Table 1 Recommended fertility preservation methods for women with planned gonadotoxic treatment (German guidelines for fertility preservation [3], Schüring et al. 2018 [4])
From: Motherhood after cancer: fertility and utilisation of fertility-preservation methods
Indication | Treatment | Comment | |
|---|---|---|---|
Hodgkin lymphoma | Fertility preservation is recommended in women with high risk of premature ovarian insufficiency (POI) | The time frame between diagnosis and treatment is often short. Controlled ovarian stimulation and cryopreservation of oocytes is possible, if treatment can be delayed by 2–3 weeks for ovarian stimulation | |
Fertility preservation may be considered in women with low or moderate risk of POI | |||
GnRH agonists, cryopreservation of ovarian tissue and oocytes after ovarian stimulation are adequate options | |||
A combination of fertility preserving methods is possible | |||
Breast cancer | Fertility preservation is recommended | The individual impact on fertility is dependent on the complex oncologic treatment: chemotherapy, antihormonal treatment, time interval until pregnancy, and ovarian aging | |
GnRH agonists, cryopreservation of ovarian tissue and oocytes after ovarian stimulation are adequate options | |||
A combination of fertility preserving methods is possible | |||
Autoimmune diseases | Fertility preservation is recommended before cyclophosphamide treatment | Treatment with GnRH agonists is now established without a specialised counselling process. Due to the need for urgent treatment, methods with cryopreservation are often not available | |
GnRH agonists are a possible option | |||
Cryopreservation of ovarian tissue and oocytes can be applied in individual cases | |||
Non-Hodgkin lymphoma/leukaemia | Fertility preservation is recommended depending on prognosis and treatment | Cryopreservation of ovarian tissue and oocytes after ovarian stimulation are not recommended because of the risk of ovarian metastasis | |
GnRH agonists are an option | |||
Ewing sarcoma | Fertility preservation is recommended depending on the clinical situation | The risk of ovarian metastasis must be discussed | |
GnRH agonists and cryopreservation of oocytes can be considered | |||
Cryopreservation of ovarian tissue is possible | |||