Lauren Ataman-Millhouse

Dr. Mahmoud Salama, Assistant Professor, Professorship-Fellow at Department of Gynecology and Obstetrics, Medical Faculty, University of Cologne, Germany, who is also an Oncofertility Global Partners Network representative from Egypt and Germany, recently published an article in Clinical Reviews of Oncology/Hematology. The article 'Updates in preserving reproductive potential of prepubertal girls with cancer: Systematic review' appears in the July issue of the journal and discusses the advantages and disadvantages associated with fertility preservation options for prepubertal girls.  Ultimately, the authors offer insights on the best FP options for prepubertal girls and and further discuss some medical and ethical considerations, as well. Below is the abstract. To read the paper in its entirety, click here. Congratulations to Dr. Salama and his colleagues on this review!


INTRODUCTION:

With increasing numbers of adult female survivors of childhood cancers due to advances in early diagnosis and treatment, the issue of preserving the reproductive potential of prepubertal girls undergoing gonadotoxic treatments has gained greater attention.

METHODS:

According to PRISMA guidelines, a systematic review of the literature was performed for all relevant full-text articles published in PubMed in English throughout the past 15 years to explore the significant updates in preserving the reproductive potential of prepubertal girls with cancer.

RESULTS:

The two established fertility preservation options, embryo freezing and egg freezing, cannot be offered routinely to prepubertal girls as these options necessitate prior ovarian stimulation and subsequent mature oocytes retrieval that are contraindicated or infeasible before puberty. Therefore, the most suitable fertility preservation options to prepubertal girls are (1) ovarian tissue freezing and autotransplantation, (2) in vitro maturation, and (3) ovarian protection techniques. In this review, we discuss in detail those options as well as their success rates, advantages, disadvantages and future directions. We also suggest a new integrated strategy to preserve the reproductive potential of prepubertal girls with cancer.

CONCLUSION:

Although experimental, ovarian tissue slow freezing and orthotopic autotransplantation may be the most feasible option to preserve the reproductive potential of prepubertal girls with cancer. However, this technique has two major and serious disadvantages: (1) the risk of reintroducing malignant cells, and (2) the relatively short lifespan of ovarian tissue transplants. Several medical and ethical considerations should be taken into account before applying this technique to prepubertal girls with cancer.

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