![]() Fertility preservation for young patients with cancer: Who is at risk and what can be offered? Lancet Oncol. ( G) shows the result of the two orthotopic transplantation techniques performed side by side.ĭonnez J., Dolmans M.M. The fragments are simply placed inside the window and covered with Interceed ®, which is fixed with fibrin glue ( F, G). Ovarian tissue transplantation inside a peritoneal window ( E– G): to create the peritoneal window, an incision is made on the anterior leaf of the broad ligament in a location where a vascular network is visible (retroperitoneal vessels) ( E). ![]() Ovarian cortical pieces are then placed on the medulla and covered with Interceed ®, the edges of which are fixed with fibrin glue ( C, D). ![]() Ovarian tissue transplantation onto the remaining ovary ( A– D): the procedure starts by removing a large piece of ovarian cortex with scissors to expose the medulla with its vascular network, and Interceed ® is stitched to the inferior part of the ovary ( A, B). The procedure is performed by laparoscopy. Orthotopic ovarian tissue transplantation in a patient aged 31 years, who underwent OTC prior to gonadotoxic chemotherapy (including cyclophosphamide) for stage IV Hodgkin’s lymphoma (according to the Ann Arbor classification). This review focuses on the available fertility preservation techniques, their appropriateness according to patient age and their efficacy in terms of pregnancy and live birth rates.Ĭancer patients fertility preservation oocyte vitrification ovarian tissue cryopreservation pediatric patients. The choice of one technique above the other depends mostly on the age and pubertal status of the patient, and personal and medical circumstances. Oocyte and/or embryo vitrification and ovarian tissue cryopreservation are the two methods currently endorsed by the American Society for Reproductive Medicine, yielding encouraging results in terms of pregnancy and live birth rates. Furthermore, fertility preservation may sometimes be needed in conditions other than cancer, such as in non-malignant diseases or in patients seeking fertility preservation for personal reasons. ![]() When the risk of premature ovarian insufficiency is high, fertility preservation strategies must be offered to the patient. Important determinants of this risk are the patient's age and ovarian reserve, type of treatment and dose. Chemotherapy, pelvic radiotherapy and ovarian surgery have known gonadotoxic effects that can lead to endocrine dysfunction, cessation of ovarian endocrine activity and early depletion of the ovarian reserve, causing a risk for future fertility problems, even in children. ![]()
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