Reproductive Medicine
Achmad Kemal Harzif; Mila Maidarti; Costan Tryono Parulian Rumapea; Sarah Miriam Ratna Pratamasari; Heidi Dewi Mutia; Nafi’atul Ummah; Aisyah Retno Puspawardani; Putri Nurbaeti; Budi Wiweko
Articles in Press, Accepted Manuscript, Available Online from 06 April 2024
Abstract
Abstract:
Background and Objective: Endometriosis is one of the primary etiology of subfertility in women; in severe cases, endometriosis surgery could result in infertility due to oophorectomy. Ovarian tissue cryopreservation is a method by which the ovarian cortex is frozen and retransplanted in patients. ...
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Abstract:
Background and Objective: Endometriosis is one of the primary etiology of subfertility in women; in severe cases, endometriosis surgery could result in infertility due to oophorectomy. Ovarian tissue cryopreservation is a method by which the ovarian cortex is frozen and retransplanted in patients. This method is unaffected by the menstrual cycle, can restore ovarian hormonal function, and does not require sperm donor or ovulation induction. This systematic review aims to review the utility of ovarian tissue cryopreservation in endometriosis patients.
Methods: We searched the literature using keywords such as “fertility preservation,” “cryopreservation,” “endometriosis,” and “ovarian tissue cryopreservation” for relevant articles in Pubmed and Embase. We included all relevant articles, including case reports, cohort studies, and clinical trials.
Results: A total of 6 articles were included in this systematic review, including three retrospective studies and three case reports. In screening for candidates of ovarian tissue cryopreservation, serum antimullerian hormone (AMH) is a good marker for primordial follicle count. Patients undergoing ovarian tissue implantation after cryopreservation demonstrated an excellent pregnancy rate (41.2%) in one study. Follicle viability and hormonal function were preserved post-transplantation.
Conclusion: The current evidence shows that endocrine function and fertility in patients grafted with cryopreserved ovarian tissue are good. However, the evidence on the long-term outcome of ovarian tissue cryopreservation in endometriosis patients is lacking.
Gynecology Oncology
Batool Hossein Rashidi; Marjan Ghaemi; Ensieh Shahrokh Tehrani; Marzieh Mohebbi; Marzieh Savari
Volume 8, Issue 5 , September and October 2023, , Pages 446-456
Abstract
Background & Objective: Preserving fertility in women with cancer before therapeutic interventions is very important. This study was evaluating the 8 years’ experience of an onco-fertility center from 2013 to 2020 on fertility preservation and its outcomes in female cancer survivors.Materials ...
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Background & Objective: Preserving fertility in women with cancer before therapeutic interventions is very important. This study was evaluating the 8 years’ experience of an onco-fertility center from 2013 to 2020 on fertility preservation and its outcomes in female cancer survivors.Materials & Methods: Participants were females with an approved cancer diagnosis of reproductive ages that were referred for fertility preservation. After proper counseling by an expert team, the final decision on the fertility preservation method was made based on the patient's condition and survival expectation. The primary goal was to collect data about the fertility, clinical and survival outcomes of these women and pregnancy rate as a secondary objective that were compared between cancer types.Results: Totally 337 participants were recruited with a mean±SD age of 30.7±6.6 years. Gynecological cancers accounted for 166 (49.3%) of all cases followed by breast (107 (31.8%)) and other cancers (64 (19.0%)) respectively. Of those, 144 (42.7%) cases entered into the ovulation induction cycle and the others did not continue due to lack of correct information and late referral, and inability to postpone treatment as the major reasons. Comparing between 3 groups (gynecological, breast and other cancers), a higher rate of pregnancy otherwise not statistically different was detected in gynecological cancer survivors. In the breast cancer survivors, the chance of oocyte retrieval and fertility was not lower than in other cancers.Conclusion: Many patients and even their therapists are unfamiliar with the methods of fertility preservation, and when they consider it, the golden time is usually passed. Therefore, having a good consultation with the survivors and patient education may be the most important issue that led to a timely referral for preserving fertility in cancer patients.
Gynecology Oncology
Soheila Aminimoghaddam; Nima Azh; Somayyeh Noei Teymoordash; Firouzeh Ghaffari
Volume 7, Issue 5 , July and August 2022, , Pages 362-373
Abstract
Uterine cancer affects more than 1.28 million people worldwide; considering current world trends in obesity and aging, a +52.7% growth by 2040 is foreseen. Around 5% of endometrial cancer patients are less than 40 years old, meaning that conventional oncologic approaches would result in fertility loss; ...
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Uterine cancer affects more than 1.28 million people worldwide; considering current world trends in obesity and aging, a +52.7% growth by 2040 is foreseen. Around 5% of endometrial cancer patients are less than 40 years old, meaning that conventional oncologic approaches would result in fertility loss; thus, it is essential to consult patients regarding their fertility and family planning.Owing to developments of oncofertility, patients are now able to preserve their fertility and complete their childbearing, drafting from the standard of care in endometrial cancer. Strict criteria should be applied to make sure of selecting patients who benefit most from the fertility preservation approach. Furthermore, careful selection of patients increases the possibility of successful treatment.Most candidates for fertility preservation have risk factors in common with infertility, including polycystic ovarian syndrome, obesity, increasing of age and irregular menses; therefore, Advanced Reproductive Technology (ART) can improve their chances for pregnancy.Current applied knowledge towards the fertility preservation approach in patients with endometrial cancer is reviewed in this article.
Gynecology Oncology
Maliheh Arab
Volume 6, Issue 1 , January 2021, , Pages 1-5
Abstract
In all cancers, the tendency for conservative treatment is on the rise. There are several options for fertility-sparing in cervical cancer including: a) Conization, b) Simple trachelectomy, c) Radical Trachelectomy including: Vaginal, Abdominal, Laparoscopic and Robotic. In conclusion, in young women ...
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In all cancers, the tendency for conservative treatment is on the rise. There are several options for fertility-sparing in cervical cancer including: a) Conization, b) Simple trachelectomy, c) Radical Trachelectomy including: Vaginal, Abdominal, Laparoscopic and Robotic. In conclusion, in young women with cervical cancer, fertility-sparing should be considered. In Conization is done in Stage 1A1 cases without LVSI. Conservative Surgery can be performed in stage 1B1 and 1A2 (Trachelectomy). MRI should be done in the early-stage cervical cancer before fertility- sparing.
Obstetrics and Gynecology
Maliheh Arab
Volume 5, Issue 1 , August 2020, , Pages 1-5
Abstract
Cancer in adolescent and young adults (AYA) includes people who are diagnosed with cancer at the age of 15–39. One of the main concerns and consequences of AYA cancer treatment in both sexes is infertility. Premature ovarian failure (POF) is common in multimodal chemotherapy regimens. There is ...
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Cancer in adolescent and young adults (AYA) includes people who are diagnosed with cancer at the age of 15–39. One of the main concerns and consequences of AYA cancer treatment in both sexes is infertility. Premature ovarian failure (POF) is common in multimodal chemotherapy regimens. There is a significant difference in the sensitivity of the ovary to drugs. In conclusion, in young cancer women, oophoropexy, infertility counseling, and embryo or oocyte cryopreservation should be considered. Medroxyprogesterone, oral contraceptive pill (OCP), or gonadotropin-releasing hormone (GnRH) should be prescribed in the risk of menorrhagia.
Azamsadat Mousavi; Mahshid Shooshtari; Setare Nassiri; Abas Ali Aipour; Setare Akhavan; Narges Zamani
Volume 2, Issue 4 , November and December 2017, , Pages 1-5
Abstract
Background: Currently, the prevalence of borderline ovarian tumors (BOT) is increasing, and given the higher diagnosis in the third and fourth decades of life, fertility sparing procedures are widely used. There are important consequences in females with borderline ovarian tumors and number of effective ...
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Background: Currently, the prevalence of borderline ovarian tumors (BOT) is increasing, and given the higher diagnosis in the third and fourth decades of life, fertility sparing procedures are widely used. There are important consequences in females with borderline ovarian tumors and number of effective factors on recurrence and fertility rate.
Methods: In this cohort study, the required information was collected from a file of 43 patients with final pathologic diagnosis of borderline ovarian tumor, who had undertaken fertility sparing surgery at Imam Khomeini Hospital, Tehran University of Medical Sciences, and recurrence rate, fertility rate, and the effect of different variables were studied.
Results: There were significant correlations between oral contraceptive pill (OCP) consumption, serous pathology, micro invasion in pathology, advanced stages, and recurrence rate of BOT, while this relationship was not found between parity, surgical methods (laparotomy and laparoscopy), surgical techniques (cystectomy and USO), papillary projection, and recurrence rate.
Conclusions: Although the recurrence rate was higher in the current research when compared to other previous studies, yet only in one patient, the pattern of recurrence was invasive epithelial carcinoma, thus in the current study the overall survival did not seem to change. The results of this study on fertility rate are comparable to other studies on this issue. Therefore, these methods are recommended for young patients and emphasis should be place on follow-up.
