Practical recommendations for fertility preservation in women by the FertiPROTEKT network. Part I: Indications for fertility preservation.
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BORIS DOI
Publisher DOI
PubMed ID
29177593
Description
PURPOSE
Most guidelines about fertility preservation are predominantly focused on scientific evidence, but are less practically orientated. Therefore, practically oriented recommendations are needed to support the clinician in daily practice.
METHODS
A selective literature search was performed based on the clinical and scientific experience of the authors, focussing on the most relevant diseases and gynaecological cancers. This article (Part I) provides information on topics that are essential for the fertility preservation indication, such as disease prognosis, disease therapy and its associated risks to fertility, recommending disease-specific fertility preservation measures. Part II specifically focusses on fertility preservation techniques.
RESULTS
In breast cancer patients, fertility preservation such as ovarian tissue and oocyte cryopreservation is especially recommended in low-stage cancer and in women < 35 years of age. In Hodgkin's lymphoma, the indication is mainly based on the chemotherapy regime as some therapies have very low, others very high gonadotoxicity. In borderline ovarian tumours, preservation of fertility usually is achieved through fertility sparing surgery, ovarian stimulation may also be considered. In cervical cancer, endometrial cancer, rheumatic diseases and other malignancies such as Ewing sarcoma, colorectal carcinoma, non-Hodgkin lymphoma, leukaemia etc., several other factors must be considered to enable an individual, stage-dependent decision.
CONCLUSION
The decision for or against fertility preservation depends on the prognosis, the risks to fertility and individual factors such as prospective family planning.
Most guidelines about fertility preservation are predominantly focused on scientific evidence, but are less practically orientated. Therefore, practically oriented recommendations are needed to support the clinician in daily practice.
METHODS
A selective literature search was performed based on the clinical and scientific experience of the authors, focussing on the most relevant diseases and gynaecological cancers. This article (Part I) provides information on topics that are essential for the fertility preservation indication, such as disease prognosis, disease therapy and its associated risks to fertility, recommending disease-specific fertility preservation measures. Part II specifically focusses on fertility preservation techniques.
RESULTS
In breast cancer patients, fertility preservation such as ovarian tissue and oocyte cryopreservation is especially recommended in low-stage cancer and in women < 35 years of age. In Hodgkin's lymphoma, the indication is mainly based on the chemotherapy regime as some therapies have very low, others very high gonadotoxicity. In borderline ovarian tumours, preservation of fertility usually is achieved through fertility sparing surgery, ovarian stimulation may also be considered. In cervical cancer, endometrial cancer, rheumatic diseases and other malignancies such as Ewing sarcoma, colorectal carcinoma, non-Hodgkin lymphoma, leukaemia etc., several other factors must be considered to enable an individual, stage-dependent decision.
CONCLUSION
The decision for or against fertility preservation depends on the prognosis, the risks to fertility and individual factors such as prospective family planning.
Date of Publication
2018-01
Publication Type
Article
Subject(s)
Keyword(s)
Borderline ovarian tumour Breast cancer Cervical cancer Fertility preservation Hodgkin’s lymphoma Rheumatic diseases
Language(s)
en
Contributor(s)
Schüring, A N | |
Fehm, T | |
Behringer, K | |
Goeckenjan, M | |
Wimberger, P | |
Henes, M | |
Henes, J |
Series
Archives of gynecology and obstetrics
Publisher
Springer
ISSN
0932-0067
Access(Rights)
open.access