Effects of malignancies on fertility preservation outcomes and relevant cryobiological advances

Sci China Life Sci. 2020 Feb;63(2):217-227. doi: 10.1007/s11427-019-9526-2. Epub 2019 May 22.

Abstract

A decrease in cancer deaths has resulted in the possibility of child bearing for many young adult cancer survivors. Most antitumor treatment modalities are detrimental to female fertility, and methods for fertility preservation before gonadotoxic treatment, including cryopreservation of oocytes, embryos and ovarian tissue, have therefore been developed. This review focuses on the ovarian function of cancer patients, the safety and efficacy of fertility preservation methods, and the pregnancy outcomes of these patients. Breast cancer and hematological tumors constitute the majority of cancers in reproductive-aged female oncology patients. Ovarian function may not be impacted by breast cancer cells, while in patients with hematological malignancies, decreases in anti-Müllerian hormone and antral follicle counts have been demonstrated. In most cases, patients can undergo ovarian stimulation without delaying treatment, and a new stimulation protocol known as dual stimulation, which may be more efficient, has now been developed. Birth outcomes are also acceptable in cancer patients.

Keywords: cancer patients; controlled ovarian stimulation; fertility preservation; safety.

Publication types

  • Review

MeSH terms

  • Anti-Mullerian Hormone / adverse effects
  • Anti-Mullerian Hormone / therapeutic use
  • Breast Neoplasms / complications
  • Breast Neoplasms / physiopathology*
  • Breast Neoplasms / therapy
  • Cryobiology / methods*
  • Cryopreservation / methods
  • Female
  • Fertility Preservation / methods*
  • Hematologic Neoplasms / complications
  • Hematologic Neoplasms / physiopathology*
  • Hematologic Neoplasms / therapy
  • Humans
  • In Vitro Oocyte Maturation Techniques
  • Infertility, Female / metabolism
  • Middle Aged
  • Oocytes / cytology
  • Oocytes / physiology
  • Ovulation Induction
  • Pregnancy
  • Pregnancy Rate

Substances

  • Anti-Mullerian Hormone