Human Reproduction Update, Vol.10, No.3 pp.251-266, 2004
© European Society of Human Reproduction and Embryology 2004; all rights reserved
Fertility preservation in female patients
1 Ankara University School of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey and 2 The Center for Reproductive Medicine and Infertility, Department of Obstetrics and Gynecology, Joan and Sanford I. Weill Medical College of Cornell University, 505 East 70th Street, HT-340, New York, NY 10021, USA 3 To whom correspondence should be addressed. e-mail: kuo9001{at}med.cornell.edu
In the USA alone, >650 000 women will be afflicted by cancer in 2003, and 8% of these cases will be aged <40 years. Due to improvements in cancer therapy, cure rates of both adult and childhood cancers increased significantly over the past three decades. However, long-term consequences of cancer therapy and impact on quality of life are now being recognized. One of the major sequelae of cytotoxic chemotherapy is gonadal failure. Cytotoxic chemotherapy and/or radiotherapy are not only used to treat malignant diseases, but also non-malignant systemic conditions. Upon reviewing the extent and mechanism of gonadal damage due to chemo-/radiotherapy, this article discusses indications and the wide range of methods of fertility preservation in a comprehensive manner. All current, emerging, experimental as well as controversial approaches are reviewed. A comprehensive algorithm to manage fertility preservation through an individualized approach is presented.
Key words: chemotherapy/fertility preservation/ovarian failure/radiotherapy
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