Advances in Fertility Preservation in Young Female Cancer Patients

Abstract

Most female cancer patients of reproductive age do not have the option of utilising in vitro fertilisation (IVF) and embryo cryopreservation to safeguard their fertility. Indeed, in many cancers chemotherapy is initiated soon after diagnosis. For patients who require immediate chemotherapy, or those with hormone-sensitive cancer or who are still pre-pubertal, the practice of oocyte and ovarian tissue cryopreservation has rapidly become the technique of choice, although it remains experimental. Cryopreservation of oocytes can be performed in single women who are able to undergo a stimulation cycle, but the effectiveness of this technique is still low, with delivery rates of 1–5% per frozen–thawed oocyte. Nevertheless, since the recent introduction of oocyte vitrification, the delivery rates are about two-fold per thawed oocyte. Cryopreservation of ovarian tissue is the only option available for pre-pubertal girls and for woman who cannot delay the start of chemotherapy. Ovarian cryopreservation and transplantation procedures have so far yielded six live births in humans after autologous transplantation.