OOCYTE CRYOPRESERVATION VERSUS OVARIAN TISSUE CRYOPRESERVATION AS FERTILITY PRESERVATION FOR ADULT WOMEN UNDERGOING GONADOTOXIC THERAPY: A COST-EFFECTIVENESS ANALYSIS
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Keywords:
Oocyte cryopreservation
Ovarian Tissue Cryopreservation
Embryo cryopreservation
Live birth
Ovarian Tissue Cryopreservation
Oocyte cryopreservation
Embryo cryopreservation
Ovarian Cortex
Vitrification
Ovarian Reserve
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With the recent report of a pregnancy and delivery after autotransplantation of cryopreserved-thawed ovarian cortical strips, preservation of the reproductive potential resurfaced. There is a growing academic and public interest in exploring the available strategies for fertility preservation in patients at risk. This is due to the increasing incidence of cancer during the reproductive age. The overall survival and cure rates of reproductive age cancers are improving due to improvements in cancer therapy. Reproductive derangement is one of the major consequences of cytotoxic chemotherapy and radiotherapy. GnRh analogues concomitant therapy, laparoscopic ovarian transposition, oocyte cryopreservation, embryo cryopreservation and transplantation of cryopreserved-thawed ovarian tissue, are all strategies for fertility preservation in patients at risk. However, no evidence-based strategy is available yet. This article discusses the mechanisms of reproductive failure after gonadotoxic therapy and the currently available fertility preservation strategies.
Oocyte cryopreservation
Ovarian Tissue Cryopreservation
Embryo cryopreservation
Premature ovarian failure
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Purpose of review This study aims to review the current state of different fertility preservation options in patients facing the risk of gonadal failure. Recent findings Various malignant and nonmalignant diseases have been successfully treated with high-dose chemotherapy or radiotherapy. Even though many young patients receiving these treatments are at risk of developing reproductive failure, a number of fertility preservation options ranging from embryo cryopreservation to ovarian tissue cryopreservation are now available. Summary Embryo cryopreservation is a well established technique to preserve fertility. The success rate with oocyte cryopreservation has been on the rise. Both oocyte and embryo freezing require ovarian stimulation and novel ovarian stimulation regimens utilizing aromatase inhibitors which have been developed for ovarian stimulation in women with estrogen sensitive cancer. Even though ovarian tissue cryopreservation is a novel technology, it is the only fertility preservation option for children and the only treatment strategy that can restore ovarian function. In-vitro maturation is a promising technology and can be applied in combination with ovarian tissue cryopreservation.
Oocyte cryopreservation
Embryo cryopreservation
Ovarian Tissue Cryopreservation
Premature ovarian failure
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Summary Several options are currently available for the preservation of fertility in cancer patients: embryo cryopreservation, oocyte cryopreservation or ovarian tissue cryopreservation. The choice of the most suitable strategy for preserving fertility depends on different parameters: the type and timing of chemotherapy, the type of cancer, the patient’s age and the partner status. Cryopreservation of ovarian tissue is the only option available for prepubertal girls and woman who cannot delay the start of chemotherapy. So far, 15 live births have been obtained after orthotopic transplantation of cryopreserved ovarian tissue.
Ovarian Tissue Cryopreservation
Oocyte cryopreservation
Embryo cryopreservation
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Most female cancer patients of reproductive age do not have the option of utilising in vitro fertilisation (IVF) and embryo cryopreservation to safeguard their fertility. Indeed, in many cancers chemotherapy is initiated soon after diagnosis. For patients who require immediate chemotherapy, or those with hormone-sensitive cancer or who are still pre-pubertal, the practice of oocyte and ovarian tissue cryopreservation has rapidly become the technique of choice, although it remains experimental. Cryopreservation of oocytes can be performed in single women who are able to undergo a stimulation cycle, but the effectiveness of this technique is still low, with delivery rates of 1–5% per frozen–thawed oocyte. Nevertheless, since the recent introduction of oocyte vitrification, the delivery rates are about two-fold per thawed oocyte. Cryopreservation of ovarian tissue is the only option available for pre-pubertal girls and for woman who cannot delay the start of chemotherapy. Ovarian cryopreservation and transplantation procedures have so far yielded six live births in humans after autologous transplantation.
Oocyte cryopreservation
Ovarian Tissue Cryopreservation
Embryo cryopreservation
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Ovarian Tissue Cryopreservation
Oocyte cryopreservation
Embryo cryopreservation
Ovarian Reserve
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Breast cancer treatments often have negative effects on fertility, which pose challenges among patients who want to be parents in the future. This study aimed to examine the efficacy of oocyte cryopreservation, embryo cryopreservation, and ovarian tissue cryopreservation in patients with breast cancer. This retrospective review evaluated 42 patients with breast cancer who underwent fertility preservation at our center from January 2012 to December 2022. This review encompassed the demographic characteristics of the patients, cancer stages, treatment details, and types of fertility preservation procedures and their outcomes. The average age at disease diagnosis was 33.4 years. Approximately 90.4% of patients presented with early-stage cancer (≤2). Of 42 patients, 26 underwent oocyte cryopreservation; 17, embryo cryopreservation; and 2, ovarian tissue cryopreservation. Further, three patients received mixed treatment. The overall live birth rate was 63.2%. There are more live births in embryo cryopreservation group. The successful pregnancy group was significantly younger and had a remarkably higher quantity of preserved oocytes/embryos than the nonsuccessful pregnancy group. The oocyte and embryo utilization rates in cryopreservation were 7.69% and 52.94%, respectively. These findings underscored the importance of prompt, informed discussions about fertility preservation options. Fertility preservation in patients with breast cancer have promising reproductive outcomes, with embryo cryopreservation being particularly effective. Prompt counseling and individualized fertility preservation strategies are important for improving the likelihood of posttreatment pregnancy. Nevertheless, future research on the long-term psychological and emotional effects of different fertility preservation methods must be performed.
Oocyte cryopreservation
Embryo cryopreservation
Ovarian Tissue Cryopreservation
Live birth
Assisted Reproductive Technology
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It is an important problem to preserve fertility of young patients with breast cancer,which infects the life quality of patients.But fertility after treatment has an impact on long-term survival,so the appropriate pregnancy time should be chosen carefully.The fertility of breast canser patient suffers all kinds of damage after systemic therapy.At the present stage,the measures of fertility protection include application of gonadotropin-releasing hormone analogue,embryo cryopreservation,oocyte cryopreservation and ovarian tissue cryopreservation.
Key words:
Breast neoplasms; Fertility
Oocyte cryopreservation
Ovarian Tissue Cryopreservation
Embryo cryopreservation
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Oocyte cryopreservation
Ovarian Tissue Cryopreservation
Embryo cryopreservation
Live birth
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The preservation of fertility in female cancer survivors has become an important health issue. The different cryopreservation options available for fertility preservation are embryo, oocyte, and ovarian tissue cryopreservation. Oocyte cryopreservation is available for women without partners, but there is a limited experience with this technique and the pregnancy rate is still low. In spite of recent reports of successful birth after autotransplantation of cryopreserved-thawed human ovarian cortical tissues, clinical experience is also limited and this technique remains still experimental. Whole ovary cryopreservation itself poses several challenges. Further researches for establishing optimal cryopreservation and thawing protocols and increasing post-thawing survival, pregnancy, and delivery rates are necessary. In this article, the strategies for fertility preservation in cancer survivors are discussed. The different options and their results are discussed, as well as their indications, efficacy and ethical issues.
Oocyte cryopreservation
Ovarian Tissue Cryopreservation
Autotransplantation
Embryo cryopreservation
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