Fertility preservation in young patients with cancer

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 forefront the potential for fertility preservation in patients being treated for cancer. Many survivors will maintain their reproductive potential after the successful completion of treatment for cancer. However total body irradiation, radiation to the gonads, and certain high dose chemotherapy regimens can place women at risk for acute ovarian failure or premature menopause and men at risk for temporary or permanent azoospermia. Providing information about risk of infertility and possible interventions to maintain reproductive potential are critical for the adolescent and young adult population at the time of diagnosis. There are established means of preserving fertility before cancer treatment; specifically, sperm cryopreservation for men and in vitro fertilization and embryo cryopreservation for women. Several innovative techniques are being actively investigated, including oocyte and ovarian follicle cryopreservation, ovarian tissue transplantation, and in vitro follicle maturation, which may expand the number of fertility preservation choices for young cancer patients. Fertility preservation may also require some modification of cancer therapy; thus, patients’ wishes regarding future fertility and available fertility preservation alternatives should be discussed before initiation of therapy.

Isolation and in vitro culture of ovarian stem cells in Chinese soft‐shell turtle (Pelodiscus sinensis)

“…Another important perspective application of the PSO1 cells lies in the potential contributions to solve fertility problems and the long‐term cryopreservation of germ cells. In human, with its feasibility of fertility preservation, cryobanking of ovarian tissue has become increasingly common in countries that have well‐established fertility centers . There has been a number of successful birth cases after autotransplantation of cryopreserved ovarian tissues in both human and mouse .…”

Control of Germline Stem Cell Lineages by Diet and Physiology

“…While our understanding of the effect of cachexia on mammalian GSC lineages is limited, cachetic patients are often insulin resistant (Honors and Kinzig 2012), and chronic inflammation, found in many cancers (Crusz and Balkwill 2015), can lead to Interleukin-6 mediated hyperactivation of the hypothalamic-gonadal-pituitary axis (Raber et al 1997). Therefore, although it is clear that many cancer treatments can impair fertility (Suhag et al 2015; Vakalopoulos et al 2015), it is also possible that the physiological changes caused by the tumors themselves may also have effects on the germ line of patients.…”

Cancer care for adolescents and young adults in Jordan

“…Several innovative techniques, including ovarian tissue cryopreservation, are being actively investigated. Current techniques are limited by the patient's sexual immaturity, and all available approaches for children are experimental (48,49). Several studies have shown that gonadotropin-releasing hormone agonists when used with chemotherapy protect against ovarian failure, reducing the risk of early menopause and improving prospects for fertility (50).…”