Fertility Preservation Options for Cancer Patients

摘要

The number of reported new cancer cases is increasing every year. The probability of surviving cancer is high and is continually improving. The cancer treatment may induce ovarian or testicular failure by damaging ovarian follicles in females and spermatogonia in the males. Gonadal failure may affect all aspects of reproductive health, including pubertal development, hormone production, and sexual function in adult life. Therefore, the primary goal for cancer treatment is to ensure the highest possibility of cure and to maintain the reproductive health. The cancer patients should be provided with maximal chance to make an optimal decision without any significant impact and delay in cancer treatment. As a result of treatment innovations, the survival rates of young people have increased substantially; therefore, the need of fertility preservation has increased as well. The sperm cryopreservation and embryo cryopreservation have been standard methods of fertility preservation. Recently, the American Society for Reproductive Medicine has removed the experimental label from oocyte cryopreservation. However, other fertility preservation options including ovarian tissue and whole ovary cryopreservation and testicular tissue cryopreservation for pre-pubertal boys are still considered experimental. A coordinated approach by gynecologists, urologists, oncologists, pediatricians, surgeons, fertility specialists and counselors is required to make use of available fertility preservation options. Timely and complete information on the impact of cancer treatment on fertility and fertility preservation options should be presented to all patients when a cancer treatment is planned. The possibility of fertility preservation removes a huge concern and enables cancer patients to concentrate on their treatment and getting better. The purpose of this review is to present different options currently available to preserve fertility in men, women and adolescent children diagnosed with cancer and undergoing gonadotoxic therapy. All options are listed in two tables for quick reference. Most of the information is extracted from recent publications and presented in such a manner that it is valuable for cancer patients and professionals associated with fertility preservation.