Cancer and fecundity issues mandate a multidisciplinary approach
Received 30 October 2008; received in revised form 8 December 2008; accepted 11 December 2008. published online 06 February 2009.
Objective
To review the existing options for preserving fecundity in young cancer patients, outlining the differences that exist in each individual cancer situation and how these affect our choice of fecundity-preserving measures.
Design
Review the pathophysiology data on ovarian function that serve for outlining the advantages and/or drawbacks of certain fecundity-preserving measures such as ovarian freezing and emergency IVF. Provide support arguments for outlining the need for setting locally rooted cancer and fecundity task forces that throw the bases for a multidisciplinary approach in this field.
Setting
Review of literature data.
Patient(s)
Women of reproductive age affected with different types of cancer.
Main Outcome Measure(s)
Outcome of selected emergency fertility preserving measures such as ovarian tissue freezing followed by grafting or emergency IVF.
Result(s)
When performed in the 30s—the typical age for breast cancer, the most frequently encountered cancer in women of reproductive age, ovarian freezing hampers ovarian recovery and the chances for spontaneous pregnancy.
Conclusion(s)
Based on a review of the different situations encountered, we recommend that fecundity-preserving measures offered to young cancer patients, including ovarian freezing and emergency IVF, emanate from multidisciplinary approaches.
aUniversité Paris Descartes, Service de Gynécologie Obstétrique II et Médecine de la Reproduction, Paris, France
bDepartment of Obstetrics and Gynecology, Hospital of Morges, Morges, Switzerland
cDepartment of Endocrine Gynecology and Reproductive Medicine, Hôpital Jeanne de Flandre, Centre Hospitalier Régional Universitaire (CHRU), Lille, France
Reprint requests: D. de Ziegler, M.D., Service de Gynécologie Obstétrique II, Hôpital St. Vincent de Paul, 82 Bd Denfert-Rocherau, 75014 Paris, France (FAX: 33-1 58 41 1870).
D.deZ. holds stock in Ultrst, LLC. I.S. has nothing to disclose. I.V. has nothing to disclose. C.D. has nothing to disclose. P.T. has received grants from Pfizer and Novartis. C.C. has nothing to disclose.
ABSTRACT