Laparoscopic Ovarian Transposition Before Pelvic Cancer Treatment: Ovarian Function and Fertility Preservation

Moawad, Nash S.; Santamaria, Estefania; Rhoton‐Vlasak, Alice; Lightsey, Judith L.

doi:10.1016/j.jmig.2016.08.831

Cited by 61 publications

(47 citation statements)

References 52 publications

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“…The most successful technique is laparoscopic lateral oophoropexy. In the same surgical setting, oophoropexy can be carried out to one ovary while the other ovary is excised for further ovarian tissue freezing [124][125][126][127][128][129][130]. According to the ASCO guidelines [23][24][25], the success of oophoropexy in protecting ovaries and preserving fertility is debatable and varies according to several factors such as the dose, type, and site of pelvic irradiation, patient age, as well as whether chemotherapy is given.…”

Section: Fertility Preservation and Restoration Options In Female Patmentioning

confidence: 99%

Preserving fertility in female patients with hematological malignancies: a multidisciplinary oncofertility approach

2019

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Oncofertility is a new interdisciplinary field at the intersection of oncology and reproductive medicine that expands fertility options for young cancer patients. The most common forms of hematological malignancies that occur in girls and young women and therefore necessitate oncofertility care are acute lymphocytic leukemia, acute myeloid leukemia, non-Hodgkin's lymphoma, and Hodgkin's lymphoma. Aggressive gonadotoxic anticancer regimens including alkylating chemotherapy and total body irradiation are used often in treating girls and young women with hematological malignancies. The risks of gonadotoxicity and subsequent iatrogenic premature ovarian insufficiency and fertility loss depend mainly on the type and stage of the disease, dose of anticancer therapy as well as the age of the patient at the beginning of treatment. To avoid or at least mitigate the devastating complications of anticancer therapy-induced gonadotoxicity, effective and comprehensive strategies that integrate different options for preserving and restoring fertility ranging from established to experimental strategies should be offered before, during, and after chemotherapy or radiotherapy. A multidisciplinary approach that involves strong coordination and collaboration between hemato-oncologists, gynecologists, reproductive biologists, research scientists, and patient navigators is essential to guarantee high standard of care.

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Section: Fertility Preservation and Restoration Options In Female Patmentioning

confidence: 99%

Preserving fertility in female patients with hematological malignancies: a multidisciplinary oncofertility approach

2019

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“…Due to radiation scatter and post-procedure migration, ovaries are not always protected and patients should be advised of the possibility of lack of success (3). The procedure should be performed as close to the time of radiation treatment onset due to risk of re-migration of the ovaries (30), and can be done laparoscopically or through a laparotomy (31,32). Concerns have been raised regarding the efficacy of this procedure, as success, measured by preservation of short-term menstrual function, is ~50% (33).…”

Section: Potential Benefit Of Ovarian Transposition (Oophoropexy)mentioning

confidence: 99%

“…Concerns have been raised regarding the efficacy of this procedure, as success, measured by preservation of short-term menstrual function, is ~50% (33). The main reasons for failure include radiation scatter, risk to the blood supply of the ovary during this procedure, which in itself may diminish ovarian function over time, and re-migration (31,32).…”

Section: Potential Benefit Of Ovarian Transposition (Oophoropexy)mentioning

confidence: 99%

Fertility preservation in post-pubescent female cancer patients: A practical guideline for clinicians

et al. 2017

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Abstract. Increasing accessibility of fertility preservation (FP) options has permitted women to retain fertility following anticancer therapies. Several published guidelines have made recommendations for FP however their implementation into practice is currently unknown. In this review, we aim to provide oncology clinicians practical information about FP options for post-pubescent female cancer patients and recommendations for care delivery in order to answer preliminary questions and help triage whether FP referral is appropriate. Herein, we present a resource for oncology providers to guide them with FP discussions. Key points that are discussed in this critical review include: i) All cancer patients beginning a new plan of care should be informed of potential fertility risk. ii) If a woman requests further information on FP interventions, referral to a FP clinic should be made. iii) Given the evolving technologies in this area, patients should be informed of those which are proven and unproven, with oocyte and embryo preservation recognized as standard practice. iv) Random start (independent of menstrual cycle day) techniques are available to minimize oncologic treatment delays. v) Specific protocols for ovarian stimulation may be center-specific. vi) There is unlikely an increased cancer recurrence risk as a result of stimulation protocols in women with hormone-sensitive cancers. vii) Lastly, given the absence of consensus in the literature, routine use of GnRH analogs is not recommended for all cancer patients, however may be considered in select cases, such as high-risk women in whom definitive FP is not possible or feasible.

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“…Although transposing the ovaries outside of the irradiation field reduces the ovarian damage to approximately 5% to 10% in comparison with the untransposed ovaries [24][25][26], complications such as vasculature injury, fallopian tube infarction, and ovarian cyst formation are reported in several cases [27,28]. It is considered that cryopreservation and autotransplantation of ovarian tissue for fertility preservation is an experimental and pilot technique.…”

Section: Discussionmentioning

confidence: 99%

Autologous Transplantation of Cryopreserved Ovarian Tissue to the Upper Extremity for the Preservation of Ovarian Function in Young Patient with Cervical Carcinoma

Chen¹,

Shao²,

Ma³

et al. 2017

J Cancer Sci Ther

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For women of reproductive age with cervical carcinoma, they usually receive not only standard surgical treatment but also postoperative radiotherapy to increase the cure rates. However, infertility and premature ovarian failure are often occurred after radiotherapy. Autotransplantation of cryopreserved ovarian tissue is a new technique for preserving gonadal function for cervical cancer patients of reproductive age. Here, a successful ovarian function recovery through cryopreservation and autotransplantation in a case of 28-year-old patient with cervical cancer was reported. In brief, a slow-programmed freezing/thawing method was conducted for ovarian cortex cryopreservation. Six thawed ovarian cortical slices were transplanted to the left upper arm after the radiotherapy. The ovarian endocrine functions and follicle growth was successfully improved to normal level at 12 months after autotransplantation. In conclusion, autotransplantation of cryopreserved ovarian cortex for ovarian function preservation is a viable option for cervical cancer patients to gain the quality of life and avoid the suffering from conventional menopause hormone therapy.[17,18]. Therefore, this study chose slow-freezing for cryopreservation of ovarian tissue.In this study, we reported a successful experience of the ovarian function recovery after radiotherapy using slow freezing/thawing method for ovarian cortex cryopreservation in a 28-year-old cervical cancer patient. Several parameters such as follicle development, level of serum estrogen 2 (E 2 ), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) after transplantation were observed and recorded for evaluating the recovery of ovarian function in a follow-up of 21 months. Materials and Methods Patient recruitmentA 28-year-old woman with cervical cancer was referred to the Department of Gynecology at the Shenzhen People's Hospital in June 2013. Her weight was 49.5 kg and the blood pressure was 92/60 mmHg at the time of determination. Her medical history revealed 1 uncomplicated pregnancy. She had irregular post-coital bleeding without the use of oral contraceptives during the last year. During the last 2 months, she had symptoms of irregular vaginal blood loss and menstruation endless dripping. MRI examination showed a cervical

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Laparoscopic Ovarian Transposition Before Pelvic Cancer Treatment: Ovarian Function and Fertility Preservation

Cited by 61 publications

References 52 publications

Preserving fertility in female patients with hematological malignancies: a multidisciplinary oncofertility approach

Preserving fertility in female patients with hematological malignancies: a multidisciplinary oncofertility approach

Fertility preservation in post-pubescent female cancer patients: A practical guideline for clinicians

Autologous Transplantation of Cryopreserved Ovarian Tissue to the Upper Extremity for the Preservation of Ovarian Function in Young Patient with Cervical Carcinoma

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