Home > Riviste > Minerva Ginecologica > Fascicoli precedenti > Minerva Ginecologica 2017 February;69(1) > Minerva Ginecologica 2017 February;69(1):57-67

ULTIMO FASCICOLO
 

ARTICLE TOOLS

Publication history
Estratti
Per citare questo articolo

MINERVA GINECOLOGICA

Rivista di Ostetricia e Ginecologia


Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Scopus, Emerging Sources Citation Index


eTOC

 

REVIEW  


Minerva Ginecologica 2017 February;69(1):57-67

DOI: 10.23736/S0026-4784.16.03992-7

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Assessment of ovarian reserve and fertility preservation strategies in children treated for cancer

Laura GUZY 1, Isabelle DEMEESTERE 2, 3

1 Obstetrics and Gynecology Department, Saint-Pierre Hospital, Brussels, Belgium; 2 Research Laboratory on Human Reproduction, Université Libre de Bruxelles, Brussels, Belgium; 3 Obstetrics and Gynecology Department, Erasme Hospital, Brussels, Belgium


PDF  


INTRODUCTION: The survival rate of chemotherapy treatments of malignant cancer or non-malignant conditions are continuously improving. As a result, there is an increased number of patients who received a gonadotoxic treatment during childhood and who later face fertility issues. Depending on the extent of the damage to the ovaries, acute or late complications may occur. Acute ovarian failure is defined by permanent amenorrhea after a high-risk treatment. When the drugs used are less gonadotoxic, ovarian insufficiency might appear later. This literature review will review both the current solutions for management of high-risk patients and the care options for low and medium risk patients.
EVIDENCE ACQUISITION: For each patient the risk of premature ovarian insufficiency should be evaluated individually before treatment. Guidelines clearly recommend to preserve fertility of high-risk group before treatment, but questions remain about the future counselling of patients with low or moderate risk.
EVIDENCE SYNTHESIS: Demand for fertility preservation methods has greatly increased. In this context, studies focusing on the best fertility preservation methods for patients, either before chemotherapy for the high-risk group or during the follow-up for the others, are essential. For the high-risk group, ovarian tissue cryopreservation is the only option for prepubertal girls. For postpubertal girls, oocytes vitrification could also be offered.
CONCLUSIONS: The risk of premature ovarian failure must be evaluated for each patient treated with gonadotoxic therapies. Fertility preservation must be offered in high-risk patients and appropriate follow-up should be proposed to anticipate later fertility issue in low and medium risk patients.


KEY WORDS: Fertility preservation - Child - Drug therapy - Neoplasms - Ovarian reserve

inizio pagina

Publication History

Issue published online: January 20, 2017
Article first published online: October 25, 2016

Per citare questo articolo

Guzy L, Demeestere I. Assessment of ovarian reserve and fertility preservation strategies in children treated for cancer. Minerva Ginecol 2017;69:57-67. DOI: 10.23736/S0026-4784.16.03992-7

Corresponding author e-mail

idemeest@ulb.ac.be