Cryopreservation of ovarian tissue in girls with oncological diseases: a multidisciplinary approach

Abstract

The issues concerning quality of life are becoming increasingly important with the improvement of survival rates in children with cancer. The possibility of minimizing the toxicity of antitumor therapy for various organs and systems without reducing the effectiveness of specific therapy, as well as the development of preventive measures, is now an important task of medical specialists. Gonadal toxicity is a frequent adverse event that negatively affects both the somatic and psychological and emotional state of the cured patients. The only prospect of reproductive function preserving in a cohort of prepubertal girls with a high risk of premature ovarian failure is the ovarian tissue cryopreservation. The main goal of this publication is to emphasize the importance of the reproductive health problem of girls with oncological diseases, with a description of the current data of international literature on the prospects of ovarian tissue cryopreservation in order to preserve fertility. Another goal is to present a multidisciplinary strategy for the management of prepubertal age patients with oncological disease within the framework of the Oncological Fertility Project at Almazov National Medical Research Center. Based on the data of Russian and international literature, as well as existing guidelines and recommendations on reproductive health, a single algorithm for selecting patients has been developed, considering the expected gonadal toxicity for the use of the ovarian cryopreservation method in prepubertal girls. Carrying out of all the steps is possible in the optimal terms of antitumor therapy in the conditions of one hospital with observance of the stages of medical aid provision. The developed algorithm will allow to identify patients of prepubertal age, requiring the use of modern possibilities of reproductive technologies. In long-term date we are planning to evaluate the effectiveness of the orthotopic reimplantation technique for cryopreserved ovarian tissue in order to realize the reproductive function. A multidisciplinary team of specialists and the possibilities of the federal center fully allow to realize the Oncofertility Program in daily practice for girls and young women who needs to undertake gonadotoxic treatment.