IMR Press / CEOG / Volume 49 / Issue 9 / DOI: 10.31083/j.ceog4909206
Open Access Review
Fertility Preservation in Girls and Women: State of Art and Future Possibilities
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1 Department of Women’s and Children’s Health, University of Padua, 35100 Padua, Italy
2 Department of Surgical, Microsurgical and Medical Sciences, Gynecologic and Obstetric Clinic, University of Sassari, 07100 Sassari, Italy
3 Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90134 Palermo, Italy
4 Clinica Medica 3, Department of Medicine-DIMED, University Hospital of Padova, 35100 Padova, Italy
*Correspondence: loris.marin@unipd.it (Loris Marin)
Academic Editor: Ariel Weissman
Clin. Exp. Obstet. Gynecol. 2022, 49(9), 206; https://doi.org/10.31083/j.ceog4909206
Submitted: 15 June 2022 | Revised: 1 July 2022 | Accepted: 1 July 2022 | Published: 5 September 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Objective: Many women worldwide are diagnosed with cancer in prepubertal, postpubertal and childbearing age. Oncological treatments can compromise future fertility through different mechanisms mainly depending on the type of treatment and the age of the patient. International societies recommend that cancer patients should receive information regarding the effects of oncological treatments on their reproductive health and cancer survivors should not be discouraged from becoming pregnant. About a quarter of these patients still do not receive an adequate counselling and young cancer survivors may face several barriers to conceiving a pregnancy due to the concerns from gynaecologists and oncologists. This review aims to investigate the infertility risk for female cancer patients who undergo oncological treatments and to provide an overview of actual and future fertility preservation possibilities for female cancer patients. Mechanism: We examined the current and future possibilities of preserving fertility for women with cancer in the available literature. Findings in brief: Different fertility preservation techniques have been developed in order to ensure the possibility for cancer survivors to complete their family planning after cancer. Oocyte/embryo freezing and ovarian tissue cryopreservation are the established choices, but the research is still going on to increase the success rate of these techniques and to develop other techniques to overcome actual limitations. Patients with a systemic oncological disease such as leukaemia could particularly benefit from the new experimental techniques which involve the creation of an artificial ovary or the in vitro growth of follicles or even the obtaining of mature oocytes from stem cells. All these techniques would allow the achievement of pregnancy without the risk of reintroducing malignant cells within autologous cryopreserved ovarian tissue transplantation. Regarding the concerns over pregnancy in cancer survivors, research is rapidly advancing and reassuring data are increasing. Conclusions: The rate of utilisation of gametes, embryos or ovarian tissue previously stored for fertility preservation is still low and the motivations can be various. Further data are needed in order to reassure both women and oncologists about the safety of pregnancy in cancer survivors and in order to increase the rate of women experiencing pregnancy after cancer.

Keywords
cancer
oncofertility
fertility preservation
pregnancy after cancer
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