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At least 19 recordsLinked to original sources
PubMed2002

[Female fertility preservation before sterilizing treatment: contribution of ovarian tissue cryopreservation].

Longer survival after anticancer treatment has lead to concern about the long-term adverse effects. Altered fertility is of particular importance. Before sterilizing treatment, three non-exclusive methods can be proposed to preserve female fertility: in vitro fertilization followed by cryopreservation of embryos, cryopreservation of mature ovocytes, cryopreservation of ovarian tissue. The method or methods chosen will depend on the age of the patient, here marital status, the urgency of the treatment, and the type of disease. Embryo cryopreservation is a routine practice in medically assisted reproduction centers, while cryopreservation of mature ovocytes and ovarian tissue is still in the experimental phase. It is known however that mature ovocytes can be used after cryopreservation. Cyropreservation of ovarian tissue is a more difficult problem. To date, there have not been any pregnancies or births after freezing-thawing of human ovarian tissue. This tissue could be used in two ways: autograft and in vitro folliculo-ovocyte maturation. Despite the uncertainty concerning use, women cryopreservation of ovarian tissue quite well.

Cryopreservation↗
PubMed2006

Colectomy with ileorectal anastomosis preserves female fertility in ulcerative colitis.

OBJECTIVES: Restorative proctocolectomy with ileoanal anastomosis (IPAA) is the surgical standard for patients with ulcerative colitis (UC). Significant reduction in female fertility and fecundity after IPAA has been shown in recent studies. In selected cases, colectomy with ileorectal anastomosis (IRA) is another surgical option. The aim of this study was to evaluate fertility in women with UC who underwent IRA. PATIENTS AND METHODS: This study included all women with UC who underwent IRA between 1962 and 1999 and who were 40 years old or younger at the time of surgery, and older than 18 years of age at the time of the interview. Data were collected using a structured telephone interview concerning reproductive behavior and waiting times to pregnancy. RESULTS: Among 40 eligible patients, 37 whose mean age at IRA was 28 years (range 11-39) answered the questionnaire. Twenty-two were unmarried, not wishful of pregnancy and/or already had children. Among 15 females wishing children after IRA, 10 (66%) became pregnant: one had therapeutic abortion, two had a miscarriage, four had 1 child, two had 2 children and one had 4 children. Five patients were sterile after IRA. CONCLUSION: These preliminary results suggest that IRA for UC preserves female fertility. If confirmed in other series this information should be provided to young women with UC before deciding surgical option.

Adult↗
PubMed2006

[Deep freezing of oocytes for preserving the fertility of young female oncology patients treated with aggressive radio- and/or chemotherapy].

The aggressive radiotherapy and chemotherapy used for treatment of oncological patients--through the damage of germ cells--may cause decrease of fertility or complete infertility. There are relatively few effective clinical options for preserving female fertility. The results of clinical experiments connected with ovarian tissue cryopreservation and oocyte freezing are very promising and indicate that we may have tools for female fertility preservation in the future. In this paper, 1) the future role of oocyte cryopreservation in fertility preservation of female oncological patients, and 2) the authors' preliminary results with oocyte cryopreservation are summarized.

Adult↗
PubMed2006

Attitudes regarding fertility preservation in female adolescent cancer patients.

Infertility is a devastating side effect of cancer treatment. Advances in fertility research have brought new preservation techniques to the forefront for women. The implication of this research in the field of pediatric oncology has not been reported. The objective of this study was to determine whether female adolescents with a diagnosis of cancer and their parents were interested in trying to preserve fertility. We conducted a cross-sectional survey of female patients, aged 10 to 21 years, and their parents. There were 39 parent/adolescent pair responses, 3 parent-only responses, and 8 adolescent-only responses. We found that adolescents and parents had thought about the future and were interested in research treatments to help preserve fertility, but not willing to postpone cancer therapy. Achieving a state of good health was most important to the adolescent group (P<0.001). There was no statistical difference between attitudes of parents and adolescents. In summary, parents and female adolescents are interested in options to help preserve fertility during cancer treatments, but they are not willing to postpone treatment for this purpose.

Adolescent↗
PubMed2026

Identification of cryosensitive niches and a targetable FOS/AP&#x2011;1 program in the human ovarian cortex by single&#x2011;cell and spatial transcriptomics.

BACKGROUND: The ovary is a vital and dynamic reproductive organ. Ovarian tissue cryopreservation (OTC) plays a vital role in preserving female fertility. However, the cellular subtypes most susceptible to cryoinjury and the molecular mechanisms underlying cryopreservation-associated damage remain poorly understood. This study aimed to identify cell populations vulnerable to freezing-thawing and to elucidate the key transcriptomic alterations and signaling pathways associated with ovarian cryoinjury at the single-cell and spatial levels. METHODS: Ovarian cortical tissues from patients undergoing three gender reassignment surgery (GRS) were divided into fresh and vitrification-rapid warming groups. Following collagenase IV digestion, 10x&#x2009;Genomics single-cell RNA-seq was used for dissociated ovarian cell suspensions (27,185 fresh and 25,480 frozen-thawed cells). Eight major cell clusters were identified. Additionally, 110 oocytes (66 fresh, 44 vitrification-rapid warming) were isolated and analyzed using the Smart-seq2 platform. Spatial transcriptomics was performed via BGI Stereo-seq. Molecular validation was performed via &#x3b2;-galactosidase staining, immunofluorescence, and qRT-PCR. RESULTS: Cryopreservation significantly altered the activity of pathways related to focal adhesion, oxidative stress, and apoptosis, particularly in stromal and perivascular cells. The number of FOS-positive perivascular cells was notably increased after vitrification-rapid warming, whereas the number of PTGDS-positive stromal cells decreased. Oocyte analysis revealed that cryopreservation primarily disrupted pathways involved in the cell cycle and meiosis, although the damage was not irreversible, supporting the relative safety of long-term cryostorage. Spatial transcriptomics and functional validation further confirmed the rapid and robust activation of the FOS/AP-1 pathway after vitrification-rapid warming, particularly in perivascular and granulosa cells. Treatment with T-5224 (a FOS/AP-1 inhibitor) significantly rescued the morphology and function of cultured frozen-thawed ovaries. CONCLUSIONS: Stromal and perivascular cells are the main cell types that are sensitive to ovarian cryopreservation. The FOS/AP-1 pathway is markedly activated after, suggesting the exacerbation of metabolic impairment. In oocytes within the ovarian cortex, the cell cycle and meiosis-related physiological processes were the primary processes affected.

Female↗
PubMed2005

Fertility preservation options for female patients with malignancies.

PURPOSE OF REVIEW: Preservation of fertility in female patients diagnosed with cancer has recently been an area of intensive investigation. This review summarizes available options and discusses recently published data concerning experimental methods. Specific strategies for fertility preservation in women with gynecologic malignancies are also presented. RECENT FINDINGS: Success with ovarian stimulation protocols using tamoxifen or aromatase inhibitors has recently been reported for women with breast cancer who attempt embryo cryopreservation prior to chemotherapy. The first embryo transfer using oocytes retrieved from cryopreserved ovarian tissue implanted at a heterotopic location, the first pregnancy following orthotopic transplantation of cryopreserved ovarian tissue, and increasing success with oocyte cryopreservation were also reported. SUMMARY: Fertility preservation in female patients with cancer has become an important health issue due to increasing survival rates and delayed childbearing especially in Western countries. Radical vaginal trachelectomy for cervical cancer, conservative surgery for ovarian tumors, and progestin treatment in endometrial cancers may be considered at early stages in order to preserve fertility. Embryo cryopreservation is an established technique that is available for fertility preservation, providing a delay in the initiation of chemotherapy or radiotherapy is acceptable, and a partner or donor sperm is available. Additional techniques that could be offered after counseling the patient about their experimental nature include oocyte cryopreservation, ovarian cryopreservation, and gonadotropin-releasing hormone agonist co-treatment with chemotherapy. Improvement of these techniques as well as better characterization of their success rates and risks await further investigation.

Antineoplastic Agents↗
PubMed2005

Present and future options for the preservation of fertility in female adolescents with cancer.

Fertility and sexuality are important aspects in the quality of life of long-term survivors of cancer. Adolescents in particular are in a very vulnerable period of their lives with respect to future fertility and sexuality. Special attention should be paid to preserve their fertility whenever possible. The gonadotoxic effect of chemotherapy is largely drug- and dosedependent and is related to age. The effect of radiotherapy is also dependent on dose and age and on the radiation therapy field. The prepubertal ovary is the least susceptible to gonadotoxicity. Ablative regimens for stem cell transplantation have an extremely high risk of ovarian failure. Alternative chemotherapy protocols can reduce long-term gonadotoxicity. Alkylating agents impose the highest risk in causing ovarian failure and should be avoided whenever possible. Up to now, the results of gonadoprotective hormonal therapy have been disappointing and contradictory. Transposition of the ovaries should be considered in each case of planned pelvic or whole body irradiation, where ovarian involvement is unlikely and chemotherapy not necessary. Cryopreservation of preimplantation embryos will seldom be possible in female adolescents due to the lack of a stable relationship with a male partner. Cryopreservation of mature and immature oocytes (necessitating in vitro maturation) is still assumed not to be safe for the offspring. Cryopreservation and transplantation of ovarian tissue seems to be the most promising way of future fertility preservation in female adolescents. At present, it is in its early experimental stage. Its safety and possibilities for fertility preservation in humans are not proven as yet. Additionally, technical and ethical issues need to be addressed. The counseling of female adolescents who are facing the threat of cancer needs careful consideration with regards to the psychosocial impact of the treatment and its consequences. Special attention should be paid to aspects of future quality of life, in particular: fertility and sexuality.

Adolescent↗
PubMed2006

Fertility preservation in female oncology patients.

Survival rates for patients treated for the majority of childhood and young adult cancers have improved dramatically in recent years. Despite the high probability of survival, and often good quality of life in female survivors, until recently the concept of fertility preservation has not been seen to be an important component of the overall management of these patients. Over the last few years, various protection and preservation strategies have been developed, which may address potential reproductive concerns. Gametes or embryos may be frozen prior to potentially gonadotoxic cancer therapy, and ovarian tissue may be frozen and stored, with several pregnancies described after subsequent grafting. There is also increasing interest in the possibility of ovarian protection using gonadotrophin-releasing hormone analogues during chemotherapy, despite the lack of randomised controlled trials. Additionally, there are reports of novel protective strategies, including therapeutic alteration or manipulation of the sphingomyelin pathways. This review summarises methods of fertility protection and preservation currently available, as well as the emergence of promising new strategies.

Adolescent↗
PubMed2006

Fertility preservation in female cancer patients: current developments and future directions.

OBJECTIVE: To review the current advances in fertility preservation strategies and to discuss future directions with an emphasis on ovarian tissue cryobanking. DESIGN: The publications related to fertility preservation in cancer patients were identified through Medline and other bibliographic databases, focusing on the most recent developments. CONCLUSION(S): There are several options for fertility preservation in cancer patients. Even though most of them are still experimental and their efficacy and reliability have not been determined, the future of fertility preservation in women with cancer is promising. In particular, the recent report of a live birth after transplantation of human ovarian tissue has reinforced the clinical potential of ovarian tissue banking for fertility preservation. Many exciting studies are underway to improve the efficacy and solve the problems with current fertility preservation strategies. It is inevitable that we will see the emergence of more complex ethical problems with the application of new technologies to humans. However, continuous efforts to improve current strategies and to develop new strategies will benefit many women and children who are facing premature ovarian failure and sterility.

Female↗
PubMed2006

Gonadal damage and options for fertility preservation in female and male cancer survivors.

It is estimated that in 2010, 1 in every 250 adults will be a childhood cancer survivor. Today, oncological surgery, radiotherapy and chemotherapy achieve relatively high rates of remission and long-term survival, yet are often detrimental to fertility. Quality of life is increasingly important to long-term survivors of cancer, and one of the major quality-of-life issues is the ability to produce and raise normal children. Developments in the near future in the emerging field of fertility preservation in cancer survivors promise to be very exciting. This article reviews the published literature, discusses the effects of cancer treatment on fertility and presents the options available today thanks to advances in assisted-reproduction technology for maintaining fertility in male and female patients undergoing this type of treatment. The various diagnostic methods of assessing the fertility potential and the efficacy of in vitro fertilization (IVF) after cancer treatment are also presented.

Adult↗
PubMedDate not supplied

Fertility preservation in female patients.

In the USA alone, >650 000 women will be afflicted by cancer in 2003, and 8% of these cases will be aged <40 years. Due to improvements in cancer therapy, cure rates of both adult and childhood cancers increased significantly over the past three decades. However, long-term consequences of cancer therapy and impact on quality of life are now being recognized. One of the major sequelae of cytotoxic chemotherapy is gonadal failure. Cytotoxic chemotherapy and/or radiotherapy are not only used to treat malignant diseases, but also non-malignant systemic conditions. Upon reviewing the extent and mechanism of gonadal damage due to chemo-/radiotherapy, this article discusses indications and the wide range of methods of fertility preservation in a comprehensive manner. All current, emerging, experimental as well as controversial approaches are reviewed. A comprehensive algorithm to manage fertility preservation through an individualized approach is presented.

Antineoplastic Agents↗
PubMed1999

Ovarian injury and modern options to preserve fertility in female cancer patients treated with high dose radio-chemotherapy for hemato-oncological neoplasias and other cancers.

High dose chemotherapy and radiotherapy have radically increased long term survival of young cancer patients. Among the side effects of chemotherapy treatments are ovarian failure and infertility, which are of particularly great concern to young cancer patients. Recently, cryopreservation procedures such as in vitro fertilization and embryo storage, or ovarian tissue cryopreservation have been used to preserve fertility in patients subjected to cancer treatments. Knowledge of the risks and probabilities of ovarian failure as well as the risks of the cryopreservation procedures is crucial for patients and physicians in order to make informed choices that will best serve the patients interests. This article presents data of a prospective study that determines the risk of ovarian failure following exposure to chemotherapy as well as a review of related publications. Progressive, dose-related depletion of primordial follicles is noted on histology, explaining the risk of undergoing premature ovarian failure years after exposure to chemotherapy. The safety of ovarian tissue cryopreservation procedures with a new round biopter was evaluated, as well as the risk of malignant cell transmission. It has been shown that laproscopic ovarian biopsy performed with the round biopter is a safe and efficient method for collection of ovarian tissue in cancer patients. In Hodgkin's disease patients' ovarian cortical tissue obtained for cryopreservation does not contain malignant cells. However the risk of cryopreserving and transferring malignant cells should be tested separately for each disease according to the risk of ovarian metastasis and the ability to detect single malignant cells.

Age Factors↗
PubMed2005

Strategies for fertility preservation in female and male cancer survivors.

Improved survival rates and quality of life following modern cancer treatment have resulted in a growing number of patients requesting maintenance of reproductive capacity, both before and after completion of treatment. Several established options are currently available. In men, sperm banking should be offered as soon as the diagnosis of any malignant disease is established, irrespective of the expected cryosurvival rate. In such cases, conception can be achieved with frozen-thawed spermatozoa following either intrauterine insemination (IUI) or intracytoplasmic sperm injection (ICSI). In women, depending on the type of cancer, the presence of an adequate ovarian reserve, and time to delay cancer treatment, in vitro fertilization (IVF) with embryo cryopreservation constitutes a valid alternative. On the other hand, cryopreservation of mature oocytes following IVF/ICSI offers some advantages, but it is still limited by its low success rate. Emerging and exciting techniques of germ cell/gonadal tissue cryopreservation (banking) followed by autotransplantation have been clinically explored, particularly in women. Novel cryotechnologies of ovarian and testicular tissue have proven efficacious and new transplantation strategies promise improved results. However, only one live birth following autotransplanted frozen-thawed ovarian tissue has been established and there are still no pregnancies reported from autotransplanted cryopreserved testicular tissue in the human. Efficiency and safety of these techniques needs to be demonstrated. Methods for gamete in vitro maturation also need further development. Gonadal tissue cryopreservation and transplantation should be considered experimental in humans for the present time until greater evidence regarding efficacy and safety is accrued.

Cryopreservation↗
PubMed2002

Late reproductive sequelae following treatment of childhood cancer and options for fertility preservation.

The successful treatment of childhood cancer can be associated with impaired gonadal function in adulthood. Chemotherapy and radiotherapy may damage germ-cell spermatogonia, resulting in impaired spermatogenesis or sterility in the male, or may hasten oocyte depletion with truncated fecundity and premature menopause in the female. The only established option in current clinical practice for preserving male fertility is cryopreservation of spermatozoa. The only strategy currently available for preserving female fertility is cryopreservation of embryos. Harvesting and storage of ovarian cortical tissue from girls and young women before potentially gonadotoxic chemotherapy has been available in a number of centres but there have been no live births and the procedure remains experimental. Standards for best practice in the cryopreservation of gonadal tissue, including the criteria for providing a service, patient identification and selection, standard operating procedures and requirements for safe storage, remain to be defined. Recent advances in assisted reproduction may circumvent natural conception barriers and the implications of impaired DNA integrity may be manifest as an increased risk of congenital abnormalities and chromosomal disorders in the offspring. In this chapter we consider the late reproductive sequelae following treatment for childhood cancer and options for fertility preservation.

Antineoplastic Agents↗
PubMed2003

Cryopreservation of nuclear material as a potential method of fertility preservation.

OBJECTIVE: To establish a cryopreservation method for female nuclear materials with the aim of creating viable embryos or offspring by nuclear transfer. DESIGN: A randomized controlled study. SETTING: Clinical and academic research facility.B6D2F1 mice. INTERVENTION(S): Female pronuclei (FPNs) and second polar bodies (2PBs) isolated from superovulated mouse zygotes were cryopreserved, thawed, and transferred into donor zygotes. MAIN OUTCOME MEASURE(S): Survival rates after freeze-thaw and blastocyst formation rates were evaluated. RESULT(S): Female pronuclei and 2PBs preserved with three tested methods resulted in survival rates ranging from 11.5% to 85% for FPNs vs. 46.9% to 95.0% for 2PBs and blastocyst formation rates ranging from 0% to 35.5% for FPNs vs. 9.1% to 47.4% for 2PBs. Live birth offspring also resulted from both FPNs and 2PBs preserved with vitrification. CONCLUSION(S): We have established a new system to effectively revive frozen nuclei into viable embryos by a combination of nuclei preservation, zygote reconstruction, and coculturing of reconstructed zygotes with mouse embryonic fibroblast cells. Our data suggest that the preserved female genomic DNA material can be potentially used for future nuclear transfer to preserve female fertility.

Animals↗