Ovarian stimulation and assisted reproductive technology outcomes in women transplanted with cryopreserved ovarian tissue: a systematic review

Andersen, Signe Taasti; Pors, Susanne Elisabeth; Poulsen, Liv la Cour; Colmorn, Lotte Berdiin; Macklon, Kirsten Tryde; Ernst, Erik; Humaıdan, Peter; Andersen, Claus Yding; Kristensen, Stine Gry

doi:10.1016/j.fertnstert.2019.07.008

Cited by 41 publications

(44 citation statements)

References 85 publications

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“…On the other hand, ART performed as soon as possible after OTT robs patients of the chance to conceive naturally. As reported in this article, this is something that happens not infrequently in patients referred for immediate IVF, as demonstrated by the five spontaneous pregnancies achieved in patients after a considerable delay (1). It does, however, highlight an obvious selection bias, hampering the interpretation of overall results.…”

Section: Timing Of Ivfmentioning

confidence: 62%

“…In Andersen et al's review (1), the stated pregnancy rate of 14.4% per cycle may appear to be extremely low compared with the general population, but this figure can be misleading. The take-home baby rate in these women after ovarian tissue cryopreservation, cancer remission, and OTT is actually almost 50% (19/40) in this review, which is limited to ART cycles only (1). This effectively means that approximately onehalf of cancer survivors who would otherwise have been menopausal are able to fulfill their dream of having their own child thanks to transplantation of their frozen-thawed tissue (3,4).…”

Section: Trials and Tribulations Of In Vitro Fertilization After Ovarmentioning

confidence: 95%

“…ART in women with transplanted ovarian tissue is much more challenging than in the general population and cannot be implemented using the same stimulation protocols, because the results will inevitably be disappointing. These patients should be treated as poor responders (1-3), and although Andersen et al found no statistical difference between modified natural cycles and antagonist protocols (probably because of a lack of power), antagonists do yield slightly better outcomes (1). This may therefore be worth considering in individuals willing to do anything to maximize their chances of success.…”

Section: Are Comparisons Accurate? Stimulation Protocolsmentioning

confidence: 99%

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Trials and tribulations of in vitro fertilization after ovarian tissue transplantation

Dolmans

2019

Fertility and Sterility

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Section: Timing Of Ivfmentioning

confidence: 62%

Section: Trials and Tribulations Of In Vitro Fertilization After Ovarmentioning

confidence: 95%

Section: Are Comparisons Accurate? Stimulation Protocolsmentioning

confidence: 99%

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Trials and tribulations of in vitro fertilization after ovarian tissue transplantation

Dolmans

2019

Fertility and Sterility

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“…Gonadal tissue re-transplantation is the currently feasible way to regain fertility following cancer treatment in women that have cryopreserved ovarian tissue and developed ovarian insufficiency. Since the first report of a live birth following ovarian tissue re-transplantation in 2004 (61), an increasing number of transplantation procedures have been reported by large FP programmes, and the number of live births following these procedures is increasing (14)(15)(16)(17)(18)(19)(20)(21)(22)(62)(63)(64)(65). However, re-transplantation may be precluded in cases where there is a high risk of reintroducing malignant cells.…”

Section: Future Developmentsmentioning

confidence: 99%

Fertility preservation for young adults, adolescents, and children with cancer

Rodriguez‐Wallberg

Anastácio

Vonheim

et al. 2020

Upsala Journal of Medical Sciences

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Options for fertility preservation (FP) through cryopreservation methods are currently available for young adults, adolescents, and children. Guidelines for FP have been provided by international clinical societies, and emergency procedures aimed at FP have been implemented into clinical practice worldwide. In this article, we review the current data on clinical standards of emergency FP in patients who are facing gonadotoxic effects of cancer treatment, and we also describe the methods that are still under development, usually denoted as experimental. In Sweden, programmes for FP have been established at large university hospitals, thus covering the whole country. The Swedish publicly financed health care covers both assisted reproduction for treatment of infertility and the cryopreservation of gametes or gonadal tissue when there is a medical indication, such as the risk to become infertile due to oncologic treatment; hence the access to FP is ensured for the whole population. At our centre at Karolinska University Hospital in Stockholm, methods for FP have been offered since 1988. In this article, we also review the oncologic indications for FP in our patient cohort of >3000 individuals during the period 1988-2018.

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“… 87 Notably, there is not uniformity on whether ART treatment should be initiated right after transplantation or women should be allowed a period to attempt natural conception before. 89 On one hand, since ovarian function is restored in the majority of patients, a natural and less invasive approach could be preferred by women. 90 91 However, other groups claim that immediate ART treatment after regaining ovarian function maximises the chances of success, because of a greater pool of follicles available.…”

Section: Fertility Preservation In Female Patients With Cancermentioning

confidence: 99%

Gender-specific aspects related to type of fertility preservation strategies and access to fertility care

et al. 2020

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Survivorship is an area of paramount importance to be addressed as early as possible after cancer diagnosis by all health care providers. On this regard, cancer care in young patients often poses several age-related considerations among which fertility and pregnancy-related issues have a crucial role. According to the available guidelines on the topic, all patients with cancer diagnosed during their reproductive years should be provided a proper oncofertility counselling before starting anticancer treatments. This is an important step in order to inform patients about the potential treatment-induced gonadotoxicity and the available strategies for fertility preservation so that they can be referred as early as possible to fertility specialists if potentially interested in these options.In this manuscript, we aim to provide an up to date overview on the available efficacy and safety data with the main strategies for fertility preservation in male and female cancer patients in order to help optimising the oncofertility counselling performed by healthcare providers involved in cancer care and dealing with young patients. In male patients with cancer, sperm cryopreservation is the standard technique for fertility preservation. Oocyte/embryo cryopreservation, ovarian tissue cryopreservation and temporary ovarian suppression with luteinising hormone-releasing hormone agonists during chemotherapy are the main options in female patients with cancer.A multidisciplinary management building a strong network between fertility and oncology/haematology units is crucial to properly address fertility care in all young patients with cancer, at both diagnosis and during oncologic follow-up. Discussing fertility and pregnancy-related issues with young patients with cancer has to be considered mandatory nowadays keeping in mind that returning to a normal life (including the possibility to have a family and to live with as few side effects as possible) should be considered an important ambition in cancer care in the 21st century .

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Ovarian stimulation and assisted reproductive technology outcomes in women transplanted with cryopreserved ovarian tissue: a systematic review

Cited by 41 publications

References 85 publications

Trials and tribulations of in vitro fertilization after ovarian tissue transplantation

Trials and tribulations of in vitro fertilization after ovarian tissue transplantation

Fertility preservation for young adults, adolescents, and children with cancer

Gender-specific aspects related to type of fertility preservation strategies and access to fertility care

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