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Fertility Preservation Options for Women With Malignancies

Marhhom, Enbal MD*; Cohen, Ilan MD

Obstetrical & Gynecological Survey: January 2007 - Volume 62 - Issue 1 - p 58-72
doi: 10.1097/01.ogx.0000251029.93792.5d

Cancer is not rare in younger women. There has been a remarkable improvement in the survival rates due to progress in cancer treatment. The necessary treatment for most of the common cancer types occurring in younger women implies either removal of the reproductive organs or cytotoxic treatment that could partially or definitively affect reproductive function. Early loss of ovarian function not only puts the patients at risk for menopause-related complications at a very young age, but is also associated with loss of fertility. Further, women in the western hemisphere have been delaying initiation of childbearing to later in life. The results of these changes have led to an increase in patients facing the risk of premature ovarian failure, and therefore seeking help in preserving their fertility. This increase in demand has resulted in a proliferation of techniques to preserve fertility. Indeed, the number of options is increasing; some are more established procedures, such as embryo cryopreservation, and some are still experimental, such as ovarian cryopreservation. Because of the variations in type and dose of chemotherapy, the type of cancer, the time available before onset of treatment, the patient's age and the partner status, each case is unique and requires a different strategy of fertility preservation.

Target Audience: Obstetricians & Gynecologists, Family Physicians

Learning Objectives: After completion of this article, the reader should be able to recall the potential early loss of ovarian function secondary to radiotherapy and/or chemotherapy for cancer at a young age; explain the increasing demands for fertility preservation; and summarize the limited number of proven, safe, and efficacious methods.

*Medical Student and †Professor of Clinical Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Sapir Medical Center, Kfar-Saba, Sackler Faculty of Medicine, Tel Aviv University, Israel

Chief Editor's Note: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA/PRA Category 1 Credits™ can be earned in 2007. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.

The authors have disclosed that they have no financial relationships with or interests in any commercial companies pertaining to this educational activity.

Lippincott Continuing Medical Education Institute, Inc. has identified and resolved all faculty conflicts of interest regarding this educational activity.

Reprint requests to: Ilan Cohen MD, Professor of Clinical Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Sapir Medical Center, Kfar-Saba, 44281, Israel. E-mail:

© 2007 Lippincott Williams & Wilkins, Inc.