Current status of fertility preservation in a Spanish tertiary public hospital: multidisciplinary approach and experience in over 1500 patients

Yasmina Barral, Aina Borrás, Pilar Carrillo, Inés Agustí, Sara Peralta, Gemma Casals, F. Fàbregues, Francesc Fàbregues, Marta Guimerà, Juan Manuel Corral, Josep Calafell-Segura, Josep Maria Calafell, Miriam Redondo, Ariel Glickman, Montserrat Rovira, Bárbara Adamo, E Ricart, Elena Ricart, Dolors Manau
Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2023 · vol. 26(5) , pp. 1129–1138 · doi:10.1007/s12094-023-03330-2 · PMID:37872422 · W4387872990
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This paper reviews the multidisciplinary approach and experience of a Spanish tertiary public hospital in fertility preservation for over 1500 patients.

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Abstract

PURPOSE: Currently, 15% of gynaecological and 9% of haematological malignancies are diagnosed before the age of 40. The increased survival rates of cancer patients who are candidates for gonadotoxic treatments, the delay in childbearing to older ages, and the optimization of in vitro fertilisation techniques have all contributed to an increased interest in fertility preservation (FP) treatments. This study reviews the experience of the Fertility Preservation Programme (FPP) of a tertiary public hospital with a multidisciplinary approach. METHODS: This retrospective study included all the available (FP) treatments, performed in patients of childbearing age between 2006 and 2022. RESULTS: 1556 patients were referred to the FPP: 332 oocyte vitrification cycles, 115 ovarian cortex cryopreservation with 11 orthotopic autotransplantations, 175 gonadotropin-releasing hormone (GnRH) agonist treatments, 109 fertility-sparing treatments for gynaecological cancer, and 576 sperm cryopreservation were performed. Malignancy was the main indication for FP (the main indications being breast cancer in women and haematological malignancies in men), although non-oncological pathologies, such as endometriosis and autoimmune diseases, have increased in recent years. Currently, the most widely used FP technique is oocyte vitrification, the increase of which has been associated with a decrease in the use of cortex CP and GnRH agonists. CONCLUSIONS: The increase in FP treatment reflects the implementation of reproductive counselling in oncology programmes. A multidisciplinary approach in a tertiary public hospital allows individualised FP treatment for each patient. In recent years, there has been a change in trend with the introduction of new indications for FP and a change in techniques due to their optimisation.

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MeSH descriptors

Breast Neoplasms Breast Neoplasms Breast Neoplasms Breast Neoplasms Breast Neoplasms Breast Neoplasms Fertility Preservation Fertility Preservation Fertility Preservation Fertility Preservation Fertility Preservation Fertility Preservation Hematologic Neoplasms Hematologic Neoplasms Hematologic Neoplasms Hematologic Neoplasms Hematologic Neoplasms Hematologic Neoplasms Hematologic Neoplasms European People

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