Toward precision medicine for preserving fertility in cancer patients: existing and emerging fertility preservation options for women

Abstract

As the number of young cancer survivors increases, quality of life after cancer treatment is becoming an ever more important consideration. According to a report from the American Cancer Society, approximately 810,170 women were diagnosed with cancer in 2015 in the United States. Among female cancer survivors, 1 in 250 are of reproductive age. Anticancer therapies can result in infertility or sterility and can have long-term negative effects on bone health, cardiovascular health as a result of reproductive endocrine function. Fertility preservation has been identified by many young patients diagnosed with cancer as second only to survival in terms of importance. The development of fertility preservation technologies aims to help patients diagnosed with cancer to preserve or protect their fertility prior to exposure to chemo- or radiation therapy, thus improving their chances of having a family and enhancing their quality of life as a cancer survivor. Currently, sperm, egg, and embryo banking are standard of care for preserving fertility for reproductive-age cancer patients; ovarian tissue cryopreservation is still considered experimental. Adoption and surrogate may also need to be considered. All patients should receive information about the fertility risks associated with their cancer treatment and the fertility preservation options available in a timely manner, whether or not they decide to ultimately pursue fertility preservation. Because of the ever expanding number of options for treating cancer and preserving fertility, there is now an opportunity to take a precision medicine approach to informing patients about the fertility risks associated with their cancer treatment and the fertility preservation options that are available to them.

High-dose Cyclophosphamide is Effective Therapy for Pediatric Severe Aplastic Anemia

“…41 None of our female patients had such therapy available at the time of their treatment, but gonadal function in our patient cohort appears to be good at the current duration of follow up. One male patient has developed premature gonadal failure following two courses of treatment, but 2 female patients have undergone spontaneous pregnancies.…”

Knowledge regarding fertility preservation in cancer patients: a population-based survey among Brazilian people during the Pink October awareness event

“…Currently, sperm, egg, and embryo banking are standards-of-care for preserving fertility for cancer patients at reproductive age; ovarian tissue cryopreservation is still considered experimental ( Kim et al , 2016 ). Our group has been vitrifying oocytes from cancer patients since it was an experimental procedure ( da Motta et al , 2014 ) and has worked hard to inform healthcare professionals about oncofertility.…”

New promising strategies in oncofertility

“…Researchers are also exploring the creation of an engineered ‘artificial ovary’ for transplantation [114]. “This artificial ovary comprises follicles isolated from a patient's cryopreserved ovarian tissue, along with other ovarian cells, which are assembled on a 3D matrix scaffold; the resulting structure would allow follicles to grow within an ovary-like environment and would potentially restore both fertility and endocrine function once transplanted into the patient” [115]. …”