Fertility Preservation: Recent Developments and New Insights

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 15 May 2024 | Viewed by 9301

Special Issue Editors


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Guest Editor
Women and Infants Hospital, Brown University, Providence, RI, USA
Interests: reproductive endocrinology and infertility; fertility preservation; in vitro fertilization; assisted reproductive technology

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Guest Editor
Department of Obstetrics, Gynecology, and Reproductive Sciences at Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
Interests: reproductive aging; AMH; racial disparities in IVF; fertility preservation; in vitro fertilization; assisted reproductive technology
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Special Issue Information

Dear Colleagues,

Since the birth of Louise Brown in 1978, assisted reproductive technology (ART) has become a mainstay of fertility treatment.  Numerous technological advances have yielded improved success rates and enabled patients to cryopreserve gametes and embryos for future use.

Historically, fertility preservation was only routinely recommended for patients at an increased risk of infertility due to treatment with chemotherapeutic agents, radiation, or surgery.  Improvements in outcomes have subsequently resulted in the lifting of experimental labels from oocyte cryopreservation and ovarian tissue cryopreservation. As such, fertility preservation has become more accessible to patients who are not yet ready to build their families but are at risk of future infertility due to reproductive aging. Fertility preservation has also been increasingly utilized for patients prior to testosterone therapy and gender-affirming surgery.

A growing body of literature supports the safety and efficacy of fertility preservation in certain patient populations.  For example, live birth rates with cryopreserved oocytes in young women are comparable to those with fresh oocytes. Data on the efficacy of ovarian tissue cryopreservation are promising, although still relatively sparse.

Given the increased utilization and rapid technological progress in the field of fertility preservation, the topic is ripe for study. This Special Issue focuses on recent developments and new insights in fertility preservation.

Dr. Jennifer L. Eaton
Dr. David B. Seifer
Guest Editors

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Keywords

  • fertility preservation
  • oocyte cryopreservation
  • in vitro fertilization
  • assisted reproductive technology
  • ovarian tissue cryopreservation

Published Papers (4 papers)

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Research

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10 pages, 253 KiB  
Article
Identification of Psychological Profiles of Cancer Patients Undergoing Fertility Preservation Counseling
by Valentina Elisabetta Di Mattei, Paola Taranto, Gaia Perego, Serena Desimone, Paola Maria Vittoria Rancoita, Antonio Catarinella, Raffaella Cioffi, Giorgia Mangili, Valeria Stella Vanni and Massimo Candiani
J. Clin. Med. 2023, 12(12), 4011; https://doi.org/10.3390/jcm12124011 - 12 Jun 2023
Viewed by 1191
Abstract
Gonadotoxicity is one of the most distressing side effects of cancer treatment. Fertility preservation strategies should be included during the treatment pathway to prevent the risk of infertility, but the decision to preserve fertility often represents a challenging process that carries an emotional [...] Read more.
Gonadotoxicity is one of the most distressing side effects of cancer treatment. Fertility preservation strategies should be included during the treatment pathway to prevent the risk of infertility, but the decision to preserve fertility often represents a challenging process that carries an emotional decision-making burden. The aim of this study is to characterize the psychological profiles of women undergoing fertility preservation counseling and to better understand their features. Eighty-two female cancer patients were included in the study. They were asked to complete a battery of self-administered tests which evaluated socio-demographic characteristics, defense mechanisms, depression, anxiety, and representations regarding the importance of parenthood. Based on the psychometric variables, cluster analysis identified four groups which showed significantly different combinations of these psychological characteristics. An additional analysis was performed to evaluate if sociodemographic variables were associated with the four groups, but the results did not show significant differences. These results suggest that very diverse psychological profiles may lead cancer patients to attend oncofertility counseling and choose fertility preservation. For this reason, all patients in childbearing age should have the opportunity to receive appropriate fertility preservation counseling in order to make an informed decision that could have an important impact on their long-term quality of life. Full article
(This article belongs to the Special Issue Fertility Preservation: Recent Developments and New Insights)

Review

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13 pages, 249 KiB  
Review
A Review of Animal Models Investigating the Reproductive Effects of Gender-Affirming Hormone Therapy
by Nicholas S. Raja, Elizabeth S. Rubin and Molly B. Moravek
J. Clin. Med. 2024, 13(4), 1183; https://doi.org/10.3390/jcm13041183 - 19 Feb 2024
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Abstract
Gender-affirming hormone therapy (GAHT) is an important component in the process of transitioning for many transgender and gender-diverse (TGD) individuals. Multiple medical organizations recommend fertility preservation counseling prior to initiation of GAHT; however, there remains little high-quality data regarding the impact of GAHT [...] Read more.
Gender-affirming hormone therapy (GAHT) is an important component in the process of transitioning for many transgender and gender-diverse (TGD) individuals. Multiple medical organizations recommend fertility preservation counseling prior to initiation of GAHT; however, there remains little high-quality data regarding the impact of GAHT on fertility and reproductive function. A PubMed literature review was performed using Boolean search operators linking keywords or phrases such as “mouse”, “rat”, “primate”, “animal model”, “transgender”, “gender”, “estrogen”, “testosterone”, “fertility”, and “fertility preservation”. Recent research has produced a number of animal models of GAHT that utilize similar hormonal regimens and produce similar phenotypic results to those used and observed in human patients. Specific to testosterone(T)-containing GAHT, animals demonstrate loss of menstrual cyclicity with therapy, resumption of menses on cessation of therapy, suppression of gonadotropin levels, and physical changes such as clitoromegaly. Models mimicking GAHT for transmasculine individuals in the peripubertal period demonstrate that pretreatment with GnRHa therapy does not modify the effects of subsequent T administration, which were similar to those described in adult models. Both models suggest promising potential for future fertility with cessation of T. With estradiol (E)-containing GAHT, animals exhibit decreased size of testicles, epididymis, and seminal vesicles, as well as ongoing production of spermatocytes, and seminiferous tubule vacuolization. Given the ethical challenges of conducting human studies in this area, high-fidelity animal models represent a promising opportunity for investigation and could eventually transform clinical counseling about the necessity of fertility preservation. Future studies should better delineate the interactions (if any exist) between treatment attributes such as dosing and duration with the extent of reversibility of reproductive perturbations. The development of models of peripubertal feminizing GAHT is an additional area for future work. Full article
(This article belongs to the Special Issue Fertility Preservation: Recent Developments and New Insights)
15 pages, 513 KiB  
Review
Oocyte Cryopreservation for Medical and Planned Indications: A Practical Guide and Overview
by Eric Han and David B. Seifer
J. Clin. Med. 2023, 12(10), 3542; https://doi.org/10.3390/jcm12103542 - 18 May 2023
Cited by 2 | Viewed by 2436
Abstract
Oocyte cryopreservation (OC) is the process in which ovarian follicles are stimulated, the follicular fluid is retrieved, and mature oocytes are isolated and vitrified. Since the first successful pregnancy utilizing previously cryopreserved oocytes in 1986, OC has become increasingly utilized as an option [...] Read more.
Oocyte cryopreservation (OC) is the process in which ovarian follicles are stimulated, the follicular fluid is retrieved, and mature oocytes are isolated and vitrified. Since the first successful pregnancy utilizing previously cryopreserved oocytes in 1986, OC has become increasingly utilized as an option for future biologic children in patients facing gonadotoxic therapies, such as for the treatment of cancer. Planned OC, also termed elective OC, is growing in popularity as a means to circumvent age-related fertility decline. In this narrative review, we describe both medically indicated and planned OC, focusing on the physiology of ovarian follicular loss, OC technique and risks, timing of when OC should be performed, associated financial considerations, and outcomes. Full article
(This article belongs to the Special Issue Fertility Preservation: Recent Developments and New Insights)
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13 pages, 631 KiB  
Review
In Vitro Gametogenesis in Oncofertility: A Review of Its Potential Use and Present-Day Challenges in Moving toward Fertility Preservation and Restoration
by Victoria G. Wesevich, Christopher Arkfeld and David B. Seifer
J. Clin. Med. 2023, 12(9), 3305; https://doi.org/10.3390/jcm12093305 - 06 May 2023
Cited by 3 | Viewed by 4140
Abstract
Current fertility preservation options are limited for cancer survivor patients who wish to have their own biological children. Human in vitro gametogenesis (IVG) has the hypothetical ability to offer a unique solution to individuals receiving treatment for cancer which subsequently shortens their reproductive [...] Read more.
Current fertility preservation options are limited for cancer survivor patients who wish to have their own biological children. Human in vitro gametogenesis (IVG) has the hypothetical ability to offer a unique solution to individuals receiving treatment for cancer which subsequently shortens their reproductive lifespan. Through a simple skin punch biopsy, a patient’s fertility could be restored via reprogramming of dermal fibroblast cells to induced pluripotent stem cells, then from primordial germ cell-like cells into viable oocytes and spermatocytes which could be used for embryogenesis. Induced pluripotent stem cells could also be used to form in vitro environments, similar to the ovary or testes, necessary for the maturation of oogonia. This would allow for the entire creation of embryos outside the body, ex vivo. While this area in stem cell biology research offers the potential to revolutionize reproduction as we know it, there are many critical barriers, both scientific and ethical, that need to be overcome to one day see this technology utilized clinically. Full article
(This article belongs to the Special Issue Fertility Preservation: Recent Developments and New Insights)
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