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Arch Gynecol Obstet. 2018 Jan;297(1):241-255. doi: 10.1007/s00404-017-4594-3. Epub 2017 Nov 24.

Practical recommendations for fertility preservation in women by the FertiPROTEKT network. Part I: Indications for fertility preservation.

Author information

1
UKM Kinderwunschzentrum, Department of Gynaecology and Obstetrics, University Hospital of Münster, Albert-Schweitzer Campus 1, D-11, 48149, Münster, Germany. Andreas.Schuering@ukmuenster.de.
2
Department of Gynaecology and Obstetrics, University Hospital of Düsseldorf, Düsseldorf, Germany.
3
Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany.
4
Department of Gynaecology and Obstetrics, TU Dresden, Dresden, Germany.
5
Department of Women's Health, University of Tübingen, Tübingen, Germany.
6
Centre for Interdisciplinary Clinical Immunology, Rheumatology and Auto-inflammatory Diseases and Department of Internal Medicine II (Oncology, Hematology, Immunology, Rheumatology, Pulmology), University of Tübingen, Tübingen, Germany.
7
Department of Medical Oncology, Inselspital and University of Berne, Berne, Switzerland.
8
Division of Gynaecological Endocrinology and Reproductive Medicine, University Women's Hospital, Berne, Switzerland.

Abstract

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.

KEYWORDS:

Borderline ovarian tumour; Breast cancer; Cervical cancer; Fertility preservation; Hodgkin’s lymphoma; Rheumatic diseases

PMID:
29177593
PMCID:
PMC5762797
DOI:
10.1007/s00404-017-4594-3
[Indexed for MEDLINE]
Free PMC Article

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