Fertility Preservation for Young Women with Cancer: Hope for the Future

Abstract

Advances in the diagnosis and successful treatment of childhood, adolescent, and adult cancers have allowed many young women to lead healthy lives after overcoming their disease. However, life-saving cancer treatment often impairs fertility. Chemotherapy and/or radiation may irreversibly damage the reproductive system. The maturing field of assisted conception, and specifically cryopreservation, has created a unique partnership between oncologists and fertility specialists. Improving assisted conception success and fertility sparing strategies provide options for young women who would like to have children of their own after cancer treatment. This review article focuses on the current practices and developing opportunities for women who wish to preserve their fertility when faced with gonadotoxic cancer treatment.

Failure of ovarian ablation with goserelin in a pre-menopausal breast cancer patient resulting in pregnancy: a case report and review of the literature

“…One strategy to preserve fertility includes treatments with Gonadotropin Releasing Hormone (GnRH) analogs, such as goserelin (Zoladex Ò ), leuprolide (Eligard Ò ), and buserelin (Suprefact Ò ) which, when used in the long-term, downregulate the release of LH and FSH, creating a state of reversible hypogonadism and chemical ovarian ablation [1][2][3][4]. Badawy et al [1] monitored the levels of FSH, LH, and estrogen in a study group of 39 women who underwent chemotherapy along with goserelin treatment (3.6 mg SC every 28 days).…”

“…The use of GnRH agonists at ablative doses has been associated with higher rates of resumption of menses and restoring ovarian function following chemotherapy [1][2][3][4]. Goserelin for fertility preservation in early stage premenopausal breast cancer remains controversial, but GnRH analogs are still offered to some women despite conflicting data regarding its efficacy in this setting.…”