EUropean REcommendations for female FERtility preservation (EU-REFER): A joint collaboration between oncologists and fertility specialists

Dolmans, Marie Madeleine; Lambertini, Matteo; Macklon, Kirsten Tryde; Almeida‐Santos, Teresa; Ruiz-Casado, Ana; Borini, Andrea; Bordes, V.; Frith, Lucy; Moer, Ellen Van; Germeyer, Ariane

doi:10.1016/j.critrevonc.2019.03.010

Cited by 55 publications

(59 citation statements)

References 68 publications

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“…Debatable options may include ovarian protection techniques such as gonadotropin-releasing hormone (GnRH) analogs and hormonal suppression, surgical ovarian transposition (oophoropexy), gonadal shielding, and fractionated radiotherapy. Experimental options may include ovarian tissue freezing and further autotransplantation, oocyte in vitro maturation (IVM), artificial ovary, stem cells, neoadjuvant cytoprotective pharmacotherapy, and others [15][16][17][18][19][20][21][22]. Nevertheless, each of those options has both advantages and disadvantages and may not be feasible for all patients.…”

Section: Fertility Preservation and Restoration Options In Female Patmentioning

confidence: 99%

Preserving fertility in female patients with hematological malignancies: a multidisciplinary oncofertility approach

2019

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Oncofertility is a new interdisciplinary field at the intersection of oncology and reproductive medicine that expands fertility options for young cancer patients. The most common forms of hematological malignancies that occur in girls and young women and therefore necessitate oncofertility care are acute lymphocytic leukemia, acute myeloid leukemia, non-Hodgkin's lymphoma, and Hodgkin's lymphoma. Aggressive gonadotoxic anticancer regimens including alkylating chemotherapy and total body irradiation are used often in treating girls and young women with hematological malignancies. The risks of gonadotoxicity and subsequent iatrogenic premature ovarian insufficiency and fertility loss depend mainly on the type and stage of the disease, dose of anticancer therapy as well as the age of the patient at the beginning of treatment. To avoid or at least mitigate the devastating complications of anticancer therapy-induced gonadotoxicity, effective and comprehensive strategies that integrate different options for preserving and restoring fertility ranging from established to experimental strategies should be offered before, during, and after chemotherapy or radiotherapy. A multidisciplinary approach that involves strong coordination and collaboration between hemato-oncologists, gynecologists, reproductive biologists, research scientists, and patient navigators is essential to guarantee high standard of care.

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Section: Fertility Preservation and Restoration Options In Female Patmentioning

confidence: 99%

Preserving fertility in female patients with hematological malignancies: a multidisciplinary oncofertility approach

2019

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“…Over the last years, cancer death rate has been continuously dropping thanks to improvement in screening techniques and therapies ensuring early diagnosis and increased survival (1). Life-saving treatments such as chemotherapy or radiotherapy have several potential long-term adverse effects including gonadotoxicity (2)(3)(4)(5)(6)(7)(8). The subsequent risk of treatment-related infertility and the loss of ovarian endocrine function represent important causes of distress for patients who are diagnosed during their reproductive years (9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Controlled Ovarian Stimulation With or Without Letrozole Co-administration for Fertility Preservation: A Systematic Review and Meta-Analysis

et al. 2020

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Background: The co-administration of letrozole during controlled ovarian stimulation (COS) with gonadotropins is used to limit the potentially harmful effects of a supra-physiological rise in estrogen levels on hormone-sensitive cancers. However, the efficacy and safety of adding letrozole to COS remain debated. Methods: This is a systematic review and meta-analysis of published studies that compared the efficacy and safety of COS with co-administration of letrozole vs. COS without letrozole in all patient populations. A secondary analysis was done including only the studies in breast cancer patients. The primary efficacy endpoint was the number of retrieved mature Metaphase II (MII) oocytes. Secondary efficacy and safety endpoints were total number of oocytes, maturation rate, fertilization rate, number of cryopreserved embryos, peak estradiol levels, progesterone levels, and total gonadotropin dose. Data for each endpoint were reported and analyzed thorough mean ratio (MR) with 95% confidence interval (CI). Results: A total of 11 records were selected including 2,121 patients (990 patients underwent COS with letrozole and 1,131 COS without letrozole). The addition of letrozole to COS did not have any negative effect on the number of mature oocytes collected (MR = 1.00, 95% CI = 0.87-1.16; P = 0.967) and the other efficacy endpoints. COS with letrozole was associated with significantly decreased peak estradiol levels (MR = 0.28, 95% CI = 0.24-0.32; P < 0.001). Similar results were observed in the secondary analysis including only breast cancer patients. Bonardi et al. Letrozole for Controlled Ovarian Stimulation Conclusions: These findings are reassuring on the efficacy and safety of COS with gonadotropins and letrozole and are particularly important for fertility preservation in women with hormone-sensitive cancers.

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“…Some form of therapy was advocated (hormonal/NACT) so that surgery could be delayed [24]. There are concerns with the safety of MIS regarding smoke evacuation and intra-abdominal pressure, which might have altered the clinician's decision to delay MIS [25]. Many early vulvar cancers were managed by observation, and only a few received surgery or neoadjuvant therapy.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 Pandemic on Gynecological Oncology Care: Glimpse into Association of Gynecological Oncologists of India (AGOI) Perspective

Bhandoria

Shylasree

Bhandarkar

et al. 2020

Indian J Gynecol Oncolog

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Purpose The notorious COVID 19 pandemic has caused rapid and drastic changes in cancer care worldwide in 2020. This online survey aims to assess the extent to which the pandemic has affected cancer care in gynecological oncology amongst members of the Association of Gynecological Oncologists of India (AGOI), a registered professional society founded in 1991. Methods We developed and administered a cross-sectional, flash survey to members of AGOI in the first week of April 2020. Data were analyzed using Microsoft Office Excel 2016. Results were expressed as percentages of total responses excluding blank or unattended response. Overall theme-specific responses were described as a spectrum of findings, and related inferences were drawn. Results Among approached practitioners, 90 responded to the survey, more than 80% were practicing consultants, and more than 50% from academic institutions. The results of the study showed that the ongoing pandemic had severely affected gynecological oncology practice and care amongst all respondents. There were modifications in diagnostic pathways, interventions, and follow-ups across all organ sites. There was a near-unanimous opinion on the use of general safety measures to combat the virus and to use complete PPEs in a high-risk situation. There were mixed responses to alternative educational activities, especially using electronic technology and distant learning methods. There was optimism among respondents with regards to the current situation normalizing in 3-6 months. Conclusion This study documents the pandemic affected scenario of gynecological cancer care and perceptions of Gynecological Oncologists in India. A significant effect on all aspects of cancer care was observed. Technological learning methods, both for patient care and educational activities, were being adopted by many respondents.

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EUropean REcommendations for female FERtility preservation (EU-REFER): A joint collaboration between oncologists and fertility specialists

Cited by 55 publications

References 68 publications

Preserving fertility in female patients with hematological malignancies: a multidisciplinary oncofertility approach

Preserving fertility in female patients with hematological malignancies: a multidisciplinary oncofertility approach

Efficacy and Safety of Controlled Ovarian Stimulation With or Without Letrozole Co-administration for Fertility Preservation: A Systematic Review and Meta-Analysis

Impact of COVID-19 Pandemic on Gynecological Oncology Care: Glimpse into Association of Gynecological Oncologists of India (AGOI) Perspective

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