Fertility Preservation Issues Research Articles

Reproductive Health Issues in Women With Cancer

According to the American Cancer Society, approximately 679,000 women are newly diagnosed with cancer in the United States annually, and approximately 10% of these cancers occur in women of reproductive age, with 1 per 1,000 in pregnant women.1–3 To achieve the primary objective of cancer treatment—survival—reproductive health issues including fertility conservation, contraception, and pregnancy are often overlooked. However, these challenging issues are critical to providing a complete continuum of care for women with cancer. Although a growing body of literature addresses the issue of fertility preservation for reproductive-aged women with cancer, very little pertains to the other facets of reproductive health. In this article, we describe six cases that illustrate some of the challenges of caring for reproductive-aged cancer patients who become pregnant, desire child bearing, or desire effective contraception.

Ethical issues in fertility preservation for adolescent cancer survivors: oocyte and ovarian tissue cryopreservation

Oocyte and ovarian tissue harvesting and implantation may one day restore fertility in adolescent cancer survivors. Discussion ensues regarding ways to respect patients and address ethical issues in future clinical trials. Study objectiveTo offer a normative analysis of ethical issues in oocyte and ovarian tissue cryopreservation and implantation for adolescent cancer survivors. DesignNormative ethical analysis. Results and conclusionOocyte and ovarian tissue harvesting and implantation hold promise in restoring fertility in adolescent cancer survivors; however, more research is required before adolescents can ethically be enrolled in clinical trials. As these methods advance, clinician investigators serve these patients best by (1) ensuring that the intervention does not harm the patient by delaying cancer treatment; (2) ensuring that no remnant cancer cells will be reintroduced in transplantation or fertilization; (3) preventing damaged cryopreserved oocytes from being fertilized and implanted; (4) seeking informed assent from adolescent patients and informed consent from their parents or guardians; (5) developing policies to protect the patient's future rights to her gametes; (6) developing policies addressing the disposition of gametes if the patient dies; and (7) respecting the patient by protecting her from harm while also honoring her right to self-determination.