryopreservation of immature oocytes and ovarian suppression with gonadotropin-releasing hormone agonists are still considered experimental. The aim of this review is to highlight the importance of fertility preservation as an important quality of life issue for young breast cancer survivors.

show abstract

Fertility Preservation in Female Patients with Breast Cancer – a Current Overview

Cited by 5 publications

References 47 publications

Can a University Reproductive Medicine Centre Be Financed Under the Pre-Existing General Conditions in Germany?

Can a University Reproductive Medicine Centre Be Financed Under the Pre-Existing General Conditions in Germany?

Is There a Need to Alter the Timing of Anti-Müllerian Hormone Measurement During the Menstrual Cycle?

Management of young women with early breast cancer – focus on fertility preservation

Contact Info

Product

Resources

About