Abstract
An improvement in the survival rates of cancer patients and recent advancements in assisted reproductive technologies have led to remarkable progress in oncofertility and fertility preservation treatments. Currently, for adults and postpubertal girls, oocyte or embryo cryopreservation is an established method. If their cancer treatment cannot be postponed for 2 weeks, ovarian tissue cryopreservation is offered as an experimental technique. For prepubertal girls, ovarian tissue cryopreservation is the only option. As for ovarian protection, there is insufficient evidence regarding the effectiveness of GnRH agonist in fertility preservation. In the past decade, the concept of fertility preservation for cancer patients has been rapidly spreading, but at present only a small part of young cancer patients receive fertility preservation services. It is partly because of the lack of adequate provision of information on fertility preservation and the lack of referral from oncology to the fertility clinic. In Japan, the clinical practice guidelines for fertility preservation in childhood, adolescent and young adult cancer patients was issued last year by the Japan Society of Clinical Oncology (JSCO). It would help Japanese health care providers, including oncologists and reproductive specialists, to increase their knowledge on fertility preservation for cancer patients and move forward the fertility preservation services. For further progress, it is also needed to establish a national registration system of fertility preservation for cancer patients to evaluate the safety and efficacy of the current management.
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References
Phillips SM, Padgett LS, Leisenring WM et al (2015) Survivors of childhood cancer in the United States: prevalence and burden of morbidity. Cancer Epidemiol Prev Biomark 24:653–663
Martinez F (2017) Update on fertility preservation from the Barcelona International Society for Fertility Preservation–ESHRE–ASRM 2015 expert meeting: indications, results and future perspectives. Fertil Steril 108(407–415):e411
Donnez J, Dolmans MM (2017) Fertility preservation in women. N Engl J Med 377:1657–1665
Loren AW, Mangu PB, Beck LN et al (2013) Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 31:2500–2510
Cobo A, Garcia-Velasco JA, Coello A et al (2016) Oocyte vitrification as an efficient option for elective fertility preservation. Fertil Steril 105(755–764):e758
Oktay K, Turan V, Bedoschi G et al (2015) Fertility preservation success subsequent to concurrent aromatase inhibitor treatment and ovarian stimulation in women with breast cancer. J Clin Oncol 33:2424–2429
Harada M, Osuga Y (2016) Where are oncofertility and fertility preservation treatments heading in 2016? Future Oncol 12:2313–2321
Dolmans MM (2018) Recent advances in fertility preservation and counseling for female cancer patients. Expert Rev Anticancer Ther 18:115–120
Rienzi L, Gracia C, Maggiulli R et al (2017) Oocyte, embryo and blastocyst cryopreservation in ART: systematic review and meta-analysis comparing slow-freezing versus vitrification to produce evidence for the development of global guidance. Hum Reprod Update 23:139–155
von Wolff M, Montag M, Dittrich R et al (2011) Fertility preservation in women—a practical guide to preservation techniques and therapeutic strategies in breast cancer, Hodgkin’s lymphoma and borderline ovarian tumours by the fertility preservation network FertiPROTEKT. Arch Gynecol Obstet 284:427–435
Cakmak H, Rosen MP (2013) Ovarian stimulation in cancer patients. Fertil Steril 99:1476–1484
Reddy J, Turan V, Bedoschi G et al (2014) Triggering final oocyte maturation with gonadotropin-releasing hormone agonist (GnRHa) versus human chorionic gonadotropin (hCG) in breast cancer patients undergoing fertility preservation: an extended experience. J Assist Reprod Genet 31:927–932
Reddy J, Oktay K (2012) Ovarian stimulation and fertility preservation with the use of aromatase inhibitors in women with breast cancer. Fertil Steril 98:1363–1369
Kim J, Turan V, Oktay K (2016) Long-term safety of letrozole and gonadotropin stimulation for fertility preservation in women with breast cancer. J Clin Endocrinol Metab 101:1364–1371
Cakmak H, Katz A, Cedars MI et al (2013) Effective method for emergency fertility preservation: random-start controlled ovarian stimulation. Fertil Steril 100:1673–1680
Grynberg M, Poulain M, le Parco S et al (2016) Similar in vitro maturation rates of oocytes retrieved during the follicular or luteal phase offer flexible options for urgent fertility preservation in breast cancer patients. Hum Reprod 31:623–629
Boots CE, Meister M, Cooper AR et al (2016) Ovarian stimulation in the luteal phase: systematic review and meta-analysis. J Assist Reprod Genet 33:971–980
Ubaldi FM, Capalbo A, Vaiarelli A et al (2016) Follicular versus luteal phase ovarian stimulation during the same menstrual cycle (DuoStim) in a reduced ovarian reserve population results in a similar euploid blastocyst formation rate: new insight in ovarian reserve exploitation. Fertil Steril 105:1488–1495
Vaiarelli A, Venturella R, Vizziello D et al (2017) Dual ovarian stimulation and random start in assisted reproductive technologies: from ovarian biology to clinical application. Curr Opin Obstet Gynecol 29:153–159
Practice Committees of American Society for Reproductive Medicine; Society for Assisted Reproductive Technology (2013) Mature oocyte cryopreservation: a guideline. Fertil Steril 99:37–43
Practice Committee of American Society for Reproductive Medicine (2014) Ovarian tissue cryopreservation: a committee opinion. Fertil Steril 101:1237–1243
Dolmans MM, Marotta ML, Pirard C et al (2014) Ovarian tissue cryopreservation followed by controlled ovarian stimulation and pick-up of mature oocytes does not impair the number or quality of retrieved oocytes. J Ovarian Res 7:80
Donnez J, Dolmans MM, Diaz C et al (2015) Ovarian cortex transplantation: time to move on from experimental studies to open clinical application. Fertil Steril 104:1097–1098
Donnez J, Dolmans MM (2015) Ovarian cortex transplantation: 60 reported live births brings the success and worldwide expansion of the technique towards routine clinical practice. J Assist Reprod Genet 32:1167–1170
Stoop D, Cobo A, Silber S (2014) Fertility preservation for age-related fertility decline. Lancet 384:1311–1319
Van der Ven H, Liebenthron J, Beckmann M et al (2016) Ninety-five orthotopic transplantations in 74 women of ovarian tissue after cytotoxic treatment in a fertility preservation network: tissue activity, pregnancy and delivery rates. Hum Reprod 31:2031–2041
Meirow D, Ra’anani H, Shapira M et al (2016) Transplantations of frozen-thawed ovarian tissue demonstrate high reproductive performance and the need to revise restrictive criteria. Fertil Steril 106:467–474
Jensen AK, Macklon KT, Fedder J et al (2017) 86 successful births and 9 ongoing pregnancies worldwide in women transplanted with frozen-thawed ovarian tissue: focus on birth and perinatal outcome in 40 of these children. J Assist Reprod Genet 34:325–336
Bastings L, Beerendonk CC, Westphal JR et al (2013) Autotransplantation of cryopreserved ovarian tissue in cancer survivors and the risk of reintroducing malignancy: a systematic review. Hum Reprod Update 19:483–506
Dolmans MM, Luyckx V, Donnez J et al (2013) Risk of transferring malignant cells with transplanted frozen-thawed ovarian tissue. Fertil Steril 99:1514–1522
Rosendahl M, Greve T, Andersen CY (2013) The safety of transplanting cryopreserved ovarian tissue in cancer patients: a review of the literature. J Assist Reprod Genet 30:11–24
Moore HC, Unger JM, Phillips KA et al (2015) Goserelin for ovarian protection during breast-cancer adjuvant chemotherapy. N Engl J Med 372:923–932
Roberts J, Ronn R, Tallon N et al (2015) Fertility preservation in reproductive-age women facing gonadotoxic treatments. Curr Oncol 22:e294–e304
Lambertini M, Boni L, Michelotti A et al (2015) Ovarian suppression with triptorelin during adjuvant breast cancer chemotherapy and long-term ovarian function, pregnancies, and disease-free survival: a randomized clinical trial. JAMA 314:2632–2640
Demeestere I, Brice P, Peccatori FA et al (2016) No evidence for the benefit of gonadotropin-releasing hormone agonist in preserving ovarian function and fertility in lymphoma survivors treated with chemotherapy: final long-term report of a prospective randomized trial. J Clin Oncol 34:2568–2574
Kim SS, Donnez J, Barri P et al (2012) Recommendations for fertility preservation in patients with lymphoma, leukemia, and breast cancer. J Assist Reprod Genet 29:465–468
Yee S (2016) Factors associated with the receipt of fertility preservation services along the decision-making pathway in young Canadian female cancer patients. J Assist Reprod Genet 33:265–280
Jones G, Hughes J, Mahmoodi N et al (2017) What factors hinder the decision-making process for women with cancer and contemplating fertility preservation treatment? Hum Reprod Update 23:433–457
Partridge AH, Gelber S, Peppercorn J et al (2004) Web-based survey of fertility issues in young women with breast cancer. J Clin Oncol 22:4174–4183
Tschudin S, Bunting L, Abraham J et al (2010) Correlates of fertility issues in an internet survey of cancer survivors. J Psychosom Obstet Gynaecol 31:150–157
Shimizu C, Bando H, Kato T et al (2013) Physicians’ knowledge, attitude, and behavior regarding fertility issues for young breast cancer patients: a national survey for breast care specialists. Breast Cancer 20:230–240
Quinn GP, Vadaparampil ST, King L et al (2009) Impact of physicians’ personal discomfort and patient prognosis on discussion of fertility preservation with young cancer patients. Patient Educ Couns 77:338–343
Shea LD, Woodruff TK, Shikanov A (2014) Bioengineering the ovarian follicle microenvironment. Annu Rev Biomed Eng 16:29–52
Hikabe O, Hamazaki N, Nagamatsu G et al (2016) Reconstitution in vitro of the entire cycle of the mouse female germ line. Nature 539:299–303
Roness H, Kashi O, Meirow D (2016) Prevention of chemotherapy-induced ovarian damage. Fertil Steril 105:20–29
Li F, Turan V, Lierman S et al (2014) Sphingosine-1-phosphate prevents chemotherapy-induced human primordial follicle death. Hum Reprod 29:107–113
Gonfloni S, Di Tella L, Caldarola S et al (2009) Inhibition of the c-Abl–TAp63 pathway protects mouse oocytes from chemotherapy-induced death. Nat Med 15:1179–1185
Kalich-Philosoph L, Roness H, Carmely A et al (2013) Cyclophosphamide triggers follicle activation and “burnout”; AS101 prevents follicle loss and preserves fertility. Sci Transl Med 5:185ra162
Acknowledgements
This work was supported by Grants from the Ministry of Health, Labor and Welfare and from the Japan Agency for Medical Research and Development (AMED) (to Y.O.).
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Harada, M., Osuga, Y. Fertility preservation for female cancer patients. Int J Clin Oncol 24, 28–33 (2019). https://doi.org/10.1007/s10147-018-1252-0
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DOI: https://doi.org/10.1007/s10147-018-1252-0