Modern Fertility Preservation Methods in Female Malignancy

S. Zafeiriou, S. Zervoudis, P. Economides, D. Polyzos, G. Iatrakis, K. Lykeridou

Abstract: Female malignancies can induce severe fertility issues in reproductive age women due to the therapeutic procedures addressing such malignancies (radiotherapy, chemotherapy, surgical intervention). Conservative treatment with medication, while allowing the ovarian tissue to remain intact (antioxidant regimens, gametogenesis- suspending regimens), does not seem to provide any clinical benefits. Ovarian tissue cryopreservation was recently developed in order to overcome the loss of viable follicles (due either to malignancy or to therapeutic side-effects) whenever patient’s clinical status permits it; the ovarian tissue is later thawed and used for patient’s fertility benefits. There are mainly three methods addressing this issue: autotransplantation (albeit orthotopic - in pelvis - or heterotopic), xenotransplantation (mainly in mice) and in vitro follicular maturation (IVM). The IVM of ovocytes (harvested either by follicular retrieval or by laparoscopic ovarian tissue biopsy) followed by modern rapid cryopreservation method (vitrification) seems to be the most promising method. Cryopreserved tissue is then restored and used (as soon as the clinical status permits it) for in vitro fertilization (IVF) and embryo transfer procedures.
Keywords: Female malignancy, ovarian tissue cryopreservation, autotransplantation, xenotransplantation, in vitro ovarian maturation, vitrification.