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Table of Contents
EDITORIAL
Year : 2020  |  Volume : 3  |  Issue : 2  |  Page : 47

Fertility preservation for patients on gonadotoxic treatment recommendations for clinical practice by Fertility Preservation Society (India)


Mother and Child Hospital, New Delhi, India

Date of Submission26-Dec-2020
Date of Acceptance27-Dec-2020
Date of Web Publication19-May-2021

Correspondence Address:
Dr. Nalini Kaul Mahajan
Mother and Child Hospital, D64, Defence Colony, New Delhi - 110 024
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2589-9597.315958

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How to cite this article:
Kaul Mahajan N. Fertility preservation for patients on gonadotoxic treatment recommendations for clinical practice by Fertility Preservation Society (India). Onco Fertil J 2020;3:47

How to cite this URL:
Kaul Mahajan N. Fertility preservation for patients on gonadotoxic treatment recommendations for clinical practice by Fertility Preservation Society (India). Onco Fertil J [serial online] 2020 [cited 2021 Dec 8];3:47. Available from: https://www.tofjonline.org/text.asp?2020/3/2/47/315958



“Science is a beautiful gift to humanity; we should not distort it.” A. P. J. Abdul Kalam.

The increasing number of young cancer survivors and their desire to have biological offspring has spurred scientists to push boundaries. Oncofertility has become an integral part of reproductive medicine in recent years. In fact, not informing the patient about risk to fertility with cancer treatment and the possibility of fertility preservation has medicolegal implications. The knowledge that cancer therapy damages gametes leads to freezing of embryos and sperms/testicular tissue before chemoradiotherapy. Improvement in technology saw a shift to oocyte freezing to provide reproductive autonomy to the woman. Unfortunately, women who needed to start chemotherapy immediately and prepubertal girls, could not benefit from this as the procedure requires ovarian stimulation. This spearheaded experimentation with ovarian tissue cryopreservation (OTC) and transplantation. Benefits of OTC and the reproductive outcome reported with transplanted tissue have compelled regulatory bodies to remove the experimental label in some countries. For prepubertal boys, an immature testicular tissue freezing protocol has been developed and attempts are being made to mature sperms in vitro. Transplantation of uterus, whole ovary, and testes is being tried with successful uterine transplantation resulting in conception and delivery being reported. There appears to be no limits to what science can achieve. Our excitement to help oncofertility patients, however, should not prevent us from being aware of the side effects and the possibility of cancer recurrence through the use of techniques like tissue transplantation.

The importance of research, knowledge, and regulation to maintain safety cannot be overemphasized. It is incumbent on us as physicians to “first do no harm” and use procedures judiciously. Racial, ethnic, social, and economic differences between countries encouraged us to come out with recommendations for fertility preservation for Indian patients. I thank all the oncologists and reproductive medicine specialists who helped in putting together this comprehensive document. This manuscript has been prepared to help reproductive medicine specialists and oncologists to provide their patients with proper counseling and management.

Acknowledgments

We gratefully acknowledge the contribution of our collaborating fertility experts and faculty from cancer hospital. We also acknowledge the immense personal assistance by Prof Claus Y Andersen (Denmark).






 

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