Journal of Reproductive Endocrinology & Infertility

Description

The knowledge of tried-and-true methods for preserving fertility is essential for residents-in-training to be equipped with as primary reproductive healthcare providers. The knowledge, attitudes, and perceptions of Filipino residents in obstetrics and gynecology regarding fertility preservation were the subject of the study. A study of a cohort over time. Women who were treated for fertility preservation in two IVF units between 2016 and 2021 and had a definitive diagnosis of ovarian endometriosis (based on histology or ultrasound) were included. The number of MII oocytes retrieved was the primary outcome because some women cryopreserved oocytes and other embryos. The incidence of endometrial cancer (EC), which is the fourth most common cancer in women worldwide, is rising annually.EC is diagnosed in 10%–15% of young patients. Surgery to remove the uterus after birth is an option for patients of childbearing age with early endometrial cancer or atypical hyperplasia. Reproductive doctors and oncologists face a significant obstacle in assisting these patients in safely becoming pregnant as soon as possible. The most recent developments in conservative treatment, candidates for fertility preservation, and the application of molecular detection, the fertility outcome, and follow-up treatment with the goal of stimulating more thought will be discussed in this article. The number of patients managed before, during, and after the lockdown, as well as the number of patients who were unable to have access to these techniques and consequently suffered definitive losses of fertility during the lockdown period in spring 2020, were all requested in a questionnaire sent to all fertility preservation centers. Despite an increase in cancer incidence worldwide, advances in early detection and treatment have maintained a decline in mortality. Chemotherapy and radiotherapy, two types of cancer treatments, can have an effect on survivors' reproductive capacity by causing premature ovarian failure and subsequent infertility, which can cause significant psychological distress and lower quality of life. In spite of the recent advancements in assisted reproductive technology and the rising demand for fertility preservation services among cancer survivors, many cancer patients in low-, middle-, and, to a lesser extent, high-income nations lack access to these services. Therefore, the purpose of this article is to provide an overview of the effects of cancer treatment on fertility, the options for fertility preservation, and the factors that influence the utilization of fertility preservation by women who have been diagnosed with cancer.

Global Access to Oncofertility Care

In addition, we highlight practical steps that can be taken to improve global access to oncofertility care for women with cancer and discuss the practices, outcomes, and availability of fertility preservation services in low, middle, and high-income nations. Increased awareness of the numerous medical and social challenges faced by cancer survivors has resulted from advancements in cancer treatment that has led to dramatic improvements in long-term survival rates. Women and transgender men are particularly concerned about the potential negative effects on fertility, and the rising trend of delaying childbearing and the higher proportion of patients who have not completed their family at the time of diagnosis raise the demand for a fertility preservation service that is optimized. A rapidly growing area of reproductive medicine is fertility preservation for this group after a cancer diagnosis, though the availability of this treatment often varies by region. This area of fertility care has significantly expanded thanks to significant advancements in oocyte cryopreservation and, more recently, ovarian tissue cryopreservation. In the past, there were few treatment options. All cisgender women, but not necessarily all transgender and non-binary people, will be covered in this review. Beyond the scope of this paper, there are distinct transgender fertility preservation considerations. Before beginning any gonadotoxic treatment, it is important to provide every person who possesses female reproductive organs with the opportunity to talk about preserving their fertility. Failure to do so may have a negative impact on their choice of anticancer treatment and treatment adherence. It is recognized that these complex patients require specialist management within recognized care pathways, and as demand for these treatment options increases, there are currently few networks streamlined around offering this service. In this section, we want to talk about some of the unique difficulties that come with providing cutting-edge services, especially in the COVID-19 pandemic's financially volatile environment. When it comes to deciding whether or not to have children as a result of gender-affirming medical or surgical procedures, the transgender and nonbinary communities face particular difficulties. Overt discrimination in the healthcare system has historically limited the options available to these patients. This comprehensive review examines both previous and current legislation pertaining to TGNB reproductive rights and trends in TGNB reproductive access and healthcare over the past two decades.

Immature Oocytes

Fertility preservation should be offered to young cancer patients because gonadotoxic cancer treatment may impair fertility. The cryopreservation rates of sperm continue to be unsatisfactory despite affirmative guidelines.The improvement of oncofertility over the course of the last ten years has restored the interest in vitro development due to the particularity of a few oncologic circumstances that might forestall the practicality of controlled ovarian hyperstimulation.It is possible to vitrify mature oocytes or embryos following IVM in urgent situations or when stimulation is contraindicated because immature cumulusoocyte complexes can be recovered from small antral follicles in any phase of the menstrual cycle within a very short time frame. From extracorporeal ovarian tissue, cumulus-oocyte complexes and immature oocytes can be obtained in the laboratory either directly or transvaginally. Because of safety tests, IVM is no longer considered experimental. However, it relies on the extremely complicated process of oocyte. To all the more likely distinguish hindrances for TGNB populace and patterns in regards to richness safeguarding, our audit analyzes the mentalities, information, and convictions of both TGNB people and medical care suppliers. Second, we examine both previous and current legislation regarding access to TGNB care and reproductive rights. Our review reveals that TGNB individuals' fertility care does not meet the standard of care, which likely contributes to the low utilization of fertility preservation services among this population. In addition, we find that healthcare providers must play a crucial role in advocating for systemic changes that can help break down barriers and provide TGNB people with reproductive health issues with equitable, gender-affirming care.