“Preserving fertility in patients receiving anticancer therapies and women with premature ovarian failure using ovarian stem cell
Young women undergoing cancer treatment are at high risk of infertility. Cancer treatment is well known to have devastating effect on reproductive cells, leading to infertility (CTRI: Cancer Treatment Related Infertility). CTRI, like premature ovarian failure (POF), becomes a permanent impairment of reproductive function in cancer survivors.
According to official estimates, infertility affects over 20% of the population of women of reproductive age in Poland. Furthermore, at least 30 young women are diagnosed with cancer every day. For many women, the lack of chance for motherhood is associated with significant psychosocial distress.
Treatment of young women for CTRI or primary POF is currently based on attempts to obtain reproductive cells after prior hormonal stimulation. The obtained eggs are assessed for morphology and then fertilised to form embryos. If indicated, embryos can be genetically screened for potential hereditary disorders (PGD: Prenatal Genetic Diagnosis) and abnormal embryos are discarded. Properly developing embryos are transferred to the uterus or frozen for future use in the cryotransfer procedure. Most often, however, it is not possible to obtain oocytes in women treated for POF or CTRI; the only solution is to use cells from non-partner donation, i.e. oocytes from an anonymous donor.
Young women who are to undergo cancer treatment may also use Fertility Preservation (FP). FP involves freezing of eggs collected before cancer treatment. In many cases, however, it is the inability of cancer patients to undergo hormonal stimulation that is the limitation. The inability to use stimulation greatly limits the number of eggs that can be retrieved for fertility preservation. For this reason, harvesting the ovarian cortex is another option proposed so far to preserve female fertility despite cancer treatment. It is the ovarian cortex where the oocytes mature in the follicles.
A fragment of cortex is frozen for re-implantation in the same patient after overcoming cancer. However, this method is not commonly used. It requires large laboratory facilities, highly specialised medical personnel and is not very effective. Also, there is a risk of re-transferring cancer cells during tissue retransplantation.
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