Advances in Fertility Preservation for Women Undergoing Cancer Treatment: From Cryopreservation to Novel Therapies.

Abstract

Advances in oncology have significantly improved survival, particularly among children and adolescents with cancer. However, many anti-cancer treatments are gonadotoxic and pose a significant risk to future fertility with important psychosocial consequences for both patients and their families. Fertility preservation should therefore be addressed at diagnosis and prior to treatment initiation. Established strategies include embryo and mature oocyte preservation; however, these options are not feasible for pre-pubertal patients or for those requiring immediate chemotherapy. In such cases ovarian tissue cryopreservation with auto transplantation following remission represents the only available option. This approach can restore both endocrine and fertility. Once considered experimental, ovarian tissue cryopreservation is now considered an established technique, however, further optimization is required to improve efficacy and long-term outcomes, as well as to develop alternative strategies for utilizing tissue unsuitable for transplantation.