Fertility after Cancer: Risks and Successes

Tucci, Chiara Di; Galati, Giulia; Mattei, Giulia; Chinè, Alessandra; Fracassi, Alice; Muzii, Ludovico

doi:10.3390/cancers14102500

Cited by 18 publications

(8 citation statements)

References 189 publications

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“…Cancer treatments have adverse effects on ovarian function, such as delayed or arrested puberty, infertility, subfertility, and premature ovarian insufficiency (POI: menopause before age of 40) [1]. Chemotherapy damages the reproductive system by destroying the hypothalamic-pituitary axis, the uterus.…”

Section: Adolescents and Young Adultsmentioning

confidence: 99%

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The impact of chemo-induced menopause on the quality of life of young women with non-metastatic breast cancer in Algeria

2023

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Background: Breast cancer is the most common cancer in females worldwide. Young women with breast cancer are treated with chemotherapy, which may exhibit gonadotoxicity thus inducing chemo- induced menopause with a risk of deterioration in their quality of life. Method: A prospective study first of its kind in Algeria was carried out on 57 patients aged between 30 and 49 years that went for consultation at the oncology department of Pierre and Marie Curie Medical Centre Algiers. The medical files obtained and criteria of questionnaires: Quality of Life Questionnaire for Breast Cancer (QLQ-BR23) and the Quality of Life Questionnaire-Core 30 (QLQ-C30) were used to assess the quality of life in patients. Results: From the medical files, patients had a dominant histological type of invasive ductal carcinoma at 96% and Scarff-Bloom-Richardson (SBR) II grade and luminal B profile were the most frequent. The (QLQ-C30) having averages of global health status, symptom score, and functional score with 56.34, 63.7, and 45.75 respectively. QLQ-BR23 having averages for symptom, functional score of 61.6 and 49.71 respectively. Conclusion: Chemotherapy induces gonadotoxicity, which results in chemo-induced menopause that has a negative impact on the quality of life of young women. QLQ-BR23 is more suitable than QLQ-C30 to access the context of this study.

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Section: Adolescents and Young Adultsmentioning

confidence: 99%

“…Breast cancer is the most common cancer in females worldwide, with 40% of diagnosed cases under 49 years [1]. This cancer in young women is frequently familial, with almost half of the reported cases harboring a germ line mutation in genes; tumor protein 53 (TP53), breast cancer genes 1 and 2 (BRCA1 and BRCA2) [2].…”

Section: Introductionmentioning

confidence: 99%

The impact of chemo-induced menopause on the quality of life of young women with non-metastatic breast cancer in Algeria

2023

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“…Global cancer incidence in women under 35 is estimated at around 430,000 per year, and about 73% of them currently survive [ 1 ]. However, cancer treatments can affect ovarian function and the chances of natural conception [ 2 ]. This issue is of great concern for cancer survivors, and it has therefore become mandatory to provide effective strategies for preserving fertility [ 3 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Follicular steroidogenesis in random start protocols for oocyte cryopreservation

Galati

Somigliana

Ciaffaglione

et al. 2023

J Assist Reprod Genet

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Purpose Random start protocols are commonly used for oocyte cryopreservation in women with cancer. However, albeit generally reassuring, available evidence is still insufficient to rule out a sub-optimal cycle outcome. This study aimed to compare follicular steroidogenesis between women initiating the random start protocol in the luteal phase and those initiating in the follicular phase. Methods Consecutive women with cancer scheduled for oocyte cryostorage were prospectively recruited. We excluded those requiring a concomitant letrozole assumption. All women received a standardized protocol with recombinant FSH and GnRH antagonists. At the time of oocyte retrieval, follicular fluids were pooled, and a sample was collected and frozen at −80 °C. All samples were assayed concomitantly after thawing by liquid chromatography-tandem mass spectrometry. The concentration of 15 different steroid hormones was determined. Results Seventy-one women were recruited. Thirty-three initiated the ovarian stimulation in the luteal phase, while the remaining 38 initiated in the follicular phase. Baseline characteristics were generally similar. Cycle outcome did also not differ; the median (interquartile range) number of frozen mature oocytes was 9 (5–14) and 10 (5–21), respectively (p = 0.42). None of the 15 tested steroid hormones differed. Conclusions The endocrine microenvironment surrounding oocytes is not markedly influenced by the phase of the menstrual cycle at the initiation of ovarian stimulation. This result further supports the validity of random start protocols.

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“…Fertility preservation options for prepubertal girls with malignant tumors include ovarian transposition, ovarian tissue cryopreservation, auto-transplantation after sexual maturity, and ovarian tissue culture in vitro [ 7 , 8 ]. However, these options are associated with the risk of re-introducing cancer cells [ 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Automatic Evaluation for Bioengineering of Human Artificial Ovary: A Model for Fertility Preservation for Prepubertal Female Patients with a Malignant Tumor

Wang

Pei

Isachenko

et al. 2022

IJMS

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Introduction: The in vitro culture of primordial follicles is the only available option for preserving fertility in prepubertal girls with malignant tumors. The cultivation of primordial follicles in scaffolds as artificial ovaries is a promising approach for this. Methods: Dissociated follicles were placed into an artificial ovarian scaffold composed of fibrinogen and thrombin. The follicles were cultured in a dish dedicated to live cell imaging and observed for growth using immunofluorescence and development via optical microscopy. The morphology of the follicles in the scaffold was three-dimensionally reconstructed using the Imaris software. Growth and development were also quantified. Results: The morphology of artificial ovaries began to degrade over time. Within approximately 7 days, primordial follicles were activated and grew into secondary follicles. A comparison of optical and confocal microscopy results revealed the superior detection of live cells using confocal microscopy. The three-dimensional reconstruction of the confocal microscopy data enabled the automatic enumeration and evaluation of the overall morphology of many follicles. Conclusions: The novel artificial ovary-enabled primordial follicles to enter the growth cycle after activation and grow into secondary follicles. The use of a fibrin scaffold as a carrier preserves the developmental potential of primordial germ cells and is a potentially effective method for preserving fertility in prepubertal girls.

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Fertility after Cancer: Risks and Successes

Cited by 18 publications

References 189 publications

The impact of chemo-induced menopause on the quality of life of young women with non-metastatic breast cancer in Algeria

The impact of chemo-induced menopause on the quality of life of young women with non-metastatic breast cancer in Algeria

Follicular steroidogenesis in random start protocols for oocyte cryopreservation

Automatic Evaluation for Bioengineering of Human Artificial Ovary: A Model for Fertility Preservation for Prepubertal Female Patients with a Malignant Tumor

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