Skip to main content
Top
Published in: Irish Journal of Medical Science (1971 -) 1/2014

01-03-2014 | Original Article

Fertility preservation in young females with non-gynaecologic malignancy: an emerging speciality

Authors: C. Smyth, I. Robertson, L. Higgins, K. Memeh, M. O’Leary, M. Keane, W. Khan, K. Barry

Published in: Irish Journal of Medical Science (1971 -) | Issue 1/2014

Login to get access

Abstract

Background

As new treatment and research advances continue to improve the prognosis of cancer patients, oncologists and surgeons are increasingly faced with the issue of fertility protection and preservation. Cancer patients are frequently exposed to gonadotoxic chemotherapy and radiation therapy as a component of their treatment regimens. There are currently various anticipatory techniques available to women who wish to retain future reproductive ability, the most successful of which involves oocyte retrieval followed by in vitro fertilisation and embryo cryopreservation. Innovative methods include oocyte cryopreservation, ovarian follicle cryopreservation and oophoropexy.

Aim

The aim of this study was to examine our combined experiences at Mayo General Hospital of treating female patients (<30 years) with non-gynaecologic malignancy and requiring referral to the HARI Unit during a 6-year period (2007–2012). Emphasis was placed on reviewing the fertility-preservation options available.

Methods

The hospital inpatient enquiry system was inspected for all cases of non-gynaecologic malignancy referred for fertility preservation from 2007 to 2012.

Results

Three cases of non-gynaecologic malignancy in young females, with an intention to protect and preserve future fertility were identified. The primary treatment plan did not initially incorporate input from a gynaecology or fertility specialist. It was after concerted inquiry and reflection by both physician and patient that oncofertility consultation was sought.

Conclusion

The responsibility is on both physicians and surgeons to consider a more holistic approach to cancer care in young female patients, which focuses not only on the elimination of malignancy but also on preservation of fertility and quality of life.
Literature
1.
go back to reference Armuand GM, Rodriguez-Wallberg KA, Wettergren L et al (2012) Sex differences in fertility-related information received by young adult cancer survivors. J Clin Oncol 30:2147PubMedCrossRef Armuand GM, Rodriguez-Wallberg KA, Wettergren L et al (2012) Sex differences in fertility-related information received by young adult cancer survivors. J Clin Oncol 30:2147PubMedCrossRef
2.
go back to reference Bines J, Oleske DM, Cobleigh MA (1996) Ovarian function in premenopausal women treated with adjuvant chemotherapy for breast cancer. J Clin Oncol 14:1718–1729PubMed Bines J, Oleske DM, Cobleigh MA (1996) Ovarian function in premenopausal women treated with adjuvant chemotherapy for breast cancer. J Clin Oncol 14:1718–1729PubMed
3.
go back to reference Blumenfeld Z (2007) How to preserve fertility in young women exposed to chemotherapy? The role of GnRH agonist co-treatment in addition to cryopreservation of embryo, oocytes, or ovaries. Oncologist 12:1044–1054PubMedCrossRef Blumenfeld Z (2007) How to preserve fertility in young women exposed to chemotherapy? The role of GnRH agonist co-treatment in addition to cryopreservation of embryo, oocytes, or ovaries. Oncologist 12:1044–1054PubMedCrossRef
4.
go back to reference Casper RF, Mitwally MF (2006) Aromatase inhibitors for ovulation induction. J Clin Endocrinol Metab 91:760–771PubMedCrossRef Casper RF, Mitwally MF (2006) Aromatase inhibitors for ovulation induction. J Clin Endocrinol Metab 91:760–771PubMedCrossRef
6.
go back to reference Clough KB, Goffinet F, Labib A et al (1996) Laparoscopic unilateral ovarian transposition prior to irradiation: prospective study of 20 cases. Cancer 77:2638–2645PubMedCrossRef Clough KB, Goffinet F, Labib A et al (1996) Laparoscopic unilateral ovarian transposition prior to irradiation: prospective study of 20 cases. Cancer 77:2638–2645PubMedCrossRef
8.
go back to reference Irsan I, Akisue T, Hara H et al (2007) Imatinib mesylate inhibits tumorigenicity of malignant fibrous histiocytoma cells in vivo. Anticancer Res 27:423–429PubMed Irsan I, Akisue T, Hara H et al (2007) Imatinib mesylate inhibits tumorigenicity of malignant fibrous histiocytoma cells in vivo. Anticancer Res 27:423–429PubMed
10.
go back to reference Matsuo G, Ushijima K, Shinagawa A et al (2007) GnRH agonist acts as ovarian protection in chemotherapy induced gonadotoxicity: an experiment using a rat model. Kurume Med J 54:25–29PubMedCrossRef Matsuo G, Ushijima K, Shinagawa A et al (2007) GnRH agonist acts as ovarian protection in chemotherapy induced gonadotoxicity: an experiment using a rat model. Kurume Med J 54:25–29PubMedCrossRef
11.
go back to reference Meirow D, Nugent D (2001) The effects of radiotherapy and chemotherapy on female reproduction. Human Reprod Updat 7:535–543CrossRef Meirow D, Nugent D (2001) The effects of radiotherapy and chemotherapy on female reproduction. Human Reprod Updat 7:535–543CrossRef
14.
go back to reference Noyes N, Porcu E, Borini A (2009) Over 900 oocyte cryopreservation babies born with no apparent increase in congenital anomalies. Reprod Biomed Online 18:769–776PubMedCrossRef Noyes N, Porcu E, Borini A (2009) Over 900 oocyte cryopreservation babies born with no apparent increase in congenital anomalies. Reprod Biomed Online 18:769–776PubMedCrossRef
15.
go back to reference Oktay K, Sonmezer M (2004) Ovarian tissue banking for cancer patients: fertility preservation, not just ovarian cryopreservation. Hum Reprod 19:477–480PubMedCrossRef Oktay K, Sonmezer M (2004) Ovarian tissue banking for cancer patients: fertility preservation, not just ovarian cryopreservation. Hum Reprod 19:477–480PubMedCrossRef
16.
go back to reference Oktay K, Buyuk E, Veeck L et al (2004) Embryo development after heterotopic transplantation of cryopreserved ovarian tissue. Lancet 363:837–840PubMedCrossRef Oktay K, Buyuk E, Veeck L et al (2004) Embryo development after heterotopic transplantation of cryopreserved ovarian tissue. Lancet 363:837–840PubMedCrossRef
17.
go back to reference Paik S, Shak S, Tang G et al (2004) Multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer. N Engl J Med 351:2817–2826PubMedCrossRef Paik S, Shak S, Tang G et al (2004) Multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer. N Engl J Med 351:2817–2826PubMedCrossRef
18.
go back to reference Parra SA (2000) Cytotoxic chemotherapy in the treatment of nonmalignant disease. J Intraven Nurs 23:359–365PubMed Parra SA (2000) Cytotoxic chemotherapy in the treatment of nonmalignant disease. J Intraven Nurs 23:359–365PubMed
19.
go back to reference Rastogi P, Anderson SJ, Bear HD et al (2008) Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27. J Clin Oncol 26:778–785PubMedCrossRef Rastogi P, Anderson SJ, Bear HD et al (2008) Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27. J Clin Oncol 26:778–785PubMedCrossRef
20.
go back to reference Schmidt KL, Andersen CY, Loft A et al (2005) Follow-up of ovarian function post-chemotherapy following ovarian cryopreservation and transplantation. Hum Reprod 20:3539–3546PubMedCrossRef Schmidt KL, Andersen CY, Loft A et al (2005) Follow-up of ovarian function post-chemotherapy following ovarian cryopreservation and transplantation. Hum Reprod 20:3539–3546PubMedCrossRef
21.
go back to reference Tao T, Zhang W, Del Valle A (2009) Human oocyte cryopreservation. Curr Opin Obstet Gynecol 21:247–252PubMedCrossRef Tao T, Zhang W, Del Valle A (2009) Human oocyte cryopreservation. Curr Opin Obstet Gynecol 21:247–252PubMedCrossRef
22.
go back to reference Woodruff TK, Snyder KA (2007) Oncofertility: fertility preservation for cancer survivors. Springer, New YorkCrossRef Woodruff TK, Snyder KA (2007) Oncofertility: fertility preservation for cancer survivors. Springer, New YorkCrossRef
Metadata
Title
Fertility preservation in young females with non-gynaecologic malignancy: an emerging speciality
Authors
C. Smyth
I. Robertson
L. Higgins
K. Memeh
M. O’Leary
M. Keane
W. Khan
K. Barry
Publication date
01-03-2014
Publisher
Springer London
Published in
Irish Journal of Medical Science (1971 -) / Issue 1/2014
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-013-0967-1

Other articles of this Issue 1/2014

Irish Journal of Medical Science (1971 -) 1/2014 Go to the issue

Literary and Historical

In a time of cholera