Female fertility preservation in cancer patients: an instrumental tool for the envisioning a postdisease life.

AIM: To verify whether fertility preservation (FP) improves the way women contemplate their life after the disease. MATERIALS & METHODS: 285 cancer patients referred for FP counseling were prospectively studied. A standardized questionnaire was submitted to all participants. RESULTS: A total of 85 patients (39.0%) returned the questionnaire. None of the women who rejected the FP proposal after oncofertility counseling returned the questionnaire. The median age of responders was 29.1 years (range: 18-40 years). In total, 35 of them (41.1%) were single and 72 (84.7%) were childless. A total of 66 women (77.6%) reported that the possibility of preserving fertility was instrumental to improving their coping with the burden of treatments. Since 61.2% patients perceived their cryopreserved oocytes or embryos as future children or family, the projection in a postdisease life may be at play in this improved subjective experience of treatment. CONCLUSION: The present results indicate that the simple fact of undergoing FP improves the patients' subjective experience of cancer treatments.

Live birth after frozen-thawed oocytes matured in vitro in a PCOS patient: a model for improving implantation rates in IVM cycles and objectively assessing the real potential of development of frozen oocytes matured in vitro.

Over the past 20 years, in vitro maturation (IVM) of oocytes has emerged in the strategy of infertility treatment, with the main indication being in patients suffering from polycystic ovarian syndrome (PCOS). More recently, IVM has been proposed as an option for fertility preservation in women having to undergo gonadotoxic treatments. However, despite the increasing application of IVM, the potential of development of in vitro matured oocytes after thawing remains ill-established and few pregnancies have been reported so far. We report herein a case of live birth after frozen-thawed oocytes matured in vitro and embryo transfer during an artificial cycle in a 29-year-old patient with primary infertility due to PCOS. The present case demonstrates that the transfer of frozen-thawed IVM oocytes during an artificial cycle in PCOS patients is feasible and leads to pregnancy and live birth. This strategy may also be an interesting option to objectively assess the developmental potential of these oocytes after freezing and thawing, which is a major concern for physicians who include the IVM approach in their fertility preservation program.

New trends in female fertility preservation: in vitro maturation of oocytes.

As antineoplastic treatments have become more successful, an increasing number of women with cancer survive to endure the long-term consequences of chemotherapy. One of the most important of these consequences in young females is premature ovarian failure and infertility. Owing to increasing survival rates, many of these young women are seeking methods to preserve their fertility. Currently, embryo/oocyte cryopreservation obtained after controlled ovarian stimulation appears to provide the best fertility preservation option. However, patients may not have enough time to undergo ovarian stimulation prior to chemotherapy and/or have contraindications to exogenous gonadotropin administration owing to estrogen-dependant tumors. In vitro maturation of oocytes is an attractive alternative for fertility preservation in cancer patients because it does not require ovarian stimulation and it can be performed at any time of the menstrual cycle. In addition, this technique can be combined with ovarian tissue cryobanking. In this review, we discuss the position of in vitro maturation of oocytes in the fertility preservation strategy in young women.