Fertility Preservation in 2016: Where Are We?

Anu David, MSc, PhD; Lisa Jeannette Green, MD, MPH; Ariella Shikanov, PhD

Disclosures

Semin Reprod Med. 2017;35(2):160-166. 

In This Article

Abstract and Introduction

Abstract

This review focuses on advances in the field of fertility preservation achieved over the past few decades. The main purpose of fertility preservation is to help young cancer survivors retain their fertility by restoring either their ability to procreate or simply their reproductive endocrine function. Although different options are available in this regard, successful fertility preservation is yet to reach its full potential. Herein, we review the most significant work conducted over the past five decades and present new methodologies.

Introduction

The past decades have seen advances in the diagnosis and treatment for young women cancer patients. Treatments have not only increased the life expectancy of these cancer survivors but have resulted in a growing population of young women,[1] who experience infertility problems due to premature ovarian insufficiency (POI).[2] Ovaries are known to be very sensitive to chemotherapeutic drugs especially alkylating agents and radiation which are classified as high risk for gonadal dysfunction.[3] Options available to preserve fertility for young women cancer survivors include embryo cryopreservation, oocyte cryopreservation, or ovarian tissue cryopreservation[3–6] and are presented in Fig. 1. However, choosing the most suitable strategy for preserving fertility depends on different parameters: type and timing of chemo- and/or radio therapy, type of cancer, and the patient's age as well as her partner status. According to the guidelines set forth by the American Society for Reproductive Medicine, the only established option for fertility preservation is embryo and oocyte cryopreservation.[7] This article reviews the progress made in all available options and discusses the future trends of creating an artificial ovary and applying new methodology such as immunoisolation in reproductive biology.

Figure 1.

Fertility preservation strategies. *Heterotopic transplantation did not yield any pregnancies.

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