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Infertility in reproductive‐age female cancer survivors

Levine, Jennifer M. ; Kelvin, Joanne Frankel ; Quinn, Gwendolyn P. ; Gracia, Clarisa R.

Cancer, 2015-05, Vol.121 (10), p.1532-1539 [Periódico revisado por pares]

United States

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Título:
Infertility in reproductive‐age female cancer survivors
Autor: Levine, Jennifer M. ; Kelvin, Joanne Frankel ; Quinn, Gwendolyn P. ; Gracia, Clarisa R.
Assuntos: Adolescent ; adolescent and young adult ; Adult ; Antineoplastic Agents, Alkylating - adverse effects ; cancer ; Child ; Child, Preschool ; Cryopreservation ; Female ; fertility preservation ; Fertility Preservation - economics ; Fertility Preservation - methods ; Fertility Preservation - standards ; Fertility Preservation - trends ; Gonadotropin-Releasing Hormone - administration & dosage ; Gonadotropin-Releasing Hormone - analogs & derivatives ; Humans ; infertility ; Infertility - economics ; Infertility - etiology ; Infertility - prevention & control ; Infertility, Female - etiology ; Infertility, Female - prevention & control ; Infertility, Male - etiology ; Infertility, Male - prevention & control ; Interdisciplinary Communication ; Male ; Menopause, Premature ; Neoplasms - complications ; Neoplasms - therapy ; Oocyte Retrieval ; Organ Sparing Treatments ; Ovary - drug effects ; Ovary - radiation effects ; Program Development ; Quality of Life ; Radiotherapy - adverse effects ; Risk Assessment ; Sperm Retrieval ; Survivors - statistics & numerical data ; Uncertainty
É parte de: Cancer, 2015-05, Vol.121 (10), p.1532-1539
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
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ObjectType-Review-1
Descrição: Improved survival rates among reproductive‐age females diagnosed with cancer have increased the focus on long‐term quality of life, including maintenance of the ability to conceive biological children. Cancer‐directed therapies such as high‐dose alkylating agents and radiation to the pelvis, which deplete ovarian reserve, radiation to the brain, which affects the hypothalamic‐pituitary‐gonadal axis, and surgical resection of reproductive structures can decrease the likelihood of having biological children. Standard fertility preservation strategies such as embryo and oocyte cryopreservation before the onset of therapy offer the opportunity to conserve fertility, but they may not be feasible because of the urgency to start cancer therapy, financial limitations, and a lack of access to reproductive endocrinologists. Ovarian tissue freezing is considered experimental, with limited data related to pregnancies, but it minimizes treatment delay. Studies evaluating gonadotropin‐releasing hormone analogues have had mixed results, although a recent randomized, prospective study in women with breast cancer demonstrated a protective effect. Fertility preservation programs are increasingly being developed within cancer programs. In this article, we describe risks to infertility and options for preservation, raise psychosocial and ethical issues, and propose elements for establishing an effective fertility preservation program. Cancer 2015;121:1532–1539. © 2015 American Cancer Society. This review summarizes risks for infertility in reproductive‐age females with cancer, presents options for fertility preservation, addresses psychosocial issues, raises ethical issues, and outlines considerations for developing an institutional fertility preservation program.
Editor: United States
Idioma: Inglês

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Infertility in reproductive‐age female cancer survivors

Levine, Jennifer M. ; Kelvin, Joanne Frankel ; Quinn, Gwendolyn P. ; Gracia, Clarisa R.

United States

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