Data on the characteristics of female patients counselled for fertility preservation and the efficacy and risk of the applied procedures are still poor. We therefore analysed the registry of a network of 70 infertility centers which are involved in fertility preservation in Germany, Switzerland and Austria, called FertiPROTEKT (
 hhtp://www.fertiprotekt.eu
 ). 1,280 counselled patients (15–40 years) were analysed regarding characteristics and different fertility preservation treatments before cytotoxic therapy in 2007–2009. 34.8% of the counselled patients were diagnosed with breast cancer, 30.5% with Hodgkin’s lymphoma, 25.4% with other malignancies and 9.3% with non-malignant diseases. 89.6% of the treated breast cancer patients were 25–40 years of age, and 87.5% of the lymphoma patients were 15–30 years of age. At the time of counselling, 85.3% of the breast cancer patients and 92.7% of the lymphoma patients were childless. 1,080 patients received a single or combined therapy such as GnRH agonists (n = 823), cryopreservation of ovarian tissue (n = 500), ovarian stimulation (n = 221) and transposition of the ovaries (n = 24). Only one severe complication, requiring postponement of the chemotherapy, was documented. In stimulated patients, 2,417 oocytes (mean n = 11.6, SD ± 7.7) were received. Fertilisation rate per received oocyte was 61.3%. Fertility preservation programmes mainly involve women without children, diagnosed with breast cancer or Hodgkin’s lymphoma. Fertility preservation techniques can be applied with low risk. The limited and age-dependant success rate of the different therapies require individualised approaches of single or combined fertility preservation techniques.

/pdf/fertility-preservation-in-1-000-patients-patient-s-6gntbkfk9u.pdf

Fertility preservation in >1,000 patients: patient's characteristics, spectrum, efficacy and risks of applied preservation techniques.

https://www.fertstert.org/article/S0015-0282(10)01007-1/pdf

Efficacy and safety of ovarian stimulation before chemotherapy in 205 cases.

Aging is universal and underlies chronic disease as well as tissue and cellular deterioration. The female reproductive system is the first to age in humans, with functional decline occurring decades prior to other organs. Reproductive aging is associated with a decrease in both the number and quality of eggs within the ovary, which together contribute to increased incidences of miscarriages, infertility, and birth defects. Reproductive aging also affects general health because ovarian hormones, such as estrogen, regulate downstream organ systems. The negative consequences of female reproductive aging are becoming more prevalent as women globally are delaying childbearing and more women are living well beyond menopause due to life-extending medical interventions and advances. Here we synthesize data from mouse models and humans to define age-associated changes in endocrinology, gamete quality, and the somatic ovarian environment, and we describe how genetic, lifestyle, and environmental factors accelerate such changes. There is a clinical need to generate tools to assess reproductive aging and to develop methods to improve reproductive outcomes in the setting of advanced reproductive age. The delineation of new biological mechanisms underlying reproductive aging is continuously informing therapeutic interventions, which are largely focused on targeting mitochondrial function. However, the diversity of therapeutic strategies is likely to expand as we learn more about the complex, multifactorial phenomenon of reproductive aging, which will impact every single female.

Female Reproductive Aging: From Consequences to Mechanisms, Markers, and Treatments

Introduction To evaluate the influence of type of cancer and cancer itself on the ovarian response during controlled ovarian stimulation (COS) for fertility preservation (FP). Materials and methods This was a retrospective cohort study performed at a single academic tertiary-care infertility center. Women diagnosed with cancer who underwent COS with GnRH antagonist protocol between January 2009 and December 2018 were included in this study. Patients were categorized into three groups; breast/gynecologic, hematologic, and other cancers. We secondarily compared the COS parameters and ovarian reserve markers in oncofertility cases against non-cancer patients who pursued FP for deferred reproduction. The primary outcome was number of mature oocytes. Secondary outcomes included oocyte yield (number of retrieved oocytes/number of follicles aspirated at time of retrieval) and oocyte-maturity index, defined as number of mature oocytes/total oocytes retrieved. Results A total of 96 cancer patients were referred for FP counseling before starting their anti-cancer therapy. Clinical characteristics and ovarian response parameters were comparable between the three groups. Type of cancer was not a predictor for number of mature oocytes (p = 0.329), oocyte-maturity index (p = 0.815), or oocyte yield, (p = 0.161) after adjustment to cycle covariates. Moreover, cancer did not have impact on the number of mature oocytes (p = 0.699), oocyte-maturity index (p = 0.251) and oocyte yield (p = 0.094). Discussion There is no difference observed in outcomes of ovarian stimulation based on primary cancer diagnosis in oncofertility patients undergoing FP. Interestingly, no significant impact for cancer itself was observed on ovarian reserve or response to gonadotrophins stimulation.

Does type of cancer affect ovarian response in oncofertility patients

Fertility preservation for female cancer patients: early clinical experience

Fertility Preservation in Female Cancer Patients

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Fertility Preservation in Female Cancer Patients