Journal of Reproductive Endocrinology & Infertility

Description

In countries with middle and low incomes, access to fertility preservation and Assisted Reproductive Technology (ART) remains restricted. We wanted to see how ART and fertility preservation are doing in Brazil, taking into account social indicators and legislative issues that may make it difficult for everyone to access these services. Access to ART and fertility preservation services in Brazil is neither simple nor equitable, despite the fact that the Constitution explicitly guarantees the right to health and common law mandates that the state support family planning. Free ART is offered by very few public hospitals, and their capacity far outpaces demand. Private treatment is out of reach for most people, and ART is not covered by health insurance. In order to guarantee the right to family planning, Brazilian law supports but does not mandate the provision of ART and fertility preservation by the state; The fact that only a small number of treatments are still covered by the state contributes to social inequality. According to financial projections, remembering Workmanship for the Brazilian health system is a reasonable option that has the potential to significantly benefit the state in the long run. They also suggest that being excluded from a health system that claims to be "widespread" is not the moral foundation of viewing infertility as a disease. As a preventative measure against the anticipated decline in ripeness, oocyte vitrification, also known as egg freezing, is gaining popularity among women. Roughness facilities have made elective oocyte vitrification an essential part of their treatment plan in countries where this method is permitted.

Hormone Receptors

Women are being encouraged to consider oocyte vitrification and increase their reproductive autonomy as a result of the widespread tendency to postpone motherhood and advancements in laboratory technologies. However, there is still a lot of debate surrounding elective oocyte vitrification, or EEF, both in terms of ethical and medical concerns and in terms of cost-effectiveness. Although vitrification, a laboratory tool, has revolutionized the treatment of infertility, the benefits and drawbacks of EEF must be made abundantly clear. Gynecologic cancer affects a lot of women who are in their reproductive years and want to keep their fertility so they can have children in the future. Nowadays, a growing number of women wait until they are 35 to have children. As a result, providing women with gynecologic cancer with treatment options for longevity preservation has emerged as an essential component of disease survivorship care. The most recent findings regarding fertilitypreserving surgical methods and assisted reproductive technologies that can be utilized to preserve reproductive potential in women with cervical, endometrial, and ovarian cancer were discussed in this review article. A brief section on ripeness conservation in pediatric gynecologic diseases is also included. Richness conservation is a major concern when patients with bosom disease receive oncological treatment. Due to the patients' physical and mental stress, fertility counseling is necessary.

The most common method for preserving fertility at the moment is cryopreservation of mature oocytes. Other experimental options like gonadal protection during chemotherapy and ovarian tissue preservation have been shown to be effective. To ensure high-quality care, it is strongly suggested that you seek a prompt referral to a fertility unit. The various methods for preserving ripeness in patients with breast disease and the safety of pregnancy and breastfeeding after malignant growth are the subject of this article. Using the search terms "breast cancer" and "fertility," we carried out a systematic review of English-language research articles that were published in PubMed or as abstracts from annual meetings of the European Society for Medical Oncology (ESMO), San Antonio Breast Cancer Symposium (SABCS), and American Society of Clinical Oncology (ASCO). There is little information available regarding the availability of fertility preservation services, despite the fact that cancer patients who are reproductively active are particularly concerned about preserving fertility. As the long-term survival rate following a childhood Hematopoietic Stem Cell Transplant (HSCT) continues to rise, patients are increasingly confronted with treatment's late effects. One of the most debilitating side effects of HSCT is infertility, which affects men and women equally.

Hypothyroidism

Post-HSCT gonadal disappointment can't be switched, however a few patients might have the option to take on or give eggs or sperm from a proxy mother. We recently launched a program with a dedicated oncofertility specialist. During the pre- HSCT evaluation period, she typically meets with all ageappropriate patients and their families. Patients and their families can learn about the risk of infertility that comes with treatment and the options for keeping their fertility. Despite being established practices, many children and adolescents are unable to practice sperm banking and egg or embryo cryopreservation. A novel surgical option that recently made fertility preservation for children of all ages possible is the harvesting and cryopreservation of ovarian and testicular tissue. The goal of this study is to find out how safe these close-to-HSCT procedures and conditioning therapy are. This review report covers all patients between the ages of 0 and 25 who, after consulting with our oncofertility trained professional, decided to undergo careful wealth protection (laparoscopic one-sided oophorectomy or testicular biopsy) at our foundation between Walk 2018 and April 2020. Prior to the beginning of HSCT molding, these procedures were carried out under general anesthesia during the focal line situation. In terms of their effects on the HSCT course and postoperative complications, we evaluate the procedures' safety. 22 patients had procedures done to keep their fertility. With a median age of 13 years (ranging from 1 to 22 years), there were nine male patients (41 percent) and thirteen female patients (59 percent).

Thirteen were juvenile (63%) and eight were grown-up (36%). Nonmalignant conditions and hematologic malignancies/solid tumors accounted for 40% of HSCT indications. Eighty-one percent were subjected to myeloablative conditioning, and the majority, or 68%, were given an allogenic graft. One patient with aplastic anemia had their primary graft fail due to a low cell dose. After a second transplant from a different donor, this patient successfully engrafted, but she died of multiorgan failure. He had neutropenia for more than 60 days but never contracted a disease at the carefully chosen location. There were no delays related to the procedure in the time between the beginning of conditioning and discharge. Fertility preservation after HSCT for both benign and malignant conditions is now available to children of all ages. According to the findings of our investigation, these procedures can be carried out on both males and females right at the beginning of conditioning, making central access placement and coupling easier. This meta-analysis examined the effects of various ovarian stimulation protocols on the fertility preservation outcomes of breast cancer patients. The Cochrane Library, Embase, and PubMed databases were searched. The prognosis and survival rates of cancer patients continue to improve with the development of new treatments. However, the gonadotoxicity of aggressive oncological treatment, which can also be used to treat other non-malignant disorders, puts women of reproductive age at risk for premature ovarian failure. Advances in cryobiology and assisted reproduction have made it possible to preserve fertility, which has led to an increase in the number of requests.