Fertility preservation

Abstract

Advances in early diagnosis and cancer treatment have allowed the quality of life postcancer treatment as a recognized issue, and efforts have been made to preserve the fertility potential. Radiotherapy and chemotherapy have detrimental effects on ovarian reserve. Well-established methods against radiotherapy-induced gonadotoxicity are pelvic shielding or removal of the ovaries from the radiation field. Gonadal toxicity of chemotherapy depends mainly on the type of treatment and patient's age. In vitro fertilization (IVF) and embryo cryopreservation are the most commonly used procedures for females undergoing chemotherapy. Oocyte cryopreservation is a promising method and has the advantage of eliminating the contribution of a partner. Ovarian tissue cryopreservation is experimental and the only method for prepubertal girls. The trend toward delaying child-bearing results in increased prevalence of age-related infertility and has raised debates on social egg freezing in many countries. Fertility preservations options for different indications are discussed in the light of recent literature.