Women who were treated with a conditioning protocol to prepare them for stem cell transplantation have a high risk of infertility. Patients treated with a conventional protocol have a low risk of infertility.
Women treated with a conditioning protocol to prepare them for stem cell transplantation have a high risk of infertility. These patients must be informed and receive counseling about methods to protect their fertility. GnRH agonists must not be administered to prepubertal patients. The recommendation for ovariopexy must be discussed with the patient and her family. This must be done before starting treatment for malignant disease if cancer therapy can be postponed by 2 weeks. The decision for or against cryopreservation requires the type of therapy and the gonadotoxic dose to be weighed up in each individual case.
The patient and his family must be informed about these options. The subsequent maturation of sperm from spermatogonial stem cells, which would be necessary for this approach, is currently not yet possible in humans. Transplanting cryopreserved tissue always carries the risk of transplanting malignant cells. Information about the options for and the limits of fertility protection should be made available to affected patients both orally and in writing e. Appendix to the Guideline A standard operating procedure SOP on managing the contact with a patient before the patient starts oncologic treatment which will reduce their fertility while the patient may still want to have children is included in the appendix of the long German version of the guideline, together with leaflets on preserving fertility which were compiled together with the German Cancer Society DKG.
Having children after cancer. Decision-making in female fertility preservation is balancing the expected burden of fertility preservation treatment and the wish to conceive. American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. Cancer and fertility preservation: Predicting age of ovarian failure after radiation to a field that includes the ovaries.
Fertility and pregnancy outcome after abdominal irradiation that included or excluded the pelvis in childhood tumor survivors. Human oocyte cryopreservation with slow freezing versus vitrification. Results from the National Italian Registry data, — A randomized controlled trial comparing two vitrification methods versus slow-freezing for cryopreservation of human cleavage stage embryos.
J Assist Reprod Genet. Clinical outcomes following cryopreservation of blastocysts by vitrification or slow freezing: Optimizing outcomes from ovarian tissue cryopreservation and transplantation; activation versus preservation. Risk of transferring malignant cells with transplanted frozen-thawed ovarian tissue. Autotransplantation of cryopreserved ovarian tissue in cancer survivors and the risk of reintroducing malignancy: Incidence and time course of bleeding after long-term amenorrhea after breast cancer treatment: Fertility preservation options for young women with breast cancer.
Prof. Dr. Michael Kaeding - Forschung
Curr Opin Obstet Gynecol. Fertility conservation in breast cancer patients. Womens Health Lond ; 7: Safety and feasibility of performing two consecutive ovarian stimulation cycles with the use of letrozole-gonadotropin protocol for fertility preservation in breast cancer patients. Fertility preservation in female cancer patients: The role of menstrual cycle phase and AMH levels in breast cancer patients whose ovarian tissue was cryopreserved for oncofertility treatment. Association of BRCA1 mutations with occult primary ovarian insufficiency: Age-related decline in DNA repair function explains diminished ovarian reserve, earlier menopause, and possible oocyte vulnerability to chemotherapy in women with BRCA mutations.
Utility of gonadotropin-releasing hormone agonists for prevention of chemotherapy-induced ovarian damage in premenopausal women with breast cancer: Ovarian suppression using luteinizing hormone-releasing hormone agonists during chemotherapy to preserve ovarian function and fertility of breast cancer patients: Copyright and License information Disclaimer. Jens Hirchenhain Arbeitsgemeinschaft Reproduktionsbiologie des Menschen e.
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Jana Liebenthron Fertiprotekt Netzwerk e. Frank Nawroth Fertiprotekt Netzwerk e. Verena Nordhoff Arbeitsgemeinschaft Reproduktionsbiologie des Menschen e. Falk Ochsendorf Deutsche Dermatologische Gesellschaft e. Roxana Schwab Experte Dip. Petra Thorn Beratungsnetzwerk Kinderwunsch Deutschland e. Beratungsnetzwerk Kinderwunsch Deutschland e. Diese Leitlinie entspricht der Stufe: Eine gonadotoxische Wirkung ist nicht wahrscheinlich.
GnRH-Agonisten im Jugendalter ist bislang noch fraglich. Die Empfehlung soll mit der Patientin und der Familie besprochen werden.
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Dies soll vor Therapiebeginn stattfinden, wenn dieser um 2 Wochen verschoben werden kann. Bei Transplantation des kryokonservierten Gewebes besteht die Gefahr der Transplantation von malignen Zellen. Support Center Support Center. Please review our privacy policy.
Assessing the risk of possible infertility and the choice of method s for fertility preservation must be done by an interdisciplinary panel and discussed with the patient in good time before the start of oncologic therapy. Women scheduled to receive a potentially gonadotoxic dose of chemotherapeutic drugs must be informed about the risk of ovarian insufficiency and about methods to preserve fertility.
The negative impact of the gonadal toxicity of chemotherapies increases with patient age. Whether women develop ovarian insufficiency depends on the radiation dose, the age when the patient was exposed to radiation and the volume of irradiated ovarian tissue. Patients who are scheduled to receive radiotherapy which will also irradiate the anatomical area of the ovaries must be informed about the risk of ovarian damage and must be made aware of methods which could preserve their fertility.
Irradiation of the uterus can lead to uterine and tubal sterility and to increased pregnancy risks such as preterm birth, miscarriage and lower birth weight of the infant. Women receiving therapy with bevacizumab should be informed about the risk of ovarian insufficiency and about methods to preserve fertility.
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Patients who receive immunotherapy or targeted therapy should be informed about the unclear risk of ovarian insufficiency and about methods to preserve fertility. Data on gonadal toxicity of tamoxifen are limited and inconsistent; there are no data on the possible effects of aromatase inhibitors combined with GnRH agonists.
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The most important fertility-reducing effect of endocrine therapy used to treat breast cancer is the length of the treatment, as it postpones the time when the patient can have children to a stage in life when patient has reduced ovarian reserve. The possibility of postponing or interrupting endocrine therapy may be discussed with the patient if this would allow her to have children early. Transposition of the ovaries out of the area which will be irradiated may reduce the risk of radiogenic ovarian insufficiency.
Kaeding, Michael and Niko Switek Hrsg. Palomares "A more balanced composition of the European Parliament with degressive proportionality", in: Kaeding "Report allocation in the European Parliament after eastern enlargement", in: Journal of European Public Policy 19 4 , Modelle und Anwendungen, Wiesbaden: Journal of European Integration 29 3: Rapporteurship assigbnment in the European Parliament", in: Journal of Legislative Studies 11 1: European Union Politics, 5 3: Practical experience in the European Union with post-Lisbon legislative vetoes with quasi-legislative acts" in: Bruges Politicsl Research Papers No Laeding "The European Commission: What it is, what it does, and how it does it", London: European Agencies in between Institutions and Member States.
Versluis "Regulatory governance through EU Agencies? Journal of European Public Policy 17 8: Regieren in der Einwanderungsgesellschaft. Impulse zur Integrationsdebatte aus Sicht der Regierungsforschung. Selck "Mapping out the Politicsl Europea: Coalition Patterns in EU decision-making", in: International Political Science Review 26 3: French Politics 2 1: Capital and Credit Markets 51 1: Stack "Legislative Scrutiny?
Journal of Common Market Studies 53 6: The Theory and Practice of Legislation 2 1: European Law Journal 19 3: Versluis "de nieuwe wereld van de Brusslse comitoogie: Obholzer "The new kid on the block.
Journal of European INtegration 29 4: Kaeding "Europeanization beyond the goodness-of-it", in: Comparative Euroepan Politics 4: A Critical Assessment," in: European Journal of Risk Regulation 8 4: Klika "Pharmacovigilance in Europe: Practical implementation across Member States". He graduated in energy engineering Dipl. Jens Weinmann's research focus lies in the analysis of decision-making in regulation, competition policy, and innovation, with a special interest in energy and transport.
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Prof. Dr. Michael Kaeding - Forschung
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