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Preservation of Female Fertility: An Essential Progress

Tulandi, Togas MD, MHCM; Huang, Jack Y. J. MD; Tan, Seang Lin MD, MBA

Obstetrics & Gynecology:
doi: 10.1097/AOG.0b013e31818bba31
Clinical Expert Series
Expert Discussion
Abstract

Chemotherapy and radiation treatment for malignancies or other conditions such as hematologic and autoimmune disorders, have resulted in improved survival rates but may lead to sterility. Women who postpone conception until late reproductive years are also at increased risk to become infertile. The purpose of our review is to evaluate advances and techniques for fertility preservation. We performed a literature search using the keywords fertility preservation, vitrification, oocytes, embryo, ovarian cryopreservation, and ovarian suspension and conducted the search in MEDLINE, EMBASE, and the Cochrane Database of systematic reviews. The results show that today, it is possible to cryopreserve oocytes, embryos, or ovarian tissue. The most commonly used technique remains embryo cryopreservation. Another improvement is the development of vitrification or rapid freezing technique. For women undergoing local pelvic radiation, one should consider ovarian suspension. Medical professionals, patients, and their families should be aware that in some conditions, the reproductive function can be preserved. Although one cannot guarantee future fertility, a realistic hope for women at risk of having premature ovarian failure can now be offered.

In Brief

Techniques of fertility preservation include cryopreservation of oocytes, embryos, or ovarian tissue and ovarian suspension for women undergoing local pelvic radiation.

Author Information

From the Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.

Continuing medical education is available online at www.greenjournal.org

Corresponding author: Togas Tulandi, MD, MHCM, Department of Obstetrics and Gynecology, McGill University, 687 Pine Avenue West, Montreal, H3A 1A1, Quebec, Canada; e-mail: togas.tulandi@mcgill.ca.

Financial Disclosure Dr. Tulandi has been an advisor to Genzyme (Cambridge, MA), Baxter (Deerfield, IL), and Johnson & Johnson (New Brunswick, NJ). Dr. Huang does not have any potential conflicts of interest to disclose. Dr. Tan has received royalties from Medicult (Copenhagen, Denmark) for the sale of the Cryoleaf vitrification device.

© 2008 The American College of Obstetricians and Gynecologists