par Demeestere, Isabelle 
Référence Female and Male Fertility Preservation, Springer International Publishing, page (279-292)
Publication Publié, 2022-01
Référence Female and Male Fertility Preservation, Springer International Publishing, page (279-292)
Publication Publié, 2022-01
Partie d'ouvrage collectif
| Résumé : | The quality of life of childhood cancer survivors has become a major concern as disease-free survival rates now reach greater than 80%. Moreover, the incidence of cancer diagnosis in children continues to increase in the large majority of countries. Oncological treatments, such as conditioning regimens before stem cell transplantation, can also be used for non-oncological indications such as haematological diseases (sickle cell anaemia, thalassemia) with similar long-term consequences on ovarian function. All guidelines now recommend that patients and their parents be informed about the risks of future infertility and premature ovarian insufficiency and that children at high risk be referred for fertility preservation. However, fertility preservation procedures remain experimental in children and should only be offered after careful evaluation of the risk/benefit balance by a multidisciplinary team. The only established procedure is oocyte or embryo cryopreservation, but this cannot be applied in prepubertal patients and has limitations in adolescents. The most frequently used procedure is the cryopreservation of ovarian tissue that can be combined with ex vivo immature oocyte collection when feasible. Although this procedure has been performed in thousands of children worldwide, limited data are available on outcomes after transplantation of cryopreserved ovarian tissue in this population. Finally, more specific techniques have been addressed in this review, such as ovarian transposition. |
