Impact of cancer chemotherapy before ovarian cortex cryopreservation on ovarian tissue transplantation

Poirot, Catherine; Fortin, Anne; Lacorte, Jean‐Marc; Akakpo, Jean-Paul; Genestie, Catherine; Vernant, Jean Paul; Brice, Pauline; Morice, Philippe; Leblanc, Thierry; Gabarre, Jean; Delmer, Alain; Badachi, Yasmina; Drouineaud, Véronique; Gouy, Sébastien; Chalas, Céline; Egels, Sophie; Dhédin, Nathalie; Touraine, Philippe; Dommergues, Marc; Lebègue, Géraldine; Wolf, Jean-Philippe; Capron, Frédérique; Lefèbvre, Gilles; Boissel, Nicolas

doi:10.1093/humrep/dez047

Cited by 61 publications

(47 citation statements)

References 25 publications

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“…The risk is about 1.2%, which is comparable with the occurrence of major fetal malformations in the general population [17]. The latest data on the occurrence of fetal malformations in 22 patients who underwent the first course of chemotherapy before OTC indicate the birth of eight healthy children from 13 pregnancies [22].…”

Section: Risk To the Fetusmentioning

confidence: 72%

Updating the recommendations of the Working Group for the Preservation of Fertility in Oncological and Hematological Patients and Other Patients Treating Gonadier Therapies "ONCOFERTILITY" (GROF) of the Polish Society of Oncological Gynecology regarding cryopreserves and autologous transplant

Jach

Spaczyński

Kurzawa³

et al. 2021

Ginekol Pol

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Section: Risk To the Fetusmentioning

confidence: 72%

Updating the recommendations of the Working Group for the Preservation of Fertility in Oncological and Hematological Patients and Other Patients Treating Gonadier Therapies "ONCOFERTILITY" (GROF) of the Polish Society of Oncological Gynecology regarding cryopreserves and autologous transplant

Jach

Spaczyński

Kurzawa³

et al. 2021

Ginekol Pol

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“…If the coadministration of a targeted drug with cytotoxic treatment proves to be feasible with no increase in toxicity, it could be used in fertility preservation regardless of the cancer subtype. Coadministration protocols might slow PF exhaustion and could be used alone or in association with other strategies, such as ovarian tissue transplantation, which is more effective at high follicle density [84]. By stopping follicle activation, the cotreatment strategy might also increase the follicular content of the ovary and improve ovarian tissue quality, thereby promoting the recovery of ovarian tissue function after transplantation.…”

Section: Discussion and Perspectivesmentioning

confidence: 99%

Can Some Anticancer Treatments Preserve the Ovarian Reserve?

et al. 2021

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Background Preventing premature ovarian failure (POF) is a major challenge in oncology. With conventional regimens, cytotoxicity‐associated POF involves primordial follicles (PF) pool depletion by apoptosis or overactivation mechanisms, notably mediated by the ABL/TAp63 and PI3K/Akt/mTOR pathways. New anticancer treatments have been designed to target pathways implicated in tumor growth. Although concerns regarding fertility arise with these targeted therapies, we hypothesized that targeted therapies may exert off‐tumor effects on PF that might delay POF. We provide an overview of evidence concerning these off‐tumor effects on PF. Limitations and future potential implications of these findings are discussed. Design PubMed was searched by combining Boolean operators with the following keywords: fertility, ovarian, follicle, anti‐tumoral, cancer, targeted, cytotoxic, and chemotherapy. Results Cisplatin‐related PF apoptosis via the ABL/TAp63 pathway was targeted with a tyrosine kinase inhibitor, imatinib, in mice, but effects were recently challenged by findings on human ovarian xenografts in mice. In cyclophosphamide‐treated mice, PI3K/Akt/mTOR pathway inhibition with mTOR inhibitors and AS101 preserved the PF pool. Proteasome and GSK3 inhibitors were evaluated for direct and indirect follicle DNA damage prevention. Surprisingly, evidence for cytotoxic drug association with PF pool preservation was found. We also describe selected non‐anticancer molecules that may minimize gonadotoxicity. Conclusion Not all anticancer treatments are associated with POF, particularly since the advent of targeted therapies. The feasibility of associating a protective drug targeting PF exhaustion mechanisms with cytotoxic treatments should be evaluated, as a way of decreasing the need for conventional fertility preservation techniques. Further evaluations are required for transfer into clinical practice. Implications for Practice Anticancer therapies are associated with infertility in 10%–70% of patients, which is the result of primordial follicles pool depletion. Alone or associated with gonadotoxic treatments, some targeted therapies may exert favorable off‐targets effects on the primordial follicle pool by slowing down their exhaustion. Current evidence of these effects relies on murine models or human in vitro models. Evaluation of these protective strategies in humans is challenging; however, if these results are confirmed with clinical and biological data, it not only could be a new approach to female fertility preservation but also would change standard fertility strategies.

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“…Parenthood is important to cancer survivors 143 – 145 . However, despite the best intentions of patients, families, and medical professionals, fertility preservation can be difficult to accomplish in the compressed and stressful time frame between diagnosis and initiation of treatment 30 , 37 , 38 , 105 , 146 – 149 .…”

Section: In Vitro Gametes From Pluripotent Stem Cellsmentioning

confidence: 99%

Recent advances: fertility preservation and fertility restoration options for males and females

Doungkamchan¹,

Orwig²

2021

Fac Rev

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Fertility preservation is the process of saving gametes, embryos, gonadal tissues and/or gonadal cells for individuals who are at risk of infertility due to disease, medical treatments, age, genetics, or other circumstances. Adult patients have the options to preserve eggs, sperm, or embryos that can be used in the future to produce biologically related offspring with assisted reproductive technologies. These options are not available to all adults or to children who are not yet producing mature eggs or sperm. Gonadal cells/tissues have been frozen for several thousands of those patients worldwide with anticipation that new reproductive technologies will be available in the future. Therefore, the fertility preservation medical and research communities are obligated to responsibly develop next-generation reproductive technologies and translate them into clinical practice. We briefly describe standard options to preserve and restore fertility, but the emphasis of this review is on experimental options, including an assessment of readiness for translation to the human fertility clinic.

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Impact of cancer chemotherapy before ovarian cortex cryopreservation on ovarian tissue transplantation

Cited by 61 publications

References 25 publications

Updating the recommendations of the Working Group for the Preservation of Fertility in Oncological and Hematological Patients and Other Patients Treating Gonadier Therapies "ONCOFERTILITY" (GROF) of the Polish Society of Oncological Gynecology regarding cryopreserves and autologous transplant

Updating the recommendations of the Working Group for the Preservation of Fertility in Oncological and Hematological Patients and Other Patients Treating Gonadier Therapies "ONCOFERTILITY" (GROF) of the Polish Society of Oncological Gynecology regarding cryopreserves and autologous transplant

Can Some Anticancer Treatments Preserve the Ovarian Reserve?

Recent advances: fertility preservation and fertility restoration options for males and females

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