Oral Presentation The Annual Scientific Meeting of the Endocrine Society of Australia and the Society for Reproductive Biology 2014

Protection and preservation of fertility for young women with cancer or other conditions which threaten female fertility (#176)

Kate Stern 1
  1. Melbourne IVF, East Melbourne, Vic, Australia

Therapies for malignant and benign pathology may  compromise female fertility. Chemotherapy including alkylating agents, radiation and surgery may cause ovarian failure and damage to the uterus.

Risk of damage from Cancer treatment

Effects of chemo-radiotherapy on ovarian function:

1)    temporary ovarian failure

2)    permanent ovarian failure

3)    persistence/return of ovarian function after therapy but high risk of early menopause ie early to mid 30s

4)    irreparable damage to the uterus

Options for fertility preservation and protection

Given the toxic effects of chemotherapy agents on the ovary, with the resultant risk of temporary and more permanent ovarian failure, the availability of options to preserve and protect fertility is of great importance to these young women and their families.  

Options prior to commencing gonadotoxic treatment::

1)    protection of ovaries with GnRh analogues

2)    preservation of mature oocytes

3)    preservation of embryos

4)    preservation of ovarian tissue

Options for fertility after development of premature ovarian failure:

1)    oocyte donation

2)    embryo donation

3)    adoption/permanent care

4)    surrogacy if significant uterine damage

5)    childlessness

Important messages

1)    any young woman at risk of fertility compromise should have the opportunity for discussion with fertility specialist

2)    prompt referral and discussion of options is of paramount importance

3)    various options currently available may offer a genuine opportunity to preserve fertility