Background: Ovarian function in young females with cancer can be damaged due to chemo-radiotherapy. One option to preserve fertility in these patients is the cryopreservation of ovarian tissue, but this is still experimental.
Objective and hypotheses: Evaluate our experience with cryopreservation (indications, complications, and reimplantation). Through surveys, understand patient perspectives.
Method: A total of 63 women were diagnosed with cancer (20062013). 25 were peripuberal (>9 years old). Nine presented with high risk of ovarian failure (eight Hodgkins disease and one metastatic rhabdomyosarcoma but was not a candidate due to her advanced condition); cryopreservation was offered to these eight patients including one with a medium risk for osteogenic sarcoma, and all accepted. Patient opinion of the procedure is evaluated, and gonadal function is analyzed through hormonal analysis.
Results: Characteristics of the nine patients in which cryopreservation was conducted: age at diagnosis 1115 years old, current age 1423 years old. FSH levels were from to 2.7 to >200 mU/ml and 17β-estradiol 577 pg/ml. Inhibin B ranged from 77 to <10 pg/ml, and AMH 8.1 to <0.1 ng/ml. One patient had ovarian failure, FSH >200, estradiol 5, inhibin B 4 and is under replacement therapy. The cryopreservation was conducted at a specialty clinic via laparoscopy with general anestesia. In 13 days, without delay of oncological treatment, they returned to our center. Patients positively reviewed the procedure conducted and none of them had undergone reimplantation at the time of the survey.
Conclusion: Given the potential risk of oncological treatment, the cryopreservation of ovarian tissue in high-risk adolescents is an option to consider. The procedure is minimally invasive and well-received by the patients. The procedure should be considered on a case-by-case basis, and patients should be informed of the risks/benefits associated with the procedure.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology