Female fertility preservation in cancer patients

Abstract

Fertility preservation in cancer patients or oncofertility is a relatively new trend in modern medicine. In patients with unfulfilled reproductive plans, the possibility of starting a family is one of the key parameters of quality of life after overcoming a cancer. Guidelines have existed since 2013 and in 2020 the European Society of Human Reproduction and Embryology has also published a guideline, but the main problem of their application in clinical practice is the lack of information for both patients and, unfortunately, professionals, as well as the high cost of treatment. From 2022, health insurance companies in the Czech Republic partially cover the expenses for fertility preservation treatment for cancer patients. The possibilities of oncofertility are based, on the one hand, on improving the results of oncological treatment, on the other hand, on the development of reproductive technologies. Thanks to progress in treatment, up to 80% of pediatric oncology patients survive into adulthood, but chemotherapy, especially highly eff ective alkylating agents, is associated with a high risk of impaired fertility. This article overviewed modern global trends of fertility preservation in women undergoing cancer treatment based on an analysis of the English-language literature over the past 5 years. Key words: oncofertility – fertility preservation – oocyte cryopreservation – embryo cryopreservation – ovarian tissue cryopreservation – oocyte in vitro maturation – gonadotropin-releasing hormone agonists