Hamish B Wallace
University of Edinburg, United Kingdom
Title: Female fertility in survivors of childhood malignancy
Biography
Biography: Hamish B Wallace
Abstract
With 70% of young patients with cancer becoming long-term survivors the issue of fertility outcome has become an issue of great importance (Wallace et al 2012). Female fertility preservation provides significantly different challenges to that for the male (Wallace et al. 2005). Embryo freezing is now a well-established procedure in many centres, but is not available for children who do not have a partner. Cryopreservation using vitrification of mature oocytes has become increasingly successful, but requires the patient to go through a course of hormone stimulation and is therefore not appropriate for children and young girls. Ovarian tissue cryopreservation has the potential advantages of preservation of a large number of oocytes within primordial follicles, it does not require hormonal stimulation when time is short, and is appropriate for the pre-pubertal girl. Disadvantages include the need for an invasive procedure, and the uncertain risk of ovarian contamination in haematological and other malignancies. Ovarian tissue cryopreservation in adult women with later re-implantation has resulted in at least 20 live births worldwide. rnrnWe strongly recommend that all young patients with cancer have an assessment made of their fertility prognosis before they commence treatment (Wallace WH et al 2012). We have previously published guidelines for patient selection in young female patients with cancer and in this lecture I will report our practise in a single centre that has offered fertility preservation since 1996. Ovarian cryopreservation was offered to 9% of our patients, and performed in 5%. The procedure was safe and without complications. All but one of our patients who have thus far developed premature ovarian insufficiency were identified pre-treatment using our criteria. More research is required before ovarian tissue cryopreservation in young patients with cancer can be considered to be an established technique available to patients out with IRB approved studies.rn