Fertility Preservation Options for Cancer Patients

Murid Javed, Essam Michael

Astra Fertility Clinic, Mississauga, Canada.

DOI: 10.4236/arsci.2015.34008                

Abstract

The number of reported new cancer cases is increasing every year. The probability of surviving cancer is high and is continually improving. The cancer treatment may induce ovarian or testicular failure by damaging ovarian follicles in females and spermatogonia in the males. Gonadal failure may affect all aspects of reproductive health, including pubertal development, hormone production, and sexual function in adult life. Therefore, the primary goal for cancer treatment is to ensure the highest possibility of cure and to maintain the reproductive health. The cancer patients should be provided with maximal chance to make an optimal decision without any significant impact and delay in cancer treatment. As a result of treatment innovations, the survival rates of young people have increased substantially; therefore, the need of fertility preservation has increased as well. The sperm cryopreservation and embryo cryopreservation have been standard methods of fertility preservation. Recently, the American Society for Reproductive Medicine has removed the experimental label from oocyte cryopreservation. However, other fertility preservation options including ovarian tissue and whole ovary cryopreservation and testicular tissue cryopreservation for pre-pubertal boys are still considered experimental. A coordinated approach by gynecologists, urologists, oncologists, pediatricians, surgeons, fertility specialists and counselors is required to make use of available fertility preservation options. Timely and complete information on the impact of cancer treatment on fertility and fertility preservation options should be presented to all patients when a cancer treatment is planned. The possibility of fertility preservation removes a huge concern and enables cancer patients to concentrate on their treatment and getting better. The purpose of this review is to present different options currently available to preserve fertility in men, women and adolescent children diagnosed with cancer and undergoing gonadotoxic therapy. All options are listed in two tables for quick reference. Most of the information is extracted from recent publications and presented in such a manner that it is valuable for cancer patients and professionals associated with fertility preservation.

Keywords

Fertility Preservation, Oocyte Cryopreservation, Sperm Cryopreservation, Ovarian Tissue, Cancer

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Rodriguez-Wallberg, K.A. and Oktay, K. (2014) Fertility Preservation during Cancer Treatment: Clinical Guidelines. Cancer Management and Research, 6, 105-117. http://dx.doi.org/10.2147/CMAR.S32380
[2]	Hoeg, D., Schmidt, L. and Macklon, K.T. (2015) Cancer and Fertility—A Qualitative Pilot Study of Young Female Cancer Patients’ Experiences with Fertility Counseling and Fertility Preservation. Austin Journal of Reproductive Medicine & Infertility, 2, 1005.
[3]	Dursun, P., Dogan, N.U. and Ayhan, A. (2014) Oncofertility for Gynecologic and Non-Gynecologic Cancers: Fertility Sparing in Young Women of Reproductive Age. Critical Reviews in Oncology/Hematology, 92, 258-267. http://dx.doi.org/10.1016/j.critrevonc.2014.07.001
[4]	Practice Committee of the American Society for Reproductive Medicine (2014) Ovarian Tissue Cryopreservation: A Committee Opinion. Fertility and Sterility, 101, 1237-1243. http://dx.doi.org/10.1016/j.fertnstert.2014.02.052
[5]	ACOG: Committee Opinion No. 584 (2014) Oocyte Cryopreservation. Obstetrics & Gynecology, 123, 221-222. http://dx.doi.org/10.1097/01.AOG.0000441355.66434.6d
[6]	Lee, S.J., Schover, L.R., Partridge, A.H., Patrizio, P., Wallace, W.H., Hagerty, K., et al. (2006) American Society of Clinical Oncology Recommendations on Fertility Preservation in Cancer Patients. Journal of Clinical Oncology, 24, 2917-2931. http://dx.doi.org/10.1200/JCO.2006.06.5888
[7]	Mahajan, N. (2015) Fertility Preservation in Female Cancer Patients: An Overview. Journal of Human Reproductive Sciences, 8, 3-13. http://dx.doi.org/10.4103/0974-1208.153119
[8]	Chung, J.P., Haines, C.J. and Kong, G.W. (2013) Sperm Cryopreservation for Chinese Male Cancer Patients: A 17- Year Retrospective Analysis in an Assisted Reproductive Unit in Hong Kong. Hong Kong Medical Journal, 19, 525- 530. http://dx.doi.org/10.12809/hkmj134055
[9]	Gangrade, B.K. (2013) Cryopreservation of Testicular and Epididymal Sperm: Techniques and Clinical Outcomes of Assisted Conception. Clinics, 68, 131-140. http://dx.doi.org/10.6061/clinics/2013(Sup01)15
[10]	Hotaling, J.M., Pate, D.P., Vendryes, C., Lopushnyan, N.A., Presson, A.P., Zhan,g C., Muller, C.H. and Walsh, T.J. (2015) Predictors of Sperm Recovery after Cryopreservation in Testicular Cancer. Asian Journal of Andrology. [Epub Ahead of Print] http://www.ajandrology.com/preprintarticle.asp?id=155535 http://dx.doi.org/10.4103/1008-682X.155535
[11]	de Lambert, G., Poirot, C., Guérin, F., Brugières, L. and Martelli, H. (2015) Preservation of Fertility in Children with Cancer. Bulletin du Cancer, 102, 436-442. (In French) http://dx.doi.org/10.1016/j.bulcan.2015.02.015
[12]	Rodriguez-Wallberg, K.A. and Oktay, K. (2014) Fertility Preservation during Cancer Treatment: Clinical Guidelines. Cancer Management and Research, 6, 105-117.
[13]	Rodriguez-Wallberg, K.A. and Oktay, K. (2012) Recent Advances in Oocyte and Ovarian Tissue Cryopreservation and Transplantation. Best Practice & Research Clinical Obstetrics & Gynaecology, 26, 391-405. http://dx.doi.org/10.1016/j.bpobgyn.2012.01.001
[14]	Oktay, K., Rodriguez-Wallberg, K.A. and Sahin, G. (2010) Fertility Preservation by Ovarian Stimulation and Oocyte Cryopreservation in a 14-Year-Old Adolescent with Turner Syndrome Mosaicism and Impending Premature Ovarian Failure. Fertility and Sterility, 94, 753.e15-753.e19. http://dx.doi.org/10.1016/j.fertnstert.2010.01.044
[15]	Rienzi, L., Romano, S., Albricci, L., Maggiulli, R., Capalbo, A., Baroni, E., et al. (2010) Embryo Development of Fresh “versus” Vitrified Metaphase II Oocytes after ICSI: A Prospective Randomized Sibling-Oocyte Study. Human Reproduction, 25, 66-73. http://dx.doi.org/10.1093/humrep/dep346
[16]	Edgar, D.H. and Gook, D.A. (2012) A Critical Appraisal of Cryopreservation (Slow Cooling versus Vitrification) of Human Oocytes and Embryos. Human Reproduction Update, 18, 536-554. http://dx.doi.org/10.1093/humupd/dms016
[17]	Donnez, J., Dolmans, M.M., Demylle, D., Jadoul, P., Pirard, C., Squifflet, J., et al. (2004) Livebirth after Orthotopic Transplantation of Cryopreserved Ovarian Tissue. Lancet, 364, 1405-1410. http://dx.doi.org/10.1016/S0140-6736(04)17222-X
[18]	Imbert, R., Moffa, F., Tsepelidis, S., Simon, P., Delbaere, A., Devreker, F., Dechene, J., Ferster, A., Veys, I., Fastrez, M., Englert, Y. and Demeestere, I. (2014) Safety and Usefulness of Cryopreservation of Ovarian Tissue to Preserve Fertility: A 12-Year Retrospective Analysis. Human Reproduction, 29, 1931-1940. http://dx.doi.org/10.1093/humrep/deu158
[19]	Kim, S.S. (2012) Assessment of Long Term Endocrine Function after Transplantation of Frozen-Thawed Human Ovarian Tissue to the Heterotopic Site: 10 Year Longitudinal Follow-Up Study. Journal of Assisted Reproduction and Genetics, 29, 489-493. http://dx.doi.org/10.1007/s10815-012-9757-3
[20]	Gunasheela, D. and Gunasheela, S. (2014) Strategies for Fertility Preservation in Young Patients with Cancer: A Comprehensive Approach. Indian Journal of Surgical Oncology, 5, 17-29. http://dx.doi.org/10.1007/s13193-014-0291-x
[21]	Bedaiwy, M.A., Hussein, M.R., Biscotti, C. and Falcone, T. (2006) Cryopreservation of Intact Human Ovary with Its Vascular Pedicle. Human Reproduction, 21, 3258-3269. http://dx.doi.org/10.1093/humrep/del227
[22]	Kim, S.S. (2010) Time to Rethink: Ovarian Tissue Transplantation versus Whole Ovary Transplantation. Reproductive BioMedicine Online, 20, 171-174. http://dx.doi.org/10.1016/j.rbmo.2009.11.019
[23]	Silber, S., Pineda, J., Lenahan, K., DeRosa, M. and Melnick, J. (2015) Fresh and Cryopreserved Ovary Transplantation and Resting Follicle Recruitment. Reproductive BioMedicine Online, 30, 643-650. http://dx.doi.org/10.1016/j.rbmo.2015.02.010
[24]	Dolmans, M., Marotta, M., Pirard, C., Donnez, J. and Donnez, O. (2014) Ovarian Tissue Cryopreservation Followed by Controlled Ovarian Stimulation and Pick-Up of Mature Oocytes Does Not Impair the Number or Quality of Retrieved Oocytes. Journal of Ovarian Research, 7, 80. http://dx.doi.org/10.1186/s13048-014-0080-8
[25]	Huober-Zeeb, C., Lawrenz, B., Popovici, R.M., Strowitzki, T., Germeyer, A., Stute, P. and von Wolff, M. (2011) Improving Fertility Preservation in Cancer: Ovarian Tissue Cryobanking Followed by Ovarian Stimulation Can Be Efficiently Combined. Fertility and Sterility, 95, 342-344. http://dx.doi.org/10.1016/j.fertnstert.2010.07.1074
[26]	Dittrich, R., Lotz, L., Mueller, A., Hoffmann, I., Wachter, D.L., Amann, K.U., Beckmann, M.W. and Hildebrandt, T. (2013) Oncofertility: Combination of Ovarian Stimulation with Subsequent Ovarian Tissue Extraction on the Day of Oocyte Retrieval. Reproductive Biology and Endocrinology, 11, 19. http://dx.doi.org/10.1186/1477-7827-11-19
[27]	Oktay, K., Türkçüoglu, I. and Rodriguez-Wallberg, K.A. (2010) GnRH Agonist Trigger for Women with Breast Cancer undergoing Fertility Preservation by Aromatase Inhibitor/FSH Stimulation. Reproductive BioMedicine Online, 20, 783-788. http://dx.doi.org/10.1016/j.rbmo.2010.03.004
[28]	Reddy, J., Turan, V., Bedoschi, G., Moy, F. and Oktay, K. (2014) Triggering Final Oocyte Maturation with Gonadotropin-Releasing Hormone Agonist (GnRHa) versus Human Chorionic Gonadotropin (hCG) in Breast Cancer Patients Undergoing Fertility Preservation: An Extended Experience. Journal of Assisted Reproduction and Genetics, 31, 927- 932. http://dx.doi.org/10.1007/s10815-014-0248-6
[29]	González, C., Boada, M., Devesa, M. and Veiga, A. (2012) Concise Review: Fertility Preservation: An Update. Stem Cells Translational Medicine, 1, 668-672. http://dx.doi.org/10.5966/sctm.2012-0076
[30]	Partyka, A., Nizanski, W. and Ochota, M. (2012) Methods of Assessment of Cryopreserved Semen. In: Katkov, I.I., Ed., Current Frontiers in Cryobiology, InTech, Rijeka, 547-575. http://dx.doi.org/10.5772/33565
[31]	Gosden, R.G. (2013) Memoir of Fertility Preservation. In: Kim, S.S., Ed., Oocyte Biology in Fertility Preservation, Advances in Experimental Medicine and Biology, Vol. 761, Springer, New York, 85-94. http://dx.doi.org/10.1007/978-1-4614-8214-7_7
[32]	Tournaye, H., Dohle, G. and Barratt, C.L.R. (2014) Fertility Preservation 1: Fertility Preservation in Men with Cancer. Lancet, 384, 1295-1301. http://dx.doi.org/10.1016/S0140-6736(14)60495-5
[33]	DeVos, M., Smitz, J. and Woodruff, T. (2014) Fertility Preservation 2: Fertility Preservation in Women with Cancer. Lancet, 384, 1302-1310. http://dx.doi.org/10.1016/S0140-6736(14)60834-5