Revisión clínica
Medwave 2017 Nov-Dic;17(9):e7090 doi: 10.5867/medwave.2017.09.7090
Preservación de la fertilidad en la paciente oncológica
Fertility preservation in the oncology patient
Anibal Scarella Chamy, César Díaz-García, Sonia Herraiz , Jhenifer Kliemchen Rodrigues
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Palabras clave: fertility preservation, neoplasms, infertility, female

Abstract

In recent years, medical advances have substantially improved survival of cancer patients, generating growing concern about the quality of life of the survivors. Increased attention has been paid to reproductive problems after oncological treatments. International guidelines on fertility preservation in cancer patients require that healthcare teams discuss, as early as possible, the impact of cancer treatments on fertility and encourage access to fertility preservation techniques. The development of these techniques in women is a recent effort and many patients and health care providers are not familiar with their rapid expansion. This article discusses indications, results, and risks of the different options currently available.


 

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In recent years, medical advances have substantially improved survival of cancer patients, generating growing concern about the quality of life of the survivors. Increased attention has been paid to reproductive problems after oncological treatments. International guidelines on fertility preservation in cancer patients require that healthcare teams discuss, as early as possible, the impact of cancer treatments on fertility and encourage access to fertility preservation techniques. The development of these techniques in women is a recent effort and many patients and health care providers are not familiar with their rapid expansion. This article discusses indications, results, and risks of the different options currently available.

Autores: Anibal Scarella Chamy[1,2], César Díaz-García[3,4,5], Sonia Herraiz [3,6], Jhenifer Kliemchen Rodrigues[7,8,9]

Filiación:
[1] Centro de Reproducción Humana, Facultad Medicina, Universidad de Valparaíso, Valparaíso, Chile
[2] Departamento de Obstetricia y Ginecología, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile
[3] Grupo Acreditado de Investigación en Medicina Reproductiva, IIS La Fe, Valencia, España
[4] Departamento de Pediatría, Obstetricia y Ginecología, Facultad de Medicina, Universidad de Valencia, Valencia, España
[5] IVI-London, IVI-RMA Global, Londres, Reino Unido
[6] IVI Foundation, Valencia, España
[7] Latin American Oncofertility Network, Minas Gerais, Brasil
[8] In Vitro Embriologia Clínica e Consultoria, Nova Lima, Minas Gerais, Brasil
[9] Departamento de Ginecologia e Obstetrícia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil

E-mail: anibal.scarella@uv.cl

Correspondencia a:
[1] Hontaneda 2664
Valparaíso
Región de Valparaíso, Chile
CP: 2341386

Citación: Scarella Chamy A, Díaz-García C, Herraiz S, Kliemchen Rodrigues J. Fertility preservation in the oncology patient. Medwave 2017 Nov-Dic;17(9):e7090 doi: 10.5867/medwave.2017.09.7090

Fecha de envío: 23/6/2017

Fecha de aceptación: 19/10/2017

Fecha de publicación: 16/11/2017

Origen: no solicitado

Tipo de revisión: con revisión por dos pares revisores externos, a doble ciego

Ficha PubMed

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  2. Globalcan 2012 France: World Health Organization [on line]. | Link |
  3. Díaz Sanzana N, Jofré Salazar AM, Moya Cortés J, Umaña Cid ME, Vallebuona Stagno C, Vicuña Pruzzo P. Informe RPC Chile 2003-2007. Santiago, Chile: MINSAL; 2012.
  4. Hayat MJ, Howlader N, Reichman ME, Edwards BK. Cancer statistics, trends, and multiple primary cancer analyses from the Surveillance, Epidemiology, and End Results (SEER) Program. Oncologist. 2007 Jan;12(1):20-37. | PubMed |
  5. Siegel R, Naishadham D, Jemal A. Cancer statistics for Hispanics/Latinos, 2012. CA Cancer J Clin. 2012 Sep-Oct;62(5):283-98. | CrossRef | PubMed |
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  8. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016 Jan-Feb;66(1):7-30. | CrossRef | PubMed |
  9. McLaren JF, Bates GW. Fertility preservation in women of reproductive age with cancer. Am J Obstet Gynecol. 2012 Dec;207(6):455-62. | CrossRef | PubMed |
  10. Strauss J, Williams C. The ovarian life cycle. .en: Yen and Jaffe’s reproductive endocrinology: physiology, pathophysiology, and clinical management. Philadelphia, PA: Elsevier; 2004.
  11. Sonmezer M, Oktay K. Fertility preservation in female patients. Hum Reprod Update. 2004 May-Jun;10(3):251-66. | PubMed |
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  17. Carter J, Rowland K, Chi D, Brown C, Abu-Rustum N, Castiel M, Barakat R. Gynecologic cancer treatment and the impact of cancer-related infertility. Gynecol Oncol. 2005 Apr;97(1):90-5. | PubMed |
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  32. Lee S, Ozkavukcu S, Heytens E, Moy F, Oktay K. Value of early referral to fertility preservation in young women with breast cancer. J Clin Oncol. 2010 Nov 1;28(31):4683-6. | CrossRef | PubMed |
  33. Oktay K, Hourvitz A, Sahin G, Oktem O, Safro B, Cil A, Bang H. Letrozole reduces estrogen and gonadotropin exposure in women with breast cancer undergoing ovarian stimulation before chemotherapy. J Clin Endocrinol Metab. 2006 Oct;91(10):3885-90. | PubMed |
  34. Azim AA, Costantini-Ferrando M, Oktay K. Safety of fertility preservation by ovarian stimulation with letrozole and gonadotropins in patients with breast cancer: a prospective controlled study. J Clin Oncol. 2008 Jun 1;26(16):2630-5. | CrossRef | PubMed |
  35. Mandelbaum J, Belaïsch-Allart J, Junca AM, Antoine JM, Plachot M, Alvarez S, et al. Cryopreservation in human assisted reproduction is now routine for embryos but remains a research procedure for oocytes. Hum Reprod. 1998 Jun;13 Suppl 3:161-74;discussion175-7. | PubMed |
  36. Rienzi L, Cobo A, Paffoni A, Scarduelli C, Capalbo A, Vajta G, et al. Consistent and predictable delivery rates after oocyte vitrification: an observational longitudinal cohort multicentric study. Hum Reprod. 2012 Jun;27(6):1606-12. | CrossRef | PubMed |
  37. Grifo JA, Noyes N. Delivery rate using cryopreserved oocytes is comparable to conventional in vitro fertilization using fresh oocytes: potential fertility preservation for female cancer patients. Fertil Steril. 2010 Feb;93(2):391-6. | CrossRef | PubMed |
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Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011 Mar-Apr;61(2):69-90. | CrossRef | PubMed |

Globalcan 2012 France: World Health Organization [on line]. | Link |

Díaz Sanzana N, Jofré Salazar AM, Moya Cortés J, Umaña Cid ME, Vallebuona Stagno C, Vicuña Pruzzo P. Informe RPC Chile 2003-2007. Santiago, Chile: MINSAL; 2012.

Hayat MJ, Howlader N, Reichman ME, Edwards BK. Cancer statistics, trends, and multiple primary cancer analyses from the Surveillance, Epidemiology, and End Results (SEER) Program. Oncologist. 2007 Jan;12(1):20-37. | PubMed |

Siegel R, Naishadham D, Jemal A. Cancer statistics for Hispanics/Latinos, 2012. CA Cancer J Clin. 2012 Sep-Oct;62(5):283-98. | CrossRef | PubMed |

Donnez J, Dolmans MM. Fertility preservation in women. Nat Rev Endocrinol. 2013 Dec;9(12):735-49. | CrossRef | PubMed |

Hickey M, Peate M, Saunders CM, Friedlander M. Breast cancer in young women and its impact on reproductive function. Hum Reprod Update. 2009 May-Jun;15(3):323-39. | CrossRef | PubMed |

Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016 Jan-Feb;66(1):7-30. | CrossRef | PubMed |

McLaren JF, Bates GW. Fertility preservation in women of reproductive age with cancer. Am J Obstet Gynecol. 2012 Dec;207(6):455-62. | CrossRef | PubMed |

Strauss J, Williams C. The ovarian life cycle. .en: Yen and Jaffe’s reproductive endocrinology: physiology, pathophysiology, and clinical management. Philadelphia, PA: Elsevier; 2004.

Sonmezer M, Oktay K. Fertility preservation in female patients. Hum Reprod Update. 2004 May-Jun;10(3):251-66. | PubMed |

Morgan S, Anderson RA, Gourley C, Wallace WH, Spears N. How do chemotherapeutic agents damage the ovary? Hum Reprod Update. 2012 Sep-Oct;18(5):525-35. | CrossRef | PubMed |

Roness H, Gavish Z, Cohen Y, Meirow D. Ovarian follicle burnout: a universal phenomenon? Cell Cycle. 2013 Oct 15;12(20):3245-6. | CrossRef | PubMed |

Morgan S, Lopes F, Gourley C, Anderson RA, Spears N. Cisplatin and doxorubicin induce distinct mechanisms of ovarian follicle loss; imatinib provides selective protection only against cisplatin. PLoS One. 2013 Jul 29;8(7):e70117. | CrossRef | PubMed |

Le Floch O, Donaldson SS, Kaplan HS. Pregnancy following oophoropexy and total nodal irradiation in women with Hodgkin's disease. Cancer. 1976 Dec;38(6):2263-8. | PubMed |

Bath LE, Critchley HO, Chambers SE, Anderson RA, Kelnar CJ, Wallace WH. Ovarian and uterine characteristics after total body irradiation in childhood and adolescence: response to sex steroid replacement. Br J Obstet Gynaecol. 1999 Dec;106(12):1265-72. | PubMed |

Carter J, Rowland K, Chi D, Brown C, Abu-Rustum N, Castiel M, Barakat R. Gynecologic cancer treatment and the impact of cancer-related infertility. Gynecol Oncol. 2005 Apr;97(1):90-5. | PubMed |

Loren AW, Mangu PB, Beck LN, Brennan L, Magdalinski AJ, Partridge AH, et al. Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013 Jul 1;31(19):2500-10. | CrossRef | PubMed |

De Vos M, Smitz J, Woodruff TK. Fertility preservation in women with cancer. Lancet. 2014 Oct 4;384(9950):1302-10. | CrossRef | PubMed |

Lee SJ, Schover LR, Partridge AH, Patrizio P, Wallace WH, Hagerty K, et al. American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J Clin Oncol. 2006 Jun 20;24(18):2917-31. | PubMed |

Wallace WH, Kelsey TW. Human ovarian reserve from conception to the menopause. PLoS One. 2010 Jan 27;5(1):e8772. | CrossRef | PubMed |

Rodriguez-Wallberg KA, Oktay K. Fertility preservation and pregnancy in women with and without BRCA mutation-positive breast cancer. Oncologist. 2012;17(11):1409-17. | CrossRef | PubMed |

Anderson RA, Weddell A, Spoudeas HA, Douglas C, Shalet SM, Levitt G, et al. Do doctors discuss fertility issues before they treat young patients with cancer Hum Reprod. 2008 Oct;23(10):2246-51. | CrossRef | PubMed |

Peccatori FA, Azim HA Jr, Orecchia R, Hoekstra HJ, Pavlidis N, Kesic V, et al. Cancer, pregnancy and fertility: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013 Oct;24 Suppl 6:vi160-70. | CrossRef | PubMed |

Ataman LM, Rodrigues JK, Marinho RM, Caetano JP, Chehin MB, Alves da Motta EL, et al. Creating a Global Community of Practice for Oncofertility. J Glob Oncol. 2016 Apr;2(2):83-96. | PubMed |

Knopman JM, Noyes N, Talebian S, Krey LC, Grifo JA, Licciardi F. Women with cancer undergoing ART for fertility preservation: a cohort study of their response to exogenous gonadotropins. Fertil Steril. 2009 Apr;91(4 Suppl):1476-8. | CrossRef | PubMed |

Robertson AD, Missmer SA, Ginsburg ES. Embryo yield after in vitro fertilization in women undergoing embryo banking for fertility preservation before chemotherapy. Fertil Steril. 2011 Feb;95(2):588-91. | CrossRef | PubMed |

Wolff EF, Martel M, Gwin K, Lannin D. Synchronous primary breast and ovarian cancer with ovarian cancer metastases to a breast sentinel lymph node. Breast J. 2009 Mar-Apr;15(2):203-5. | CrossRef | PubMed |

Anderson RA, Kinniburgh D, Baird DT. Preliminary experience of the use of a gonadotrophin-releasing hormone antagonist in ovulation induction/in-vitro fertilization prior to cancer treatment. Hum Reprod. 1999 Oct;14(10):2665-8. | PubMed |

Turan V, Bedoschi G, Moy F, Oktay K. Safety and feasibility of performing two consecutive ovarian stimulation cycles with the use of letrozole-gonadotropin protocol for fertility preservation in breast cancer patients. Fertil Steril. 2013 Dec;100(6):1681-5.e1. | CrossRef | PubMed |

Baynosa J, Westphal LM, Madrigrano A, Wapnir I. Timing of breast cancer treatments with oocyte retrieval and embryo cryopreservation. J Am Coll Surg. 2009 Nov;209(5):603-7. | CrossRef | PubMed |

Lee S, Ozkavukcu S, Heytens E, Moy F, Oktay K. Value of early referral to fertility preservation in young women with breast cancer. J Clin Oncol. 2010 Nov 1;28(31):4683-6. | CrossRef | PubMed |

Oktay K, Hourvitz A, Sahin G, Oktem O, Safro B, Cil A, Bang H. Letrozole reduces estrogen and gonadotropin exposure in women with breast cancer undergoing ovarian stimulation before chemotherapy. J Clin Endocrinol Metab. 2006 Oct;91(10):3885-90. | PubMed |

Azim AA, Costantini-Ferrando M, Oktay K. Safety of fertility preservation by ovarian stimulation with letrozole and gonadotropins in patients with breast cancer: a prospective controlled study. J Clin Oncol. 2008 Jun 1;26(16):2630-5. | CrossRef | PubMed |

Mandelbaum J, Belaïsch-Allart J, Junca AM, Antoine JM, Plachot M, Alvarez S, et al. Cryopreservation in human assisted reproduction is now routine for embryos but remains a research procedure for oocytes. Hum Reprod. 1998 Jun;13 Suppl 3:161-74;discussion175-7. | PubMed |

Rienzi L, Cobo A, Paffoni A, Scarduelli C, Capalbo A, Vajta G, et al. Consistent and predictable delivery rates after oocyte vitrification: an observational longitudinal cohort multicentric study. Hum Reprod. 2012 Jun;27(6):1606-12. | CrossRef | PubMed |

Grifo JA, Noyes N. Delivery rate using cryopreserved oocytes is comparable to conventional in vitro fertilization using fresh oocytes: potential fertility preservation for female cancer patients. Fertil Steril. 2010 Feb;93(2):391-6. | CrossRef | PubMed |

Practice Committee of Society for Assisted Reproductive Technology; Practice Committee of American Society for Reproductive Medicine. Preimplantation genetic testing: a Practice Committee opinion. Fertil Steril. 2008 Nov;90(5 Suppl):S136-43. | CrossRef | PubMed |

Cobo A, García-Velasco JA, Coello A, Domingo J, Pellicer A, Remohí J. Oocyte vitrification as an efficient option for elective fertility preservation. Fertil Steril. 2016 Mar;105(3):755-764.e8. | CrossRef | PubMed |

Goldman KN, Noyes NL, Knopman JM, McCaffrey C, Grifo JA. Oocyte efficiency: does live birth rate differ when analyzing cryopreserved and fresh oocytes on a per-oocyte basis? Fertil Steril. 2013 Sep;100(3):712-7. | CrossRef | PubMed |

Ginsburg ES, Yanushpolsky EH, Jackson KV. In vitro fertilization for cancer patients and survivors. Fertil Steril. 2001 Apr;75(4):705-10. | PubMed |

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