Hematological Malignancies and Fertility
In the last decades, survival rate of hematological malignancies has been significantly improved and sparing reproductive potential after treatment has become one of the goals in both male and female patients. A comprehensive consultation with reproductiv
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Hematological Malignancies and Fertility Zehra Narli Ozdemir and Sinem Civriz Bozdag
Abstract
In the last decades, survival rate of hematological malignancies has been significantly improved and sparing reproductive potential after treatment has become one of the goals in both male and female patients. A comprehensive consultation with reproductive specialists before the onset of any kind of cancer treatment procedure is an essential issue which would increase the likelihood of parenting in survivors. In this context, cryopreservation of oocyte, embryo or ovarian tissue in reproductive aged women and sperm or testicular tissue cryopreservation in adult male are feasible approaches that must be considered before gonadotoxic therapy. Notably, all options should be regarded as experimental during pre-pubertal period. Herein, we aim to review the available literature with regard to safety, efficacy of fertility preservation methods and the pregnancy outcomes in patients with hematological malignancies. Keywords
Hematological malignancies · Infertility · Fertility preservation
Abbreviations AL AlloHSCT AMH ASCO cGVHD CIBMTR CML CRT Cy DLBCL EBMT FL FORT FSH GnRHa Gy HL HSCT IVM
Z. N. Ozdemir Ankara City Hospital, Ankara, Turkey S. C. Bozdag (*) Faculty of Medicine, Department of Hematology, Ankara University, Ankara, Turkey e-mail: [email protected]
LH MA MMR NHL
Acute leukemia Allogeneic hematopoietic stem cell transplantation Anti-Mullerian hormone American Society of Clinical Oncology Chronic graft versus host disease Center for International Blood and Marrow Transplant Registry Chronic myeloid leukemia Cranial radiation therapy Cyclophosphamide Diffuse large B cell lymphoma European Bone Marrow Transplantation Follicular lymphoma Follicular output rate Follicle stimulating hormone Gonadotropin-releasing hormone agonists Gray Hodgkin lymphoma Hematopoietic stem cell transplantation Invitro maturation of immature oocytes Luteinizing hormone Myeloablative Major molecular response Non-Hodgkin lymphoma
Z. N. Ozdemir and S. C. Bozdag
OTC OTT PCR POF RIC TBI TKI
1
Ovarian tissue cryopreservation Ovarian tissue transplantation Polymerase chain reaction Primary ovarian failure Reduced intensity conditioning Total body irradiation Tyrosine kinase inhibitor
Introduction
Advances in cancer therapy and supportive care have led to significant improvement in survival rates for cancer patients. However, infertility remains to be one of the most devastating complications in long term follow up. Nevertheless, immediately after diagnosis, American Society of Clinical Oncology (ASCO) recommends health care providers to inform their patients about the risk of infertility and fertility preservation options. Therefore, counseling with a fertility specialist during the treatment process in order to inform their fertility potential after a possible gonadotoxic treatment is a crucial step within a cancer journey (Oktay et al. 2018). Progress in assisted reproductive technology provided chance of fertility preservation to hematolog
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