Fertility preservation in women—a practical guide to preservation techniques and therapeutic strategies in breast cancer, Hodgkin’s lymphoma and borderline ovarian tumours by the fertility preservation network FertiPROTEKT

Abstract

PurposeFertility preservation methods are playing an increasing role in women up to the age of 40 years because of rising survival rates in those affected by cancer. However, balanced practical recommendations concerning all relevant fertility preservation, to support doctors in counselling and treating patients, are still rare.MethodsThese recommendations were prepared by the network FertiPROTEKT (http://www.fertiprotect.eu), a collaboration of around 70 centres in Germany, Switzerland and Austria. The recommendations were developed by specialists in reproductive medicine, reproductive biology and oncology, which gave a comprehensive overview of all named techniques as well as their benefits and risks. Furthermore, practice-orientated recommendations for the individual use of fertility preservation methods for various indications such as breast cancer, Hodgkin’s lymphoma and borderline ovarian tumours are given.ResultsVarious options such as ovarian stimulation and cryopreservation of unfertilised or fertilised oocytes, cryopreservation and transplantation of ovarian tissue, GnRH-agonist administration and transposition of the ovaries can be offered. All the techniques can be performed alone or in combination within a maximum of 2 weeks with low risk and different success rates.ConclusionsFertility preservation in women has become an option with realistic chances to become pregnant after cytotoxic therapies. The information provided allows a well balanced and realistic counselling and treatment.

An evaluation of the Gifu Model in a trial for a new regional oncofertility network in Japan, focusing on its necessity and effects

“…The network involves the collaboration of regional medical specialists from a range of hospitals and specialties to support AYA cancer patients in making their own decisions on fertility preservation. The Oncofertility Consortium in the Unites States [11] and the FertiPROTEKT network in German-speaking countries [10,12] work well and have become good models for the GPOFS network. Their network system is very progressive and mature, not only in their huge scale, but also in enriched content that was comprehensive with regard to research and education.…”

Systematic Review of Available Guidelines on Fertility Preservation of Young Patients with Breast Cancer

“…The search strategy retrieved 2606 citations; 72 were considered for full-text screening, and seven guidelines (Goldhirsch et al, 2009;Von Wolff et al, 2011;Cardoso et al, 2012;Coccia et al, 2012;ISFP Practice Committee et al, 2012;Klemp and Kim, 2012;Loren et al, 2013) were included in the study (Figure 1 DOI:http://dx.doi.org/10.7314/APJCP.2015.16.3…”

Twenty-five-year-old Woman with Bilateral Borderline Ovarian Tumour Desiring to Preserve Fertility – Case Report and Literature Review on the Current State of Fertility Preservation in Women with Borderline Ovarian Tumours

“…The decision for or against organ-sparing surgery depends on a variety of factors, including the patientʼs desire for fertility, age, gynaecological findings and the volume of ovarian tissue remaining [8]. If an organ-sparing surgical procedure is not an option despite the patientʼs current or future desire to become pregnant, for example, in the case of bilateral ovarian involvement or due to the disease progression, cryopreservation of oocytes after hormonal stimulation therapy and/or of ovarian tissue may be considered [9,10].…”

“…If our 25-year-old patient is unable to become pregnant, either spontaneously or by means of fertilisation of the cryopreserved oocytes with subsequent transfer, she will still have the option of transplantation of the resected ovarian tissue. The tissue can be implanted into the peritoneal pouch by means of laparoscopy and in 70 % of cases it regains its function [9]. Since hormone production usually only occurs for a limited period, the patient should try to become pregnant very soon after the transplantation.…”

“…Nevertheless, Fain-Kahn et al reported that cryopreservation of ovarian tissue is possible in over half of patients with borderline ovarian tumour [28]. Other research groups also recommend removal and later transplantation of ovarian tissue for preserving fertility in women with a borderline tumour [9]. While the removal and later transplantation of ovarian tissue in general is no longer considered to be experimental, and is now the standard procedure for preserving fertility, in the specific situation of our patient, it must be considered to be an individual deviation from the generally recommended approach due to the elevated risk of ovarian tumour implants owing to the bilateral ovarian involvement [29].…”