Recent advances in oncofertility care worldwide and in Japan

Abstract

BackgroundOncofertility is a crucial facet of cancer supportive care. The publication of guidelines for the cryopreservation of oocytes and ovarian tissue is becoming increasingly prevalent in Japan and an updated overview is necessary.MethodsIn order to provide an updated overview of oncofertility care, original research and review articles were searched from the PubMed database and compared in order to present clinical care in Japan.ResultsIn Western countries, various methods for ovarian stimulation, such as the combined use of aromatase inhibitors and random‐start protocols, have been reported. Although ovarian tissue cryopreservation, mainly performed via the slow‐freezing method, also has yielded >100 live births, the optimal indications and procedures for the auto‐transplantation of cryopreserved tissue have been under investigation. In Japan, however, vitrification is prevalent for ovarian tissue cryopreservation, although its efficacy has not yet been established. The quality of network systems for providing oncofertility care in Japan varies greatly, based on the region.ConclusionThere remain many issues in the optimization of oncofertility care in Japan. Along with the regional oncofertility networks, the creation of “oncofertility navigators” from healthcare providers who are familiar with oncofertility, such as nurses, psychologists, and embryologists, could be useful for supplementing oncofertility care coordination, overcoming the issues in individual regions.

Association between spontaneous ovulation and serum anti‐Müllerian hormone levels in a premature ovarian insufficiency patient after a multimodal treatment for breast cancer

“…In our case report, fertility preservation of the patient's oocytes or ovaries was not performed before cancer therapy. Cryopreservation of sperm, embryos, unfertilized mature oocytes and ovarian tissues is performed for fertility preservation before AYA patients with cancer irreversibly lose fertility due to cancer therapy . Guidelines from the American Society of Clinical Oncology state that the possibility of cancer treatment‐induced infertility should be discussed with all cancer patients of reproductive age before adjuvant chemotherapy .…”

“…Thus, all healthcare providers should pay attention to fertility preservation guidelines to make it possible for AYA patients to conceive in the future before they are treated with chemotherapy, radiation therapy, or surgery . In order to provide information related to onco‐fertility counseling, as of December 2017, a regional onco‐fertility network was established in Gifu, Shiga, Saitama and 18 other prefectures in Japan . This network makes it easier for oncologists and reproduction specialists to exchange information about fertility preservation and cancer treatment in Japan.…”

Oocyte collection and in vitro maturation after train transportation of human follicular fluid aspirated from resected non‐stimulated ovaries of patients with endometrial adenocarcinoma

“…In the future, however, transportation of HFF may be beneficial for oncofertility applications in cases where the hospital performing the pathological diagnosis of resected ovaries is geographically distant from the hospital involved in FP. Such hospitals are relatively rare in Japan; for instance, while in 2017 there were more than 400 cancer hospitals nationwide, there were only 30 hospitals with the ability to cryopreserve both oocytes and ovarian tissue . It may also allow human oocytes to be stored as research materials during transportation from operating hospitals to research institutions.…”

“…hospitals with the ability to cryopreserve both oocytes and ovarian tissue. 37 It may also allow human oocytes to be stored as research materials during transportation from operating hospitals to research institutions. In this study, mature oocytes in meiosis II were obtained in both the transportation and non-transportation groups, and we anticipate that it will be feasible to use these oocytes for the study of blastocysts, for instances using parthenogenetic activation techniques.…”

Advances in the Treatment and Prevention of Chemotherapy-Induced Ovarian Toxicity

“…It is known that the pregnancy rate per cryopreserved embryo is 30–35%, and the risk of congenital anomaly is not increased [ 66 , 67 , 68 , 69 ]. One retrospective study demonstrated that pregnancy rate per transfer for cancer patients was similar to patients who underwent IVF due to tubal factor infertility (37% versus 43%, p = 0.49) and live birth rate per transfer was also was not significantly different (30% versus 32%, p = 0.85) [ 70 ].…”