Ovarian tissue cryopreservation for treating POI post bone marrow transplant
Discussion
Background
- What is POI (definition)
- How often can it happen after HCT
Fertility preservation
- Little bit about fertility preservation as one part of treatment (and why it’s needed? e.g. causes mental health harm and could reference case)
- List of potential fertility preservation techniques (table)
- How is it decided which to use?
- Why is it hard to compare with the other methods of FP?
- Heterogenous methodologies
- Ovarian tissue cryopreservation does not carry risks associated with ovarian stimulation and treatment delays, but it does come with repeated surgical risks
- Outcomes of oocyte and embryo cryopreservation are limited to a single conception and live birth per embryo transfer but OCT can lead to potentially multiple pregnancies from a single transplant
Ovarian tissue cryopreservation
- What is ovarian tissue cryopreservation?
- Has a LBR of 32-57% choose references based on number we have
- Approved by ASRM, ESHRE and BFS recently → explain what guidelines each say
- Has resulted in an estimate of over 200 births - Graph with increasing live births
- [10] Donnez J, Dolmans MM. Fertility preservation in women. New England Journal of Medicine. 2017 Oct 26;377(17):1657-65.
- Modifed to include one of the references saying there’s 200 live births predicted now
- Better than the other 2 because:
- It restores endocrine function, which the other 2 don’t, and in >90% of women
- A lot quicker than both the other 2 (which can take 2-3 weeks), as it doesn’t need ovarian stimulation, which may be risky in patients with cancer who need immediate treatment
- Here’s what factors affect it and how: age, anti-cancer therapy before retrieval, type of cancer etc
- Age - does
- Radiotherapy and chemo - does and does not
- Type of cancer - does not
- freezing technique
What are the gaps in the literature?