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Korean Journal of Obstetrics & Gynecology 2008;51(8):820-834.
Published online August 1, 2008.
Fertility preservation in female cancer survivors.
Jung Ryeol Lee, Seok Hyun Kim
1Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, Korea. seokhyun@snu.ac.kr
2Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul, Korea.
3Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University, Seoul, Korea.
Abstract
Cancer is not rare in women in reproductive ages, and there has been a remarkable improvement in the survival rates due to progress in cancer treatment. Moreover, women have been delaying the initiation of childbearing to later in life. Thus the preservation of fertility in female cancer survivors has become an important health issue. Because of the variations in the type of cancer, type and dose of chemotherapy, the time available before onset of treatment, the patient's age, and the status of partners, each case should be individualized and requires a different strategy in fertility preservation. When a partner or donor sperm is available, embryo cryopreservation is now an established and acceptable technique for fertility preservation, providing a delay in the initiation of chemotherapy or radiotherapy. Oocyte cryopreservation is available for women without partners, but there is a limited experience with this technique and pregnancy rate is still low. In spite of the recent reports of successful birth after autotransplantation of cryopreserved-thawed human ovarian tissue, clinical experience is also limited and this technique remains still experimental. Further researches for establishing optimal cryopreservation and thawing protocols and increasing post-thawing survival, pregnancy, and delivery rates are necessary. In this article, the mechanisms of reproductive failure after cancer therapy and the strategies for fertility preservation in cancer survivors are discussed.
Key Words: Fertility preservation, Cancer survivors, Embryo cryopreservation, Oocyte cryopreservation, Ovarian cryopreservation


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