Cryopreservation Of Gametes Research Articles

Cryopreservation, cryoprotectants, and potential risk of epigenetic alteration.

The cryopreservation of gametes and embryos has increased notably over the past 20years and is now an essential part of assisted reproductive technologies (ARTs). However, because the cryopreservationprocess is un-physiological for human cells, gametes, and embryos, cryobiologists have suggested diverse methods to successfully cryopreserve human gametes and embryos in order to maintain their viability and assure successful pregnancy. During the first period of early development, major waves of epigenetic reprogramming-crucial for the fate of the embryo-occur. Recently, concerns relating to the increased incidence of epigenetic anomalies and genomic-imprinting disorders have been reported after ARTs and cryopreservation. Epigenetic reprogramming is particularly susceptible to environmental and un-physiological conditions such as ovarian stimulation, embryo culture, and cryopreservation that might collectively affect epigenetics dysregulation. Additionally, recent literature suggests that epigenetic and transcriptomic profiles are sensitive to the stress induced by vitrification, osmotic shock, oxidative stress, rapid temperature and pH changes, and cryoprotectants; it is therefore critical to have a more comprehensive understanding of the potential induced perturbations of epigenetic modifications that may be associated with vitrification. The aim of this paper is to present a critical evaluation of the association of gamete and embryo cryopreservation, use of cryoprotectants, and epigenetic dysregulations with potential long-term consequences for offspring health.

Male Gamete Cryopreservation for Adolescent Fertility Preservation: Our Experience to Date

Male Gamete Cryopreservation for Adolescent Fertility Preservation: Our Experience to Date

Trehalose, Glycerol and Dimethyl Sulfoxide Supplementation for Cryopreservation Media of Honey Bee Drone Semen

The cryogenic storage of honey bee drone (Apis mellifera) semen is a rapidly developing practice, driven by the need to preserve bee colonies and the decline in gamete quality following cryopreservation. Advances in cryobiology, coupled with procedural refinements and the development of new methods for cryopreservation of male gametes at different temperatures, provide promising results for improving drone semen preservation. Innovative strategies involve the incorporation of additives within preservation media to enhance important spermatozoa parameters. Our study aimed to assess the effectiveness of cryoprotectants (CPAs), namely trehalose, glycerol, and dimethyl sulfoxide (DMSO), on the motion characteristics of honey bee drone sperm cells during cryopreservation and subsequent thawing. Using Sperm Class Analyzer (SCA) and Computer-Assisted Sperm Analysis (CASA), we evaluated the impact of these supplements on sperm motility and kinetic parameters. Our findings indicated significant differences in sperm motility (non-progressiveness and progressiveness) and kinetics (curvilinear velocity and linearity) across treatments with trehalose, DMSO, and glycerol. Trehalose supplementation retained significantly higher percentages of sperm motility and kinetic parameters post-cryopreservation compared to DMSO and glycerol. Nevertheless, despite the utilization of new protocols, media, and supplementation, the results obtained are often unsatisfactory. The research provides valuable information for enhancing the efficacy of cryopreservation media to optimize the successful outcome of honey bee drone spermatozoa storage.

P-220 Two strategies for reducing cryoprotectant toxicity: recent trends in oocyte, embryo and tissue cryopreservation

Abstract Study question In this study, we demonstrate two methods to reduce the toxicity of cryoprotectants. Both have been tested in cells and tissues Summary answer Employing both the theoretical model of the incubation process and an ultra-rapid rewarming based on high-intensity focused ultrasound, it is possible to reduce this toxicity What is known already Cryoprotectants used in assisted reproduction for the cryopreservation of gametes, embryos, or ovarian or testicular tissue are based on DMSO, ethylene glycol, glycerol, etc. ... Minimizing exposure to these substances is always desirable. In this work, we show how, by modeling the hydraulic permeability of the embryo membrane and by the practical application of high-intensity focused ultrasound, it is possible to drastically reduce the biological material’s exposure to these agents. The former achieves a 90% reduction in incubation times in the cryoprotectant. The latter significantly increases the speed of rewarming, thereby reducing the amount of cryoprotectant needed for tissue recovery. Study design, size, duration The system was modeled using computer simulations based on MATLAB algorithms. It has been verified that in 1 minute, 90% of the cryoprotectant penetrates the embryo. The results have been experimentally validated in human embryos and oocytes. Regarding rewarming, High-Intensity Focused Ultrasound (HIFU) has achieved rewarming rates two orders of magnitude higher than standard rewarming. This has enabled the recovery of tissue samples that otherwise would not have been viable. Participants/materials, setting, methods For this study, donated oocytes and embryos were used. The MATLAB programming language was utilized for computer simulations. For ultrasonic rewarming, a piezoelectric excited at a frequency of 1.2 MHz and 60VDC was used. Standard vitrification was compared with our toxicity reduced protocol in the case of oocytes and embryos, Standard slow freezing was used in the case of rewarming with high intensity focused ultrasound. Main results and the role of chance The application of mathematical modeling, together with the experimental resultas on oocytes and embryos, demonstrate that is it possible to reduce in 90% the toxicity of the cryoprotectant in a typical vitrification protocol. Also, the application of High Intensity Focused Ultrasound reaches warming rates that are two orders of magnitud higher than the conventional rewarming in a water bath. This finding represent a significative improvement of the present cryopreservation protocols. The success of both strategies is demonstrated, both in reducing incubation time and the superiority of rewarming using ultrasound. The study is generally applicable to oocytes, sperm, embryos, ovarian and testicular tissue. Limitations, reasons for caution No limitations. Wider implications of the findings We believe that these findings will soon be adopted by centers where the cryopreservation of biological material is necessary. Trial registration number NOT APPLICABLE

Barriers to fertility preservation access in transgender and gender diverse adolescents: a narrative review.

Fertility preservation (FP) involves the cryopreservation of gametes, embryos, and/or gonadal tissue oocytes, for future use in family building. FP as part of a comprehensive approach to care of transgender and gender diverse (TGD) individuals is an understudied topic. Current evidence indicates that gender affirming therapies may increase the risk for infertility. As a result, TGD individuals, including adolescents, should receive counseling regarding FP prior to beginning gender affirming treatment. Many barriers exist to TGD adolescents receiving FP counseling and undergoing FP if desired. The objective of this narrative review is to summarize the literature regarding the desire for FP in TGD adolescents, the barriers to TGD adolescents in accessing of FP, and to discuss potential interventions for alleviation of such barriers. A literature search using the following Medical Subject Headings search terms: 'transgender persons' and 'fertility preservation' and 'adolescents' was conducted via searching PubMed. Additional articles were located via reference review. Included articles consist of qualitative and quantitative research and society guidelines. Articles from inception to 1st July 2023 were included. The results of the literature search have been summarized into the format of a narrative review. Key barriers to FP for TGD adolescents include inconsistencies in form and timing of counseling, potential worsening of gender dysphoria with FP treatment, high cost of treatment, limited research on FP outcomes, and legal barriers. Intersectionality between gender identity and other forms of minority status can compound these barriers to FP and healthcare in general. Barriers to TGD adolescents accessing FP are significant. Increased research is needed upon methods to mitigate these barriers. Solutions include increasing uniformity and timing of FP counseling by varying health care providers, advocacy efforts to mitigate legal and financial barriers, increased research efforts in FP outcomes, and increased cultural competency in clinics offering FP care to TGD adolescents.

Problems of cryopreservation of male gametes of Gallus gallus domesticus – the role of membrane lipids (review)

The review reveals the current state of knowledge of the plasma membranes molecular composition of rooster spermatozoa and its role in maintaining the morphofunctional integrity of cells under low-temperature stress. The use of the method of cryopreservation of the semen in poultry breeding is still in the field of scientific development, since the level of fertility of the frozen-thawed semen is not high enough to be used for application in the commertial poultry flocks. When solving the problems of improving the quality of thawed roosters semen it is necessary to rely on the effectiveness of cryoprotective media, as well as to determine the most vulnerable organells of structure of the spermatozoa apparatus during freezing. Rooster spermatozoa are surrounded by a unique plasma membrane, which includes a high content of polyunsaturated fatty acids (PUFAs), sterols, a number of phospholipids, glycolipids, which play an important functional role in the interactions between spermatozoa and oocytes and affect their ability to fertilize. The study of the lipid composition of the cell plasma membranel and its dynamic state is necessary to identify the key factors of cell cryoresistance; the manifestation of their quantitative and qualitative changes may indicate a possible degradation occurring inside the cells under conditions of low-temperature stress. This review presents the results of studies proving the exceptional role of the lipid composition of spermatozoa membranes in the mechanisms of cell cryoresistance and the preservation of their morphofunctional usefulness under thermal stress.

Embryological Perspectives on Gamete and Embryo Donation

This article addresses the issue of gamete and embryo donation from the perspective of the assisted reproduction laboratory, where the so-called "clinical" embryologists work making all the current variants of in vitro fertilization including the andrology laboratory, oocyte collection, conventional insemination or through ICSI, embryo culture, gamete and embryo quality evaluation, embryo transfer, cryopreservation of gametes and embryos, preimplantation genetic studies, results analyses and quality control, assessment and improvement. To think that the responsibility of an ART laboratory only attains the strictly technical or logistical areas is an error or a simplification that excludes embryologists from other important matters. Clinical embryologists have the obligation to ensure that procedures follow strict ethical rules, highlight deviations or errors from these canons, and refuse to act in cases of violation of said standards. Donating embryos to assist in others´ efforts on building a family is an important option for patients who are considering the disposal of cryopreserved embryos, in excess those needed to meet their own fertility goals.
 Gamete donation, a more widespread procedure, can help us to better understand certain aspects of embryo donation. Donation must be a free transaction, not influenced by guilt or any other type of pressure or coercion of any kind.
 We are facing a totally new issue because we are the only species on the planet that can manipulate our own gametes and embryos in a context where assisted reproduction represents a dramatic challenge to the social values that govern our way of being born, without precedent in human history.
 
 

Creation of a Biobank of the Sperm of the Honey Bee Drones of Different Subspecies of Apis mellifera L.

The cryopreservation of gametes and embryos is an important element of biodiversity conservation. One species in need of conservation is the honey bee Apis mellifera L. Changing environmental factors, especially the anthropogenic factor, have led to a reduction in the numbers of this insect species. In this study, we provide an example of the creation of a biobank of honey bee drone sperm. For sperm cryopreservation, drones of the most common subspecies of honey bees common in Russia were selected. These were the dark forest bee, Apis mellifera mellifera, from the Republic of Bashkortostan, with three subspecies (A. m. carnica, A. m. carpatica, and A. m. caucasica) from the southern regions of Russia, as well as two breeding stocks, the Far Eastern bee and Prioksky bee. For subspecies identification, morphometric and genetic methods were used. The subspecies of the studied samples were confirmed via the analysis of the tRNAleu-COII locus of mitochondrial DNA and nine microsatellite markers of nuclear DNA. It was shown that bees of the Prioksky breeding stock belong to the subspecies A. m. caucasica based on phylogenetic analysis, and the Far Eastern breeding stock is a stable hybrid, descending on the maternal line from the evolutionary lineage C or O. The results of the morphometric analysis are consistent with the results of the genetic analysis. For the cryopreservation of sperm, we used a cryoprotectant solution with honey. As a result, the viability of frozen–thawed sperm decreased by 20.3% compared to fresh sperm, and overall motility decreased 25-fold. The measurement of the sperm concentration in the spermatheca of artificially inseminated queens showed that it varied from 0.22 to 4.4 million/μL. Therefore, the use of honey in sperm cryopreservation has great potential.

Semen Cryopreservation to Expand Male Fertility in Cancer Patients: Intracase Evaluation of Semen Quality.

To preserve male fertility after diagnosis of any kind of cancer, a prompt assessment of the semen quality and an appropriate semen cryopreservation must be performed before radio-chemotherapy starts. The present work aims to evaluate the semen parameters at diagnosis of different cancer patients before cryopreservation and after thawing. Testicular tumors and lymphomas are among the most common cancers in younger patients, and while chemotherapy significantly increases patients' survival, it can epigenetically alter the semen fluid, resulting in temporary or permanent infertility. We analyzed data from the database of the Gamete Cryopreservation Center (Annunziata Hospital, CS; Italy) in the period of 2011-2020 from a cohort of 254 cancer patients aged 18-56 years. The evaluation was performed in a blind manner and anonymously recovered; the main parameters referring to semen quality were assessed in accordance with the WHO guidelines and decision limits (6th edition; 2021). The cancer types were as follows: testis cancers (TC; n = 135; 53.1%), hematological cancers (HC; n = 76; 29.9%), and other types of cancer (OC; n = 43; 17%). Comparing TC vs. HC (P1) and vs. OC (P2), TC had the worst semen quality: sperm number/mL (P1 = 0.0014; P2 = 0.004), total motility (P1 = 0.02; P2 = 0.07), progressive motility (P1 = 0.04; P2 = 0.05), viability (P1 = 0.01; P2 = 0.02), and percentage of atypical morphology (P1 = 0.05; P2 = 0.03). After semen thawing, viability and progressive motility recovery lowered, accounting for 46.82% and 16.75%, respectively, in the whole cohort; similarly, in the subgroups ascribed to TC, they showed the lowest recovery. Strong correlation existed between pre- and post-cryopreservation viability and progressive motility in the whole cohort (p < 0.001) and in the TC subgroup (p < 0.05). All cancer subgroups, to significantly different extents, had semen findings below the WHO reference values, suggesting diverse sperm susceptibilities to different cancers and cryodamage. Cancer and associated treatments epigenetically affect patients' semen quality, meaning cryopreservation should be considered a useful personalized prerogative for any kind of cancer in a timely manner.

Fertility preservation before and after cancer treatment in children, adolescents, and young adults.

Fertility is a top concern for many survivors of cancer diagnosed as children, adolescents and young adults (CAYA). Fertility preservation (FP) treatments are effective, evidence-based interventions to support their family building goals. Fertility discussions are a part of quality oncology care throughout the cancer care continuum. For nearly 2 decades, clinical guidelines recommend counseling patients about the possibility of infertility promptly at diagnosis and offering FP options and referrals as indicated. Multiple guidelines now recommend post-treatment counseling. Infertility risks differ by cancer treatments and age, rendering risk stratification a central part of FP care. To support FP decision-making, online tools for female risk estimation are available. At diagnosis, females can engage in mature oocyte/embryo cryopreservation, ovarian tissue cryopreservation, ovarian suppression with GnRH agonists, in vitro oocyte maturation, and/or conservative management for gynecologic cancers. Post-treatment, several populations may consider undergoing oocyte/embryo cryopreservation. Male survivors' standard of care FP treatments center on sperm cryopreservation before cancer treatment and do not have the same post-treatment indication for additional gamete cryopreservation. In practice, FP care requires systemized processes to routinely screen for FP needs, bridge oncology referrals to fertility, offer timely fertility consultations and access to FP treatments, and support financial navigation. Sixteen US states passed laws requiring health insurers to provide insurance benefits for FP treatments, but variation among the laws and downstream implementation are barriers to accessing FP treatments. To preserve the reproductive futures of CAYA survivors, research is needed to improve risk stratification, FP options, and delivery of FP care.

Fertility Preservation Options for Transgender Patients: An Overview

Fertility preservation technologies have existed for decades, and the field is rapidly advancing; limited data exist regarding the use of these technologies by transgender patients. Many options are available for transgender patients who wish to preserve fertility before transitioning. These options include the cryopreservation of gametes, embryos, or ovarian tissue. Currently, ejaculated, or testicular sperm, immature oocytes, and ovarian tissue can be preserved for later use, but no such use option exists for immature testicular tissue. Many financial, sociological, and legal barriers and a lack of awareness among physicians and patients also hinders the utilization of these fertility preservation services. While options are abundant, usage rates are relatively low. The initial data regarding the successful use of preserved tissues appears promising, with birth rates not dissimilar to non-transgender patients. Further investigations into this area are needed. In addition, counseling regarding fertility preservation options should become a significant part of the provider-patient conversation before transitioning therapies.

Cryopreservation Cooling Rate Impacts Post-Thaw Sperm Motility and Survival in Litoria booroolongensis.

The cryopreservation and storage of gametes (biobanking) can provide a long-term, low-cost option for the preservation of population genetic diversity and is particularly impactful when applied to manage selective breeding within conservation breeding programs (CBPs). This study aimed to develop a sperm cryopreservation protocol for the critically endangered Booroolong frog (Litoria booroolongensis) to capture founder genetics within the recently established (est. 2019) CBP for this species. Hormone-induced sperm release was achieved using established protocols, and spermic urine samples were collected over a 6-h period. Pooled spermic urine samples (n = 3 males) were divided equally between two cryoprotectant (CPA) treatments and diluted by 1:5 (sperm:CPA) with either 15% (v/v) dimethyl sulfoxide + 1% (w/v) sucrose in simplified amphibian Ringer's (SAR; CPAA) or 10% (v/v) dimethylformamide + 10% (w/v) trehalose dihydrate in SAR (CPAB). The samples were cryopreserved in 0.25 mL straws using either a programmable freezer (FrA) or an adapted dry shipper method (FrB). The thawed samples were activated via dilution in water and assessed for viability and motility using both manual assessment and computer-assisted sperm analysis (CASA; 0 h, 0.5 h post-thaw). Upon activation, the survival and recovery of motility (total motility, forward progression and velocity) of cryopreserved sperm suspensions were higher for sperm preserved using FrB than FrA, regardless of CPA composition. This work supports our long-term goal to pioneer the integration of biobanked cryopreserved sperm with population genetic management to maximize restoration program outcomes for Australian amphibian species.

Lipid modification to improve cryotolerance of gametes, embryos and larvae and its potential application in aquaculture species: a review

Cryopreservation is a technique to maintain biological materials’ physiological and genetic stability at an ultralow temperature. For commercially important livestock or aquatic species, gamete and embryo cryopreservation could play a significant role in breeding programs and commercial production. For example, it could help overcome key problems such as asynchronous maturation and an unbalanced sex ratio. However, the physiochemical stresses imposed by cryopreservation can negatively affect gametes and embryos, leading to a poor survival rate. Recent studies on cryoinjury have demonstrated that the cryosensitivity of lipids is one of the key causes of cryodamage in mammalians, as lipid compositions in membranes of gametes and embryos are closely related to their cryoresistance. In addition, the cryotolerance of gametes and embryos in some mammalian species has been improved by lipid modification. However, studies on the role of lipids in the cryopreservation of gametes, embryos, and larvae are rare in fish and shellfish. Therefore, this review focuses on recent methodological advances to improve cryotolerance by lipid modification, including lipid application or manipulation in human and livestock sperm, oocytes, and embryos, and how these novel approaches could improve cryopreservation techniques in aquatic species, especially for oocytes and embryos.

O-276 Fertility preservation and sperm quality in adolescent transgender patients prior to hormonal treatment

Abstract Study question This study investigated the take-up, hormonal profile and sperm quality in adolescents undergoing fertility preservation via different methods, prior to medical intervention for gender dysphoria. Summary answer Fertility preservation via surgical sperm retrieval (SSR) or masturbation, is possible in this group, however long-term data is required to check gamete health. What is known already As increasing numbers of adolescents with gender dysphoria (GD) start gonadotrophin-releasing hormone agonists (GnRHa) to delay puberty to minimise psychological distress. However, the uncertainty of the long-term effects of these medications highlights the importance of undergoing fertility preservation (FP) prior to starting any hormone treatment. Study design, size, duration Data for adolescents wanting to FP was prospectively maintained. A total of 122 patients were referred for FP, of which 23 declined (19%). Participants/materials, setting, methods Young people were counselled for FP and serum testosterone, FSH, and LH were recorded prior to providing semen samples. Semen samples were classified by concentration; normal &amp;gt;15mil/ml, oligospermia &amp;lt;15mil/ml, poor &amp;lt;1sperm/slide, azoospermia. Insufficient samples, or unwillingness to masturbate, meant SSR was offered in a stepwise manner using electroejaculation (EE), TESE and mTESE. Main results and the role of chance Most patients (n = 78, 64% - median age 16.7) were able to produce semen by masturbation, cryopreserving an average of 6.6 straws. Sperm concentration was normal in 44% of samples produced, 36% were oligozoospermic, 9% were poor sperm concentration, and 12% were azoospermic. Mean blood results showed: testosterone 12.32nmol/l, FSH 3.83 IU/L, LH 4.39 IU/L. 21 patients required SSR - median age of 14.9. EE was successful in 4 patients, 9 underwent TESE, and 8 underwent mTESE. 4 mTESE patients were azoospermic. Success rate was 77%, with an average of 5.5 vials stored. Semen parameters in this cohort were poor - however possibly adequate for ICSI. Hormone levels were similar to the masturbation cohort: mean testosterone 11.7nmol/l, FSH 3.4 IU/L, LH 3.5 IU/L. 3 patients used GnRHa pre-SSR. Following a washout period, 1 patient remained azoospermic despite a testosterone of 21 nmol/l. The other 2 patients had sperm found with abnormal morphology and motility. This is the largest UK cohort of transgender girls referred for FP. The results showed that semen parameters were abnormal in 67% of the masturbation samples produced, and within the SSR group, all patient’s testosterone levels were &amp;gt;8nmol/l, with an average of 5.5 vials saved. Limitations, reasons for caution The quantity of long-term data on whether adolescents end up using their gametes post FP is a factor to consider with this study, as more evidence is needed in order to display the actual long-term usage of gamete cryopreservation. Wider implications of the findings Masturbation is often possible in this group, but alternatively, SSR provides patients with a safe opportunity to potentially have their own biological children in the future. Trial registration number not applicable

Response to Controlled Ovarian Stimulation Is Not Impaired in Young Patients with a Sarcoma: Results from a Monocentric Case-Control Study.

Sarcomas are relatively common in the young and their treatment can impair fertility. Fertility preservation can be achieved via the cryopreservation of gametes after controlled ovarian stimulation before cancer treatment. A reduced response to hormonal stimulation in patients suffering from certain types of malignancy is reported. The purpose of this study was to assess the performance of oocyte cryopreservation in patients with sarcoma by comparing their outcomes with those of a population without cancer. Patients were matched by age with control women undergoing hormonal stimulation for isolated male factor infertility. The population included 84 women with a sarcoma and 355 controls. In the final analysis, 37 patients with sarcoma were matched in a 1:3 ratio with 109 healthy controls. Patients with sarcoma were generally younger and were stimulated with lower FSH doses. They did not perform worse than controls during stimulation, with an average retrieval of 10.6 oocytes vs. 8.1 in the controls. Linear regression on the number of retrieved mature oocytes confirmed that patients with sarcoma performed comparably to controls. In conclusion, patients with sarcoma can expect retrieval outcomes comparable to those of patients without cancer.

Assessment of male reproductive traits in endangered leuciscids from the Iberian Peninsula: first attempts to store gametes both at short- and long-term

During the spring of 2022, several endangered leuciscid species (Anaecypris hispanica, Squalius aradensis, Anachondrostoma Occidentale, and Iberochondrostoma lusitanicum) were sampled both at the Vasco da Gama aquarium facilities and in some rivers of the Algarve region, Portugal. Sperm samples were extracted by gentle abdominal pressure and sperm motion parameters were assessed for the first time in four species, using a computerized analysis system. The results obtained showed that spermatozoa kinetic patterns were similar for all 4 species, with high motility and velocity values after the sperm activation time and with a marked decrease after 20. On the other hand, sperm longevity was highly variable between species, with short longevities (around 40s) for A. hispanica and S. aradensis, and longer longevities (100-120s) for A. occidentale and I. lusitanicum, which could indicate a latitudinal pattern in terms of sperm longevity. At the same time, morphometric analysis was carried out for the four target species, revealing that spermatozoa showed similar sizes and shapes to other external fertilizers belonging to Leuscididae, with small spherical heads, uniflagellate, and without acrosomes. In addition, a short-term gamete storage trail was performed by diluting sperm in 1:9 (sperm:extender) and storing them at 4ºC. Although the results obtained were uneven among the species studied, the dilution and extender used generated motilities above 40% up to day 4 of storage in S. aradensis and I. lusitanicum, and up to days 1-2 in A. hispanica and A. occidentale, respectively. Finally, gamete cryopreservation trials were also carried out on these threatened species. Although cryopreserved samples showed significantly lower motility than fresh samples, some protocols generate acceptable percentages of viability, DNA integrity, and sperm motility in some species such as I. lusitanicum and A. occidentale. The data revealed that the protocol based on 10% DMSO plus 7.5% egg yolk generated the best results.This study is the first to assess the reproductive traits of wild and captive populations of endangered leuciscids endemic from the Iberian Peninsula, describing the spermatozoa kinetics and developing protocols for managing male gametes both in short- and long-term storage. Outcomes will provide new and useful tools to complement the management and conservation of ex situ breeding programs that are being developed for these four endangered species.

Abstract ED3-3: Oncofertility and other quality of life issues

Abstract The current availability of effective systemic treatment strategies has significantly improved the prognosis of patients with early breast cancer. However, this survival gain is often obtained at the cost of higher toxicity. The increase in life span among breast cancer survivors calls for the need to address both early and late potential adverse effects of anticancer therapies to maximize their quality of life. Among them, the potential gonadotoxicity of anticancer therapies and its implications on fertility and ovarian function need to be discussed with all young patients. According to available guidelines, oncofertility counseling should now be considered mandatory in the care of young women with newly diagnosed cancer. This counselling should focus on the risk of developing treatment-induced premature ovarian insufficiency and on the available techniques to preserve fertility and/or ovarian function. Oocyte/embryo cryopreservation, or ovarian tissue cryopreservation in those not eligible for gamete cryopreservation, are standard strategies to be offered to young patients interested in preserving fertility, i.e. to increase their chances of post-treatment pregnancies. Ovarian suppression with gonadotrophin-releasing hormone agonists (GnRHa) during chemotherapy can be offered to premenopausal patients interested in ovarian function preservation, i.e. to decrease their risk of developing chemotherapy-induced early menopause. Current available data confirm that pregnancy occurring following proper treatment for breast cancer and period of follow-up is safe, both in terms of long-term clinical outcomes for the patients and safety for the babies. However, there is a slightly higher incidence of obstetric and birth complications that require the need for a closer monitoring of these pregnancies. Beyond fertility and pregnancy-related issues, a long-term follow-up of young women with breast cancer by the oncofertility unit is recommended for improving the management of other additional gynecological-related issues faced by these women. Among them, contraception should be considered during active treatment and in the follow-up of women who do not wish to get pregnant. Moreover, in the current era of more complex endocrine therapy approaches with a major negative impact on the quality of life of premenopausal patients with breast cancer, it is essential to properly and proactively care about their treatment-related side effects. Among them, menopause related-symptoms and sexual dysfunction may be better managed by implementing a close collaboration between oncologists and gynecologists within the oncofertility unit. Citation Format: Matteo Lambertini. Oncofertility and other quality of life issues [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr ED3-3.

Ethical Need for a Fertility Decision-Aid for Transgender Adults of Reproductive Age

Ethical Need for a Fertility Decision-Aid for Transgender Adults of Reproductive Age

Investigation of motivations for depositing sperm during the COVID-19 pandemic

People are becoming parents later in life and with increased parental age adverse reproductive outcomes are increased. Cryopreservation of gametes enables men and women to protect, prolong and seemingly preserve their fertility. Social freezing is an increasingly popular way of cryopreservation. During the COVID-19 pandemic, the gamete bank Cryos International experienced an increased influx of men wanting to deposit their sperm. A questionnaire-based study was initiated to investigate their motivations for doing so. The results showed that the men chose to deposit mainly due to medical indications (e.g. cancer and sex change), and that the COVID-19 pandemic had no significant influence on the reason for banking their sperm. Investigations into the altruistic reasons for depositing sperm (i.e. caring for reproductive masculinity) could shed new light onto the sparsely studied topic of male reproductive journeys.

Cryopreservation of Gametes, Embryos and Ovarian Tissue as a Method for Fertility Preservation in Oncological Patients

Cryopreservation of Gametes, Embryos and Ovarian Tissue as a Method for Fertility Preservation in Oncological Patients