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Preserving female fertility following cancer treatment: Current options and future possibilities

Authors

  • Erin R. West PhD,

    1. Department of Chemical and Biological Engineering, Northwestern University, Evanston, Illinois
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    • Members of the Oncofertility Consortium.

  • Mary B. Zelinski PhD,

    1. Department of Reproductive Sciences, Oregon National Primate Research Center, Oregon Health and Sciences University, Beaverton, Oregon
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    • Members of the Oncofertility Consortium.

  • Laxmi A. Kondapalli MD,

    1. Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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    • Members of the Oncofertility Consortium.

  • Clarisa Gracia MD,

    1. Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
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    • Members of the Oncofertility Consortium.

  • Jeffrey Chang MD,

    1. Department of Obstetrics and Gynecology, UCSD, San Diego, California
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    • Members of the Oncofertility Consortium.

  • Christos Coutifaris MD, PhD,

    1. Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
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    • Members of the Oncofertility Consortium.

  • John Critser PhD,

    1. College of Veterinary Medicine, University of Missouri, Columbia, Missouri
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    • Members of the Oncofertility Consortium.

  • Richard L. Stouffer PhD,

    1. Department of Reproductive Sciences, Oregon National Primate Research Center, Oregon Health and Sciences University, Beaverton, Oregon
    2. Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
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    • Members of the Oncofertility Consortium.

  • Lonnie D. Shea PhD,

    1. Department of Chemical and Biological Engineering, Northwestern University, Evanston, Illinois
    2. The Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois
    3. Center for Reproductive Research, Northwestern University, Evanston, Illinois
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    • Members of the Oncofertility Consortium.

  • Teresa K. Woodruff PhD

    Corresponding author
    1. Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
    2. Center for Reproductive Research, Northwestern University, Evanston, Illinois
    • Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine 250 E. Superior Street, Suite 03-2303, Chicago, IL 60611.
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    • Members of the Oncofertility Consortium.


Abstract

Children and women of reproductive age are increasingly surviving cancer diagnoses, and therefore long-term quality-of-life issues are of greater importance at the time of diagnosis. Cancer therapies including radiation and chemotherapy can be detrimental to fertility, and therefore many patients are motivated to preserve fertility prior to cancer treatment. The only highly successful method in preserving fertility to date is embryo cryopreservation, which may not be appropriate for some patients due to age, delay in treatment, cancer type and stage, as well as availability of an acceptable sperm donor. Alternative methods including oocyte cryopreservation and ovarian tissue banking may also preserve fertility while providing additional flexibility to patients. In vitro ovarian follicle maturation following tissue banking is one potential approach that would not require a delay in cancer therapy for ovarian stimulation, would not require an immediate sperm donor, and does not carry the risk of reintroducing malignant cells following tissue transplantation. In vitro follicle culture systems have resulted in successful live births in the mouse. However, many challenges must be addressed in translating the system to the human. This review summarizes current approaches to fertility preservation and discusses recent developments and future challenges in developing a human in vitro follicle culture system. Pediatr Blood Cancer 2009;53:289–295. © 2009 Wiley-Liss, Inc.

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