Oncofertility is a new interdisciplinary field at the intersection of oncology and reproductive medicine that expands fertility options for young cancer patients through several fertility preservation and restoration strategies. Aggressive gonadotoxic anticancer regimens including alkylating chemotherapy and total body irradiation TBI are used often in treating girls and young women with hematological malignancies especially in refractory and relapsed cases where Hematopoietic stem cell transplantation HSCT is indicated. The risks of gonadotoxicity and subsequent iatrogenic premature ovarian failure POF and fertility loss depend mainly on the type and stage of the disease, dose, and dosage of anticancer therapy as well as the age of the patient at the beginning of treatment [ 4 , 5 ]. According to the recent fertility preservation guidelines by the American Society of Clinical Oncology ASCO , established options may include embryo freezing and egg freezing. Debatable options may include ovarian protection techniques such as gonadotropin-releasing hormone GnRH analogs and hormonal suppression, surgical ovarian transposition oophoropexy , gonadal shielding and fractionated chemotherapy and radiotherapy.
Preserving fertility in female patients with hematological malignancies: the key points
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