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Oncofertility: a Review

  • Reproductive Endocrinology and Infertility (REI) (R Anchan, Section Editor)
  • Published:
Current Obstetrics and Gynecology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The purpose of this review is to describe the latest methods of fertility preservation for female cancer patients, as well as the associated psychological benefits, pregnancy outcomes, and oncological outcomes of these techniques.

Recent Findings

Using random-start controlled ovarian stimulation for embryo and oocyte cryopreservation provides adequate oocyte yield and minimizes delay to starting cancer treatment. Protocols including estrogen-lowering medications should be used in women with hormone-sensitive cancers. Newer methods including ovarian tissue cryopreservation and ovarian transposition have promising pregnancy outcomes. Ovarian suppression helps prevent premature ovarian failure in young women with breast cancer and women who require rapid start systemic cancer treatment. Fertility-sparing surgery is safe in women with early-stage cervical and ovarian cancer. Providing counseling regarding fertility preservation yields significant psychological benefits for patients.

Summary

Improved cancer survival and delayed childbearing have resulted in a greater need for fertility preservation for female cancer patients. The most commonly used fertility preservation strategy is controlled ovarian stimulation (COS). A number of new studies provide data on ways to maximize COS such as through use of random-start protocols and the addition of medications that lower estrogen levels. Recent research also suggests that newer methods including ovarian tissue cryopreservation and ovarian transposition may provide valuable alternatives to COS. However, many topics remain controversial, including where to re-transplant cryopreserved ovaries, the best surgical approach to ovarian transposition, short- versus long-term benefits of ovarian transposition, and the role of ovarian suppression for fertility preservation.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, USA

    Mackenzie N. Naert & Anna Greer

  2. Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Kevin M. Elias

  3. Dana-Farber Cancer Institute, Boston, MA, USA

    Kevin M. Elias

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  1. Mackenzie N. Naert
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Correspondence to Mackenzie N. Naert.

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Naert, M.N., Greer, A. & Elias, K.M. Oncofertility: a Review. Curr Obstet Gynecol Rep 10, 83–91 (2021). https://doi.org/10.1007/s13669-021-00312-5

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