Fertilitet hos kvinner med kreft : fertilitetsbevarende metoder

Abstract

With the improved survival rates after cancer, an increasing number of young girls and women may experience one of the side effects of the treatment that saved their lives: infertility or premature ovarian failure. Different techniques are available for fertility preservation, of which some are used by routine, such as embryo cryopreservation and pelvic shielding, whereas other are still experimental. One of the investigational methods are cryopreservation of ovarian tissue. This technique has certain advantages over e.g. embryo cryopreservation, such as no need for ovarian stimulation or having a partner. It may also be the only option for prepubertal girls. The ovarian tissue may be harvested by laparoscopy and kept frozen for several years until the infertile woman requests it retransplanted. Worldwide, 18 healthy children have been born as a result of this procedure. In Norway, only two out of 131 women have gotten their ovarian tissue reimplanted, and one of them achieved an improved ovarian function with the transplant. There is, however, a risk of reimplanting malignant cells, so the procedure should be reserved to those patients and diseases having a very low risk of ovarian metastasis.

Even though the global clinical experience is limited, the results of transplanting frozen/thawed ovarian tissue are encouraging. Therefore, it is important that the young female oncological patients get adequate information about the different fertility preservering options available, including cryopreservation of ovarian tissue. Nevertheless, the health care professionals treating the patients should also reveal knowledge about this new and promising method, which may not be indicated only in malignant diseases, but also in non-oncological conditions.