State of the art on oocyte cryopreservation in female cancer patients: A critical review of the literature

Abstract

During the last decades, important advances in therapeutic options have led to increased survival rates in cancer patients; however, cancer treatments are associated with several potential adverse effects including infertility in those diagnosed during their reproductive years. A proper discussion about fertility preservation options before the use of therapies with potential gonadotoxicity (i.e. oncofertility counseling) is standard of care and should be offered to all patients of childbearing age. Temporary ovarian suppression with LH-RH analogs, oocyte and embryo cryopreservation are standard strategies for fertility preservation in female cancer patients. Oocyte cryopreservation should be preferred to embryo cryopreservation when this latter is prohibited by law, avoided for ethical or religious issues and in single women refusing sperm donation. Despite the increasing use of this strategy, data are still lacking about the efficacy and safety of the procedure in female cancer patients, with most of the evidence on this regard deriving from infertile non-oncologic women. This article aims at critically review the available evidence about the success of oocyte cryopreservation in female cancer patients with the final goal to further improve the oncofertility counseling of these women.

The BCY3/BCC 2017 survey on physicians' knowledge, attitudes and practice towards fertility and pregnancy-related issues in young breast cancer patients

“…Nonetheless, up to almost half of the respondents admitted having inadequate knowledge on these strategies and one out of three responded that these options were either not available in their countries or they were not aware about their availability; this resulted in only 39.2% and 63.3% suggesting the use of embryo and oocyte cryopreservation to their patients, respectively. Despite several research efforts have been performed in this field over the past years, data on both the efficacy [13,14] and safety [15e17] of these strategies in breast cancer patients remain limited as compared to those in infertile non-oncologic women. This, together with the lack of adequate knowledge, probably explains the percentage ranging from 24.5% to 44.3% of neutral answers related to the statements investigating these strategies.…”

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

“…Egg freezing: Egg freezing is no longer considered an experimental cryopreservation method for female fertility preservation since ASRM declaration in 2012 [77]. It involves cryopreservation of mature oocytes via slow freezing or vitrification which is now more preferred due to a better post-thaw survival rate [78][79][80][81]. Egg freezing requires prior ovarian stimulation and mature oocyte retrieval without the need for sperm or IVF.…”

Triple Negative Breast Cancer Depends on Sphingosine Kinase 1 (SphK1)/Sphingosine-1-Phosphate (S1P)/Sphingosine 1-Phosphate Receptor 3 (S1PR3)/Notch Signaling for Metastasis

“…Breast cancer is the most aggressive malignant tumor in women [ 1 , 2 ]. Triple negative breast cancer (TNBC) accounts for approximately 15% of breast cancers, and possesses properties of serious invasion, poor prognosis, and short survival [ 3 – 5 ].…”