Research

13 pages, 477 KiB

Open AccessArticle

Outcomes of Different In Vitro Maturation Procedures for Oocyte Cryopreservation for Fertility Preservation and yet Another Live Birth in a Cancer Patient

by Daniela Nogueira, Carole Fajau-Prevot, Muriel Clouet, Patrick Assouline, Marion Deslandres and Marie Montagut

Life 2023, 13(6), 1355; https://doi.org/10.3390/life13061355 - 09 Jun 2023

Viewed by 1505

Abstract

To ensure patient care in an oncological fertility preservation (FP) programme, specialists must provide technology that best suits the patients’ clinical conditions. In vitro oocyte maturation (IVM) and ovarian tissue cryopreservation (OTC) are possible fertility preservation treatments for women in need of urgent [...] Read more.

To ensure patient care in an oncological fertility preservation (FP) programme, specialists must provide technology that best suits the patients’ clinical conditions. In vitro oocyte maturation (IVM) and ovarian tissue cryopreservation (OTC) are possible fertility preservation treatments for women in need of urgent oncological treatment. IVM consists of the retrieval of immature oocytes from small antral follicles, with no or minimal ovarian stimulation by gonadotropins. Therefore, IVM has become a pertinent option for fertility preservation, especially for cases whereby ovarian stimulation is unfeasible or contra-indicated. Existing data on immature oocytes, retrieved transvaginally (OPU-IVM) or extracted from ovarian tissue ‘ex vivo’ (OTO-IVM), are still limited on technical consistency, efficacy, and safety. The present retrospective cohort study includes 89 women undergoing fertility preservation using IVM methodologies and 26 women undergoing ovarian stimulation (OS) in concomitant period. In total, 533 immature oocytes were collected from IVM patients, achieving a maturation rate of 57% and 70% in OTO-IVM and 73% and 82% in OPU-IVM at 24 h and 48 h in culture, respectively. The observed high maturation rates might be due to the use of patients’ serum in its innate status, i.e., without heat-inactivation. This permitted 7.6 ± 5.7 and 4.6 ± 4.9 oocytes to be vitrified in OTO-IVM and OPU-IVM, respectively, compared to 6.8 ± 4.6 from OS patients. Regarding OS patients, two of them underwent embryo transfer following the insemination of warmed oocytes after complete remission, resulting in a single live birth from one patient. Upon follow-up of two OTO-IVM patients after the termination of their oncological treatment, a total of 11 warmed oocytes lead to a transfer of a single embryo, but pregnancy was not achieved. From OPU-IVM, six embryos were transferred in three patients 4.25 years after oocyte vitrification, leading to the live birth of a healthy boy. The present case of live birth is among the first cases reported so far and supports the notion that IVM might be a relevant and safe FP option for cancer patients when oocyte preservation is required but ovarian stimulation is contra-indicated. Full article

(This article belongs to the Special Issue Fertility Preservation in Female and Male Benign and Malignant Conditions)

► Show Figures

Figure 1

14 pages, 856 KiB

Open AccessArticle

Impact of Breast Cancer and Germline BRCA Pathogenic Variants on Fertility Preservation in Young Women

by Elze Prokurotaite, Margherita Condorelli, Julie Dechene, Jason Bouziotis, Matteo Lambertini and Isabelle Demeestere

Life 2023, 13(4), 930; https://doi.org/10.3390/life13040930 - 01 Apr 2023

Cited by 1 | Viewed by 1435

Abstract

Background: Several studies have suggested that breast cancer (BC) and germline BRCA pathogenic variants (gBRCA PVs) could have a deleterious impact on ovarian reserve. Nevertheless, data are limited and mixed. Our objective was to evaluate the performance of fertility preservation (FP) in terms [...] Read more.

Background: Several studies have suggested that breast cancer (BC) and germline BRCA pathogenic variants (gBRCA PVs) could have a deleterious impact on ovarian reserve. Nevertheless, data are limited and mixed. Our objective was to evaluate the performance of fertility preservation (FP) in terms of the number of collected mature oocytes after ovarian stimulation (OS) in young women carrying a gBRCA PV, associated or not with BC. Methods: We conducted a retrospective monocentric study at HUB-Hôpital Erasme in Brussels. All women aged between 18 and 41 years diagnosed with invasive non-metastatic BC and/or gBRCA PV carriers who underwent OS for FP or preimplantation genetic testing for monogenic disorder (PGT-M) between November 2012 and October 2021 were included. Three groups were compared: BC patients without a gBRCA PV, BC patients with a gBRCA PV, and healthy gBRCA PV carriers. Ovarian reserve was evaluated based on the efficacy of OS and AMH levels. Results: A total of 85 patients underwent 100 cycles. The mean age (32.2 ± 3.9 years; p = 0.61) and median AMH level (1.9 [0.2–13] μg/L; p = 0.22) were similar between groups. Correlations between the number of mature oocytes and AMH level (p < 0.001) and between AMH and age (p < 0.001) were observed. No differences in the number of retrieved mature oocytes were observed between groups (p = 0.41), or for other OS parameters. Conclusion: Neither BC nor a gBRCA PV significantly affects ovarian reserve and FP efficacy in terms of the number of mature oocytes retrieved. Full article

(This article belongs to the Special Issue Fertility Preservation in Female and Male Benign and Malignant Conditions)

► Show Figures

Figure 1

8 pages, 713 KiB

Open AccessCommunication

Bladder Neck Obstruction: Experience and Management in a Sperm Bank

by Maria Neve Hirsch, Francesco Pallotti, Fabiana Faja, Alessandra Buonacquisto, Gaia Cicolani, Anna Chiara Conflitti, Silvia Di Chiano, Andrea Lenzi, Francesco Lombardo and Donatella Paoli

Life 2023, 13(3), 842; https://doi.org/10.3390/life13030842 - 20 Mar 2023

Viewed by 1381

Abstract

Primary Bladder Neck Obstruction (PBNO) management provides medical and surgical treatment, such as transurethral incisions that can lead to retrograde ejaculation. The aim of this study was to investigate the maintenance of anterograde ejaculation and semen quality before and after this surgical procedure. [...] Read more.

Primary Bladder Neck Obstruction (PBNO) management provides medical and surgical treatment, such as transurethral incisions that can lead to retrograde ejaculation. The aim of this study was to investigate the maintenance of anterograde ejaculation and semen quality before and after this surgical procedure. A retrospective evaluation was carried out between 2011 and 2020. A total of 73 patients diagnosed with PBNO were recruited. Ejaculatory function, semen quality, and the fertility of recruited subjects were evaluated. Semen parameters—Baseline, 8.2% of patients were oligozoospermic and 12.3% had a semen volume below the WHO 2010 fifth percentile. Post-surgery, 20% of patients were oligozoospermic. We detected a significant decrease in total sperm number, a significant increase in the number of abnormal forms, and a reduction in the leukocyte concentration. Ejaculatory function—A total of 7.7% of patients reported anejaculation after transurethral incision of the bladder neck. Fertility—9.2% of the patients already had children before surgery; 13.8% had naturally conceived children in the years following surgery; 76.9% had no desire for paternity at the time. Our data have important implications for sperm bank management. The alterations in semen parameters and the risk of anejaculation suggest that the use of sperm cryopreservation before surgery for PBNO should be encouraged. Full article

(This article belongs to the Special Issue Fertility Preservation in Female and Male Benign and Malignant Conditions)

► Show Figures

Figure 1

12 pages, 34366 KiB

Open AccessArticle

The Effects of Glutathione on Clinically Essential Fertility Parameters in a Bleomycin Etoposide Cisplatin Chemotherapy Model

by Hale Bayram, Yaprak Donmez Cakil, Mustafa Erinc Sitar, Gamze Demirel, Belgin Selam and Mehmet Cincik

Life 2023, 13(3), 815; https://doi.org/10.3390/life13030815 - 17 Mar 2023

Cited by 2 | Viewed by 2768

Abstract

Chemotherapeutic agents used in the treatment of testicular cancer cause damage to healthy tissues, including the testis. We investigated the effects of glutathione on sperm DNA integrity and testicular histomorphology in bleomycin etoposide cisplatin (BEP) treated rats. Twelve-week-old male rats of reproductive age [...] Read more.

Chemotherapeutic agents used in the treatment of testicular cancer cause damage to healthy tissues, including the testis. We investigated the effects of glutathione on sperm DNA integrity and testicular histomorphology in bleomycin etoposide cisplatin (BEP) treated rats. Twelve-week-old male rats of reproductive age (n = 24) were randomly divided into three groups, the (i) control group, (ii) BEP group, and (iii) BEP+ glutathione group. Weight gain increase and testes indices of the control group were found to be higher than that of the BEP group and BEP+ glutathione group. While the BEP treatment increased sperm DNA fragmentation and morphological abnormalities when compared to the control group, GSH treatment resulted in a marked decrease for both parameters. Moreover, BEP treatment significantly decreased serum testosterone levels and sperm counts in comparison to the control group, yet this reduction was recovered in the BEP+ glutathione treated group. Similarly, seminiferous tubule epithelial thicknesses and Johnsen scores in testicles were higher in the control and BEP+ glutathione groups than in the BEP-treated group. In conclusion, exogenous glutathione might prevent the deterioration of male reproductive functions by alleviating the detrimental effects of BEP treatment on sperm quality and testicular histomorphology. Full article

(This article belongs to the Special Issue Fertility Preservation in Female and Male Benign and Malignant Conditions)

► Show Figures

Figure 1

12 pages, 551 KiB

Open AccessArticle

Oncologists’ Knowledge, Practice and Attitude toward Fertility Preservation: A National Survey

by Ahmed Al Ghaithi, Eyas Al Rashdi, Maryam Al Shukri, Rahma Al Ghabshi and Halima Albalushi

Life 2023, 13(3), 801; https://doi.org/10.3390/life13030801 - 15 Mar 2023

Cited by 2 | Viewed by 1706

Abstract

Background: Improved chemotherapy and radiotherapy treatment protocols, fortunately, increased the rates of cancer survivors over the years. However, these treatments may result in infertility or subfertility. Oncologists are considered the gateway for knowledge about cancer and its treatments’ effects. Several studies showed that [...] Read more.

Background: Improved chemotherapy and radiotherapy treatment protocols, fortunately, increased the rates of cancer survivors over the years. However, these treatments may result in infertility or subfertility. Oncologists are considered the gateway for knowledge about cancer and its treatments’ effects. Several studies showed that many oncologists do not discuss fertility preservation with their patients. This study aimed to explore the perspective of oncologists in Oman on fertility preservation. Methods: A cross-sectional study of physicians and surgeons dealing with patients with cancer was conducted from June 2021 to December 2021. A standardized and validated questionnaire was used to collect data. Results: Participants reported that they are knowledgeable about sperm cryopreservation and gonadotropin-releasing hormone agonists use but not other methods of fertility preservation. About 94% of the participants reported that they need more knowledge about fertility preservation. More than half of the participants had never encountered cancer patients who used ovarian cryopreservation, testicular tissue cryopreservation, in vitro fertilization with embryo cryopreservation and oocyte cryopreservation. The majority (78%) agreed that discussing fertility preservation with newly diagnosed cancer patients is a high priority. Conclusions: Oncologists in Oman are supportive of fertility preservation. The lack of knowledge and unavailability of well-structured fertility preservation services in Oman hinders the initiation of fertility preservation discussions. Full article

(This article belongs to the Special Issue Fertility Preservation in Female and Male Benign and Malignant Conditions)

► Show Figures

Figure 1

11 pages, 1624 KiB

Open AccessCommunication

Micro RNA in Semen/Urine from Non-Obstructive Azoospermia Patients as Biomarkers to Predict the Presence of Testicular Spermatozoa and Spermatogonia

by Margo Willems, Céline Devriendt, Catharina Olsen, Ben Caljon, Toon Janssen, Inge Gies, Veerle Vloeberghs, Herman Tournaye, Dorien Van Saen and Ellen Goossens

Life 2023, 13(3), 616; https://doi.org/10.3390/life13030616 - 23 Feb 2023

Cited by 1 | Viewed by 1259

Abstract

About half of testicular sperm extraction (TESE) procedures in men with non-obstructive azoospermia (NOA), including men with Klinefelter syndrome (KS), are unsuccessful. To avoid unnecessary invasive surgery, biomarkers for spermatozoa were studied. In addition, markers for spermatogonia in testis tissue were explored. This [...] Read more.

About half of testicular sperm extraction (TESE) procedures in men with non-obstructive azoospermia (NOA), including men with Klinefelter syndrome (KS), are unsuccessful. To avoid unnecessary invasive surgery, biomarkers for spermatozoa were studied. In addition, markers for spermatogonia in testis tissue were explored. This study aimed to find biomarkers in the semen and/or urine of NOA patients to predict the presence of spermatogonia in the testis. Differentially expressed miRNAs were identified (1) between samples from patients with and without a positive TESE procedure as well as (2) between TESE-negative patients with and without spermatogonia. A total of thirteen upregulated miRNAs (ten in seminal plasma and three in urine) were found in the TESE-negative/spermatogonia-positive group compared to the TESE-negative/spermatogonia-negative group. These miRNAs could be potential biomarkers for spermatogonia; however, more research is necessary to validate their predictive power. Full article

(This article belongs to the Special Issue Fertility Preservation in Female and Male Benign and Malignant Conditions)

► Show Figures

Figure 1

Review

Jump to: Research, Other

37 pages, 1905 KiB

Open AccessReview

Bridging the Gap: Animal Models in Next-Generation Reproductive Technologies for Male Fertility Preservation

by Pedro M. Aponte, Miguel A. Gutierrez-Reinoso and Manuel Garcia-Herreros

Life 2024, 14(1), 17; https://doi.org/10.3390/life14010017 - 21 Dec 2023

Viewed by 1967

Abstract

This review aims to explore advanced reproductive technologies for male fertility preservation, underscoring the essential role that animal models have played in shaping these techniques through historical contexts and into modern applications. Rising infertility concerns have become more prevalent in human populations recently. [...] Read more.

This review aims to explore advanced reproductive technologies for male fertility preservation, underscoring the essential role that animal models have played in shaping these techniques through historical contexts and into modern applications. Rising infertility concerns have become more prevalent in human populations recently. The surge in male fertility issues has prompted advanced reproductive technologies, with animal models playing a pivotal role in their evolution. Historically, animal models have aided our understanding in the field, from early reproductive basic research to developing techniques like artificial insemination, multiple ovulation, and in vitro fertilization. The contemporary landscape of male fertility preservation encompasses techniques such as sperm cryopreservation, testicular sperm extraction, and intracytoplasmic sperm injection, among others. The relevance of animal models will undoubtedly bridge the gap between traditional methods and revolutionary next-generation reproductive techniques, fortifying our collective efforts in enhancing male fertility preservation strategies. While we possess extensive knowledge about spermatogenesis and its regulation, largely thanks to insights from animal models that paved the way for human infertility treatments, a pressing need remains to further understand specific infertility issues unique to humans. The primary aim of this review is to provide a comprehensive analysis of how animal models have influenced the development and refinement of advanced reproductive technologies for male fertility preservation, and to assess their future potential in bridging the gap between current practices and cutting-edge fertility techniques, particularly in addressing unique human male factor infertility. Full article

(This article belongs to the Special Issue Fertility Preservation in Female and Male Benign and Malignant Conditions)

► Show Figures

Figure 1

17 pages, 1143 KiB

Open AccessReview

The Clinical Application of Platelet-Rich Plasma in the Female Reproductive System: A Narrative Review

by Saaliha Vali, Srdjan Saso, Timothy Bracewell Milnes, James Nicopoullos, Meen-Yau Thum, James Richard Smith and Benjamin P. Jones

Life 2023, 13(12), 2348; https://doi.org/10.3390/life13122348 - 15 Dec 2023

Cited by 1 | Viewed by 1198

Abstract

Platelet-rich plasma is an autologous plasma containing platelets prepared from fresh whole blood drawn from a peripheral vein. Through processing, it can be prepared to contain supraphysiologic levels of platelets at three to five times greater than the level of normal plasma. PRP [...] Read more.

Platelet-rich plasma is an autologous plasma containing platelets prepared from fresh whole blood drawn from a peripheral vein. Through processing, it can be prepared to contain supraphysiologic levels of platelets at three to five times greater than the level of normal plasma. PRP has been explored both in vivo and ex vivo in the human endometrium model in its ability to harness the intrinsic regenerative capacity of the endometrium. Intrauterine autologous PRP infusions have been shown to increase endometrial thickness and reduce the rate of intrauterine adhesions. In the setting of recurrent implantation failure, intrauterine infusion of PRP has been shown to increase clinical pregnancy rate. PRP also appears to hold a potential role in select patients with premature ovarian insufficiency, poor ovarian responders and in improving outcomes following frozen–thawed transplantation of autologous ovarian tissue. Further studies are required to explore the potential role of PRP in reproductive medicine further, to help standardise PRP protocols and evaluate which routes of administration are most effective. Full article

(This article belongs to the Special Issue Fertility Preservation in Female and Male Benign and Malignant Conditions)

► Show Figures

Figure 1

16 pages, 1117 KiB

Open AccessReview

Fertility Preservation in Pediatric Age: Future Perspective among Andrological Diseases

by Nicola Zampieri

Life 2023, 13(9), 1934; https://doi.org/10.3390/life13091934 - 20 Sep 2023

Viewed by 939

Abstract

Male infertility is a condition that has always been less studied and known than female infertility. Male infertility is increasingly present and increasingly diagnosed. Although several causes are known, to date about 40% of the causes are considered idiopathic. The worldwide denasality can [...] Read more.

Male infertility is a condition that has always been less studied and known than female infertility. Male infertility is increasingly present and increasingly diagnosed. Although several causes are known, to date about 40% of the causes are considered idiopathic. The worldwide denasality can only be slowed if awareness campaigns are implemented on all the diseases that can alter fertile potential, especially in young adolescents. Male infertility is, in addition, associated with several medical conditions. In particular, the association between infertility and testicular cancer, cardiovascular disease, autoimmune diseases, and genetic diseases is well known. For this reason, fertility preservation should not be proposed or be only oncological in nature, as there are several diagnosable pediatric pathologies that are associated with altered fertile potential to whose patients we could offer a gamete preservation pathway. In this paper we propose our experience on fertility preservation in pediatric andrological diseases. Full article

(This article belongs to the Special Issue Fertility Preservation in Female and Male Benign and Malignant Conditions)

► Show Figures

Figure 1

18 pages, 1075 KiB

Open AccessReview

The Late Effects of Cancer Treatment on Female Fertility and the Current Status of Fertility Preservation—A Narrative Review

by Kenny A. Rodriguez-Wallberg, Yanyu Jiang, Tobias Lekberg and Hanna P. Nilsson

Life 2023, 13(5), 1195; https://doi.org/10.3390/life13051195 - 17 May 2023

Cited by 5 | Viewed by 2449

Abstract

Fertility counseling should be offered to all individuals of young reproductive age early in the patient’s trajectory following a cancer diagnosis. Systemic cancer treatment and radiotherapy often have an inherent gonadotoxic effect with the potential to induce permanent infertility and premature ovarian failure. [...] Read more.

Fertility counseling should be offered to all individuals of young reproductive age early in the patient’s trajectory following a cancer diagnosis. Systemic cancer treatment and radiotherapy often have an inherent gonadotoxic effect with the potential to induce permanent infertility and premature ovarian failure. For the best chances to preserve a patient’s fertility potential and to improve future quality of life, fertility preservation methods should be applied before cancer treatment initiation, thus multidisciplinary team-work and timely referral to reproductive medicine centers specialized in fertility preservation is recommended. We aim to review the current clinical possibilities for fertility preservation and summarize how infertility, as a late effect of gonadotoxic treatment, affects the growing population of young female cancer survivors. Full article

(This article belongs to the Special Issue Fertility Preservation in Female and Male Benign and Malignant Conditions)

► Show Figures

Figure 1

Other

Jump to: Research, Review

11 pages, 929 KiB

Open AccessSystematic Review

Ovarian Tissue Cryopreservation versus Other Fertility Techniques for Chemoradiation-Induced Premature Ovarian Insufficiency in Women: A Systematic Review and Future Directions

by Eman N. Chaudhri, Ayman Salman, Khalid Awartani, Zaraq Khan and Shahrukh K. Hashmi

Life 2024, 14(3), 393; https://doi.org/10.3390/life14030393 - 15 Mar 2024

Viewed by 848

Abstract

Current advances in cancer therapy have increased survival, emphasizing the need for life quality improvement. Fertility loss is common post-chemotherapy. Current guidelines establish embryo and oocyte cryopreservation to address premature ovarian insufficiency (POI). Ovarian tissue cryopreservation has also recently become an acceptable option [...] Read more.

Current advances in cancer therapy have increased survival, emphasizing the need for life quality improvement. Fertility loss is common post-chemotherapy. Current guidelines establish embryo and oocyte cryopreservation to address premature ovarian insufficiency (POI). Ovarian tissue cryopreservation has also recently become an acceptable option for fertility preservation, particularly as it is the only option for pre-pubertal patients. Few definitions for optimum fertility outcomes, and few systematic reviews comparing embryo, oocyte, and ovarian tissue cryopreservation as a means of fertility preservation (FP) in pre- and post-pubertal female cancer patients exist. This systematic review aims to improve understanding of gonadotoxic effects of chemoradiation therapy in cancer patients, to analyze the different fertility preservation techniques and procedures available to women with chemoradiation induced ovarian insufficiency, and to compare and recognize the benefits of each technique in restoring fertility, sexual hormone function, and quality of life. Searches were conducted electronically on PubMed, Cochrane, and EBSCOHost, including clinical trials, prospective, and retrospective studies of female cancer patients undergoing anti-cancer therapy, with predefined MeSH terminology. Data were collected, analyzed, and compared. Non-randomized clinical studies were evaluated for risk bias through the Newcastle–Ottawa Scale. In total, 23 studies were included. From there, 647 patients opted for oocyte cryopreservation, 267 for embryo cryopreservation, and 1382 for ovarian tissue cryopreservation (OTC). A total of 175, 18, and 121 live births resulted respectively from oocyte, embryo, and OTC, respectively. Studies without live births discussed other fertility markers as indicators of improvement in sexual hormone function and fertility. The gonadotoxic effects of chemotherapy call for FP intervention. Oocyte and embryo cryopreservation/implantation are well-established procedures. With changing trends and life quality consideration, OTC is a promising interventional method for pre-pubertal patients facing the prospect of fertility loss. Full article

(This article belongs to the Special Issue Fertility Preservation in Female and Male Benign and Malignant Conditions)

► Show Figures

Figure 1

9 pages, 564 KiB

Open AccessOpinion

Disparities in Female Oncofertility Care in the United States: More Questions Than Answers

by Kati A. Turner, Emily E. Spurlin and Patricia T. Jimenez

Life 2023, 13(7), 1547; https://doi.org/10.3390/life13071547 - 12 Jul 2023

Cited by 1 | Viewed by 770

Abstract

As cancer therapies continue to improve, the survival rates of adolescent and young adult patients have increased. Consequently, considering patient quality of life after cancer, including family building, has become an essential aspect of establishing a treatment plan. However, the gonadotoxic nature of [...] Read more.

As cancer therapies continue to improve, the survival rates of adolescent and young adult patients have increased. Consequently, considering patient quality of life after cancer, including family building, has become an essential aspect of establishing a treatment plan. However, the gonadotoxic nature of many chemotherapeutic agents limits the option of using one’s own gamete for family building. In recent years, significant advancements have been made in oncofertility, particularly vitrification of oocytes. Unfortunately, as with many areas of medicine, health disparities limit those that can access and utilize fertility preservation prior to cancer treatment. This review aims to shed light on existing disparities in oncofertility for female patients, to offer recommendations to enhance education, access, and advocacy, as well as identify potential areas for future research. Full article

(This article belongs to the Special Issue Fertility Preservation in Female and Male Benign and Malignant Conditions)

► Show Figures

Figure 1

10 pages, 614 KiB

Open AccessOpinion

Fertility Preservation as an Option for Women with Genetic Disorders: Insights from a SWOT Analysis on Elective Oocyte Freezing and Preimplantation Genetic Testing

by Greta Chiara Cermisoni, Valerio Pisaturo, Valeria Stella Vanni, Sabrina Minetto, Luca Pagliardini, Rossella Masciangelo, Massimo Candiani, Enrico Papaleo and Alessandra Alteri

Life 2023, 13(7), 1483; https://doi.org/10.3390/life13071483 - 30 Jun 2023

Viewed by 1417

Abstract

This paper uses a SWOT (strengths, weaknesses, opportunities, and threats) analysis to overview the option of fertility preservation in women with genetic diseases, who would later use preimplantation genetic testing for monogenic disorders, in order to not transmit their condition. Strengths associated with [...] Read more.

This paper uses a SWOT (strengths, weaknesses, opportunities, and threats) analysis to overview the option of fertility preservation in women with genetic diseases, who would later use preimplantation genetic testing for monogenic disorders, in order to not transmit their condition. Strengths associated with elective oocyte freezing are ethical considerations, overall maternal and fetal safety, and effectiveness, if performed at <35 years of age. Weaknesses are related to costs and rare but present (<1–3%) risks of maternal complications. Counselling on fertility management aimed at preventing infertility offers a valuable opportunity, the same as it has been in oncological patients’ care. The potentially high percentage of women with genetic conditions who would return to use their frozen oocytes also represents an opportunity together with the minimization of the need for egg donation, which has higher obstetrical risks compared to the use of autologous oocytes. Finally, a threat is represented by the potential psychological distress to young women who could never attempt to become pregnant through preimplantation genetic testing, or do it before any decline in their fertility. Potential unknown future long-term health risks for children conceived after egg vitrification/thawing are also a threat, but current knowledge is reassuring. Altogether, early counselling on the option of fertility preservation should thus be incorporated into standard care of all patients with any genetic condition. Full article

(This article belongs to the Special Issue Fertility Preservation in Female and Male Benign and Malignant Conditions)

► Show Figures

Figure 1

24 pages, 1367 KiB

Open AccessSystematic Review

The Impact of Systemic Oncological Treatments on the Fertility of Adolescents and Young Adults—A Systematic Review

by Justine Himpe, Sander Lammerant, Lore Van den Bergh, Lore Lapeire and Chloë De Roo

Life 2023, 13(5), 1209; https://doi.org/10.3390/life13051209 - 18 May 2023

Cited by 5 | Viewed by 2259

Abstract

Background: Over the past decades, advancements in oncological treatments have led to major improvements in survival. Particularly for adolescents and young adults (AYAs), fertility is an important concern in cancer survivorship. The purpose of the review is to provide physicians with a practical [...] Read more.

Background: Over the past decades, advancements in oncological treatments have led to major improvements in survival. Particularly for adolescents and young adults (AYAs), fertility is an important concern in cancer survivorship. The purpose of the review is to provide physicians with a practical overview of the current knowledge about the impact of systemic oncological treatments on the fertility of female and male AYAs. Methods: A systematic review was performed based on relevant articles obtained from 4 databases up until 31 December 2022. Results: The mechanisms of gonadotoxicity and the concurrent risk is described for the following categories: chemotherapy, targeted therapy and immunotherapy. For the category “chemotherapy”, the specific effects and risks are listed for the different classes and individual chemotherapeutics. In the category “targeted therapy”, a distinction was made between tyrosine kinase inhibitors (TKIs) and monoclonal antibodies. Information concerning immunotherapy is scarce. Conclusions: The effects of chemotherapy on fertility are well investigated, but even in this category, results can be conflicting. Insufficient data are available on the fertility effects of targeted therapy and immunotherapy to draw definitive conclusions. More research is needed for these therapies and their evolving role in treating cancers in AYAs. It would be useful to include fertility endpoints in clinical trials that evaluate new and existing oncological treatments. Full article

(This article belongs to the Special Issue Fertility Preservation in Female and Male Benign and Malignant Conditions)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Fertility Preservation in Female and Male Benign and Malignant Conditions

Share This Special Issue

Special Issue Editors

Special Issue Information

Keywords

Related Special Issue

Published Papers (14 papers)

Research

Review

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI