Possibilities of Fertility Preservation in Patients withCancer

Overview

Background.
Survival from cancer continues to improve. Antimitotic therapy can induce failure of spermatogenesisand oogenesis, gonadal disturbances and infertility. Recent advances in reproductive medicine have openedopportunities for the preservation of reproductive potential of patients with cancer. The aim of our study was toanalyse by a multidisciplinary team the contemporary state of art and proposal of the Czech model of fertilitypreservation starting in childhood and continuing through the whole reproductive period.Methods. This paper highlights the problems associated with gonadal failure as a consequence of therapy formalignancy in childhood, adolescence and adulthood. Analysis of these problems served as a principle for themanagement strategy for fertility preservation.Conclusions. Patients undergoing treatment for malignancy are at the high risk of gonadal damage and infertility.Therefore, alternative treatmentswith less gonadal toxicity and different treatment protocolswere evaluated. Fertilitycan be preserved with the freezing and banking of spermatozoa, embryos, and oocytes obtained prior to the cancertreatment. In female patients (starting in puberty) pharmacological preservation of gonads with gonadoliberinanalogues is also possible. Chance for the future fertility preservation for children offers freezing and thawing ofprimordial follicles and spermatozoa obtained during the gonadal biopsies. Long-term follow-up study by a multidisciplinarymedical team is necessary.

Key words:
cancer, chemotherapy, radiotherapy, fertility preservation.