Fertility preservation in patients with cancer

Approximately 10% of female cancer cases occur under the age of 45 years. Improvements cancer treatments, cancer patients living longer. The treatment for most of the cancer types in reproductive-age women involves removal of the reproductive organs or chemotherapy and/or radiotherapy that affect reproductive function. Advances in reproductive medicine now allow patients diagnosed with cancer during their reproductive years to undergo various fertility preservations treatments. Women of reproductive age who are scheduled to undergo cancer treatment that could lead to premature decline of ovarian function should be counseled regarding the possibility of oocyte or embryo cryopreservation.These include: embryo cryopreservation, oocyte cryopreservation, cortical and whole ovary cryopreservation, ovarian transplantation, ovarian transposition, GnRH agonist protection. Patients be counseled all Fertility Preservation methods applicable to their specific circumstance. Ideally, this counseling should be performed by a physician specializing in reproductive endocrinology and infertility who has experience working with cancer patients. The most preferred methods for fertility preservation in cancer patients is Embryo cryopreservation and Mature oocyte cryopreservation, owing to its higher success rates compared with other, more experimental technologies.Therefore, it should be recommended as long as the patient s medical condition does not preclude safely performing COS or oocyte retrieval and the patient has adequate time to undergo COS and oocyte retrieval. Ovarian transposition prior to radiation and treatment with GnRHa coincident with gonadotoxic chemotherapy are relatively simple, inexpensive, and readily available. This methods are experimental. Ovarian tissue cryopreservation is an option for patients who require immediate gonagonadotoxic treatment of malignancy. This procedure can be used when there is insufficient time to conduct ovulation induction, in patients with genetic mutations with a high risk for premature ovarian failure, in prepubertal girls or in women who have hormone-sensitive malignancies. prophylactically cryopreserve ovarian tissue can be used for hematopoietic stem cell transplantation for the treatment of benign hematologic diseases or autoimmune diseases that haven’t respond to immunosuppressive treatment. blood-borne cancers have the highest of risk for malignancy following transplantation of ovarian tissue. whereas metastatic disease was less common in most other cancers. ovarian tissue transplantation is not recommended for patients with blood-borne malignancies or malignancies that metastasize to the ovary.