Oocyte collection and outcome following oncologic treatment: a retrospective multicentre study.

PURPOSE: This study assesses fertility treatment outcomes in female patients who had undergone successful oocyte retrieval following cancer therapy. METHODS: Between January 2020 and December 2022, we collected fertility treatment data from six participating centres in Spain and Germany. All patients associated with this data had undergone successful oocyte retrieval following cancer treatment. RESULTS: Women had most frequently been diagnosed with a haematological (41.9%), breast (22.6%) or gynaecological malignancy (12.9%); two thirds (67.7%) had previously received a chemotherapy, half a radiotherapy (53.3%) and 45.2% had undergone surgery. On average, 7 years (range 0-28) had passed between cancer treatment and first ovarian stimulation cycle. Forty-nine ovarian stimulation cycles had been conducted on these 31 women between 2004 and 2021 (mean age at first oocyte collection following treatment: 34.8 ± 5.7 years). On average, 7 oocytes were collected per cycle (range 0-26) and 11 were collected per patient (range 0-51). Out of the 190 oocytes collected for immediate use of artificial reproductive technique, 139 were fertilised at a rate of 73%. Live birth rate per fresh transfer was 45% (9/20); no births were reported following cryotransfer (0/10). Mean values of anti-Mullerian hormone (AMH) before stimulation declined with time since treatment; however, oocytes were successfully collected from four women with an AMH of <0.5 ng/ml, although no pregnancies were reported. Ten pregnancies were documented; 3 ended in miscarriage. Two twin and 5 single pregnancies resulted in nine live births. On average, children were carried to term. CONCLUSION: In this small cohort, oocytes were successfully collected after chemotherapy and radiotherapy, despite-in individual cases-low AMH values. Further studies are needed to enrich the database and ultimately provide appropriate counselling to female cancer patients regarding expectations and ART outcome following cancer therapy.

Role of Creative Therapies in Gynecological Oncology: Results of a Multigenerational Survey in Patients and Caregivers.

INTRODUCTION: Although creative therapies like painting, dancing, and writing are often used and encouraged to treat various diseases, including cancer, there are few systematic scientific studies on innovative therapies in medical care. METHODS: An anonymous survey was developed for female patients, their relatives, and female medical staff on the impact of creative therapies on optimizing clinical therapy management in exclusively female trials. RESULTS: Of 718 respondents, 358 were female patients, 69 were medical personnel, and 291 were in the control group. Overall, 91.2% of respondents had sought access to creative therapies, indicating strong self-motivated engagement in activities to improve health and well-being. This study also uncovered a significant preference for creative writing among patients. Furthermore, the data suggest that integrating innovative therapies into biopsychosocial anamnesis could offer valuable insights into patients' mobility, mood, and social behaviors. Despite a general hesitation to discuss leisure activities with medical professionals, many patients wanted to incorporate creative activities into their treatment plans. Moreover, group settings for innovative therapy were preferred, highlighting the need for more structured support in medical environments to facilitate these therapeutic interactions. CONCLUSIONS: This study suggests creative therapies can be valuable in medical care.

S1 Guideline: Impairment of gonadal function After Cancer in Childhood and Adolescence.

A possible negative consequence of cancer treatment is the fertility impairment of young cancer survivors. However, most former patients express the wish to have biological children. Fertility-preserving measures are available and are - under certain circumstances - financed by health insurance. Separate information at the time of diagnosis and during follow-up care should be adapted to the individual risk and enable those affected to make a self-determined decision about cryopreservation of germ cells or germ cell tissue. Hyopgonadotropic hypogonadism can be treated by the pulsatile administration of gonadotropins. Affected individuals can be reassured. A health restriction of the offspring due to the cancer treatment is not to be expected, even after artificial insemination.

Fertility Preservation for Patients with Malignant Disease. Guideline of the DGGG, DGU and DGRM (S2k-Level, AWMF Registry No. 015/082, November 2017) - Recommendations and Statements for Girls and Women.

AIM: The aim of this official guideline published by the German Society of Gynecology and Obstetrics (DGGG) and coordinated with the German Society of Urology (DGU) and the German Society of Reproductive Medicine (DGRM) is to provide consensus-based recommendations, obtained by evaluating the relevant literature, on counseling and fertility preservation for prepubertal girls and boys as well as patients of reproductive age. Statements and recommendations for girls and women are presented below. Statements or recommendations for boys and men are not the focus of this guideline. METHODS: This S2k guideline was developed at the suggestion of the guideline commission of the DGGG, DGU and DGRM and represents the structured consensus of representative members from various professional associations (n = 40). RECOMMENDATIONS: The guideline provides recommendations on counseling and fertility preservation for women and girls which take account of the patient's personal circumstances, the planned oncologic therapy and the individual risk profile as well as the preferred approach for selected tumor entities.

Modern radiation therapy and potential fertility preservation strategies in patients with cervical cancer undergoing chemoradiation.

Young patients with cervical cancer who undergo chemoradiation might be interested in fertility preservation, not only dependent upon the use of a gestational carrier as maybe achieved by the use of ovarian transposition and cryo-conservation of oocytes or ovarian tissue, but may prefer to carry pregnancy to term after cancer treatment. The latter approach is a non-established concept needing both modern radiation therapy approaches as well as modifications -if at all possible- in current recommendations for target volume delineation to spare dose to the unaffected uterus. Future strategies to serve selected patients in this respect should only be conducted in prospective clinical evaluations and are critically discussed in this article.

Use of hormone therapy by female gynecologists and female partners of male gynecologists in Germany 8 years after the Women's Health Initiative study: results of a survey.

OBJECTIVE: The publication of the results of the Women's Health Initiative randomized controlled trial in 2002 resulted in a critical discussion on the risks and benefits of hormone therapy (HT), including estrogen plus progestogen therapy and estrogen therapy. The aim of the present study was to evaluate German gynecologists' self-prescription habits regarding HT compared with their habits of prescribing HT to their patients, as an expression of their attitude toward HT. METHODS: A self-administered, anonymous questionnaire was sent to all 9,589 German gynecologists in private practice in November 2010. RESULTS: The response rate was 3,227 (33.7%). This article reports the results for 2,549 eligible questionnaires. A total of 2,459 (97.0%) respondents favored HT for themselves or their female partner. CONCLUSIONS: This report describes the first study in Germany showing an underuse of HT among patients in comparison with the self-administration behavior of gynecologists. For various indications, most German gynecologists favored HT for themselves or their female partner (female gynecologists, n = 1,538, 96%; male gynecologists, n = 917, 98.5%, respectively). This study demonstrates that although the great majority of German gynecologists have a favorable attitude regarding personal use of HT, various discrepancies between physician and patient care exist, especially for the indications of cognitive disorders, achievement of overall well-being, and antiaging. This finding calls for a more unified treatment of perimenopausal and postmenopausal disorders.

Association between self-reported questionnaire data on fertility and results of hormone analyses in women after childhood cancer: a cross-sectional study.

AIM: The aim of this study was to compare self-reported questionnaire-based information on fertility impairment with results from hormone analyses in women who underwent chemoradiotherapy during childhood and adolescence. MATERIAL AND METHODS: In a cross-sectional study, questionnaires and hormone analyses (anti-Müllerian hormone [AMH], follicle-stimulating hormone, luteinizing hormone, estradiol, progesterone) were evaluated in 86 female former pediatric oncology patients in Berlin in 2009. RESULTS: Eighty-six women (median age 23 years, range 19-41) participated in the study with a median follow up of 14 years (range 2-30) after diagnosis. Among women with information on permanent and transient amenorrhea, 9% (5/55) of the women stated that they were permanently amenorrheic. Among women not taking oral contraceptives and giving information on the regularity of their menstrual cycle, 18% (4/22) had an irregular menstrual cycle and 82% (18/22) had a regular menstrual cycle. The median AMH values for women who were categorized as infertile by questionnaire-based information were significantly lower than the AMH values of women who were categorized as fertile by questionnaire (0.05 vs 2.2 ng/mL, P = 0.004). Questionnaire-based categories on the regularity of the menstrual cycle and categories based on AMH values showed a satisfying percentage agreement (66.7%) and were moderately correlated (r = 0.42, P = 0.002). CONCLUSION: Self-reported questionnaire data used to detect fertility impairment has limited correspondence with objectively measured AMH values.