Preliminary results of a counselling programme for fertility preservation in female cancer patients: The experience of the GEMME DORMIENTI network

Abstract

Objective: To describe a population of patients referred for fertility preservation (FP), how to efficiently provide FP care, and how FP care changed over time. Methods: This longitudinal observational study enrolled 281 female cancer patients referred between 2013 and 2016 to the non-profit organisation Gemme Dormienti ONLUS (GD) for FP care. All patients underwent the same battery of instrumental and laboratory diagnostic tests. GnRHa therapy was started at least seven days before CTh treatment. Results: From 2013 to 2016, we observed a progressive increase in the number of patients referred for FP care. Out of 251 eligible patients, 135 patients were treated with GnRHa only, and 72 patients underwent GnRHa therapy and cryopreservation.The median time from GD referral to oocyte and ovarian tissue cryopreservation was 11 and 5 days respectively. Tissue cryopreservation requests increased during our study period (from four cases in 2013 to 17 cases in 2016). During follow-up, 17β-estradiol and FSH levels were significantly increased (p < .0001), and AMH levels were significantly decreased (p < .0001). Conclusion:The rapid increase in the number of patients who requested FP care and in the complexity of FP procedures overtime reflects the need to improve quality of life for cancer patients.

Oocyte and embryo cryopreservation before gonadotoxic treatments: Principles of safe ovarian stimulation, a systematic review

“… 23 Consideration should be given to stimulation for preservation as soon as possible in patients despite ongoing treatment, as AMH decreases and follicle-stimulating hormone (FSH) increases at 1, 6, 12, 24, and 36 months following chemotherapy. 24 , 25 Providers may find the American Society for Clinical Oncology (ASCO) recommendations on fertility preservation and risk of permanent amenorrhea helpful when counseling patients. 26 …”

“…Success in treating cancer has created a new focus on the quality of life after cancer, and therefore, a demand for quality fertility preservation care. 24 …”

“…Success in treating cancer has created a new focus on the quality of life after cancer, and therefore, a demand for quality fertility preservation care. 24 At this time, evidence is largely limited to cohort studies. These are often limited in number of participants and heterogeneity of diagnosis and baseline characteristics.…”

Ovarian tissue freezing and activation after thawing: an update

“…Furthermore, we demonstrated that fragmentation of ovaries induced a transient increase in the polymerization of G-actin to Factin, decrease in phospho-YAP levels, and increase in nuclear localization of YAP, resulting in the upregulation of downstream CCN growth factors and baculoviral inhibitors of apoptosis repeat containing (BIRC) apoptosis inhibitors. Fragmentation of ovarian cortex into small cubes changed cytoskeletal actin dynamics and induced disruption of the Hippo signaling pathway, leading to the production of CCN growth factors and anti-apoptotic BIRC [16]. Because there is a tumor suppressor pathway in the human body that can regulate the size of organs, the imbalance of this pathway will lead to the growth of tissues and organs.…”

Effects of ABVD chemotherapy on ovarian function: epidemiology, hormonal dosages and ultrasound morphologic analyses in 270 patients with Hodgkin’s disease

“…To overcome this problem, alternative approaches have been developed, either to avoid COS by cryopreservation of immature oocytes or oocytes matured in vitro or to start it at any time using a random start protocol requiring at least two 2 weeks of treatment (23). Ovarian tissue cryopreservation has also been proven to be effective for ovarian function recovery, and since 2019 is no longer been considered experimental (24).…”