Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-29T13:08:09.584Z Has data issue: false hasContentIssue false

70 - Fertility Preservation in Female and Male Cancer Patients

from PART IV - ETHICAL DILEMMAS IN FERTILITY AND ASSISTED REPRODUCTION

Published online by Cambridge University Press:  04 August 2010

By
Mohamed A. Bedaiwy  and
Tommaso Falcone
Edited by
Botros R. M. B. Rizk ,
Juan A. Garcia-Velasco ,
Hassan N. Sallam  and
Antonis Makrigiannakis
Botros R. M. B. Rizk
Affiliation:
University of South Alabama
Juan A. Garcia-Velasco
Affiliation:
Rey Juan Carlos University School of Medicine,
Hassan N. Sallam
Affiliation:
University of Alexandria School of Medicine
Antonis Makrigiannakis
Affiliation:
University of Crete
Get access

Summary

INTRODUCTION

Female cancer patients between the ages of fifteen and forty-nine years are expected to not only survive their disease but also lead normal lives, mainly because of newer, more effective cancer therapies such as sterilizing chemotherapy and/or radiotherapy. Consequently, fertility preservation has become an important quality-of-life issue. Problems with fertility and obstetric disorders such as early pregnancy loss, premature labor, and low birth weight have all been described after cancer treatment (1).

Recent achievements in assisted reproductive technologies such as novel ovulation induction remedies, oocyte cryopreservation, and ovarian tissue cryopreservation and transplantation have further expanded the options for fertility preservation in women scheduled to receive chemotherapy and/or radiotherapy. However, most of the potential fertility preservation strategies do not have long-term follow-up data. The latest committee report of the American Society of Reproductive Medicine (ASRM) states that embryo cryopreservation is the only option for these patients with sufficient evidence of clinical utility. The remaining options, including orthotopic transplantation of cryopreserved ovarian tissue, are either experimental or without enough evidence to be proposed to patients at this stage.

We will review the recent evidence on the pathophysiology of chemotherapy/radiotherapy-induced gonadal toxicity and the recent data on the indications and the outcomes of techniques used for fertility preservation in female cancer patients.

BASIC OOCYTE BIOLOGY

In humans, primordial germ cells arrive in the gonadal ridge from the yolk sac endoderm by the seventh week of gestation. These germ cells become oogonia, which proliferate by mitosis before differentiating into primary oocytes.

Keywords

assisted reproductive technologieschemoprotectionchemotherapy-induced premature ovarian failurefertility preservationradiotherapy-induced premature ovarian failuresemen cryopreservationtesticular shieldingovariopexytesticular tissue cryopreservation
Type
Chapter
Information
Infertility and Assisted Reproduction , pp. 706 - 716
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Green, DM, Whitton, JA, Stovall, M, et al. Pregnancy outcome of female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Am J Obstet Gynecol 2002; 187(4):1070–80.CrossRefGoogle ScholarPubMed
Block, E. A quantitative morphological investigation of the follicular system in newborn female infants. Acta Anat (Basel) 1953; 17(3):201–6.CrossRefGoogle ScholarPubMed
Forabosco, A, Sforza, C, Pol, A, Vizzotto, L, Marzona, L, Ferrario, VF. Morphometric study of the human neonatal ovary. Anat Rec 1991;231(2):201–8.CrossRefGoogle ScholarPubMed
Gougeon, A. Regulation of ovarian follicular development in primates: facts and hypotheses. Endocr Rev 1996;17(2):121–55.CrossRefGoogle ScholarPubMed
Fauser, BC, Heusden, AM. Manipulation of human ovarian function: physiological concepts and clinical consequences. Endocr Rev 1997;18(1):71–106.Google ScholarPubMed
Wandji, SA, Srsen, V, Voss, AK, Eppig, JJ, Fortune, JE. Initiation in vitro of growth of bovine primordial follicles. Biol Reprod 1996;55(5):942–8.CrossRefGoogle ScholarPubMed
Oktay, K, Briggs, D, Gosden, RG. Ontogeny of follicle-stimulating hormone receptor gene expression in isolated human ovarian follicles. J Clin Endocrinol Metab 1997;82(11):3748–51.Google ScholarPubMed
Ahmed, CE, Dees, WL, Ojeda, SR. The immature rat ovary is innervated by vasoactive intestinal peptide (VIP)-containing fibers and responds to VIP with steroid secretion. Endocrinology 1986;118(4):1682–9.CrossRefGoogle ScholarPubMed
Ezoe, K, Holmes, SA, Ho, L, et al. Novel mutations and deletions of the KIT (steel factor receptor) gene in human piebaldism. Am J Hum Genet 1995;56(1):58–66.Google ScholarPubMed
Elvin, JA, Clark, AT, Wang, P, Wolfman, NM, Matzuk, MM. Paracrine actions of growth differentiation factor-9 in the mammalian ovary. Mol Endocrinol 1999;13(6):1035–48.CrossRefGoogle ScholarPubMed
Dong, J, Albertini, DF, Nishimori, K, Kumar, TR, Lu, N, Matzuk, MM. Growth differentiation factor-9 is required during early ovarian folliculogenesis. Nature 1996;383(6600):531–5.CrossRefGoogle ScholarPubMed
Elvin, JA, Yan, C, Wang, P, Nishimori, K, Matzuk, MM. Molecular characterization of the follicle defects in the growth differentiation factor 9-deficient ovary. Mol Endocrinol 1999;13(6):1018–34.CrossRefGoogle ScholarPubMed
Dube, JL, Wang, P, Elvin, J, Lyons, KM, Celeste, AJ, Matzuk, MM. The bone morphogenetic protein 15 gene is X-linked and expressed in oocytes. Mol Endocrinol 1998;12(12):1809–17.CrossRefGoogle ScholarPubMed
Johnson, J, Canning, J, Kaneko, T, Pru, JK, Tilly, JL. Germline stem cells and follicular renewal in the postnatal mammalian ovary. Nature 2004;428(6979):145–50.CrossRefGoogle ScholarPubMed
Johnson, J, Bagley, J, Skaznik-Wikiel, M, et al. Oocyte generation in adult mammalian ovaries by putative germ cells in bone marrow and peripheral blood. Cell 2005;122(2):303–15.CrossRefGoogle ScholarPubMed
Gosden, RG. Germline stem cells in the postnatal ovary: is the ovary more like a testis?Hum Reprod Update 2004;10(3):193–5.CrossRefGoogle Scholar
Telfer, EE. Germline stem cells in the postnatal mammalian ovary: a phenomenon of prosimian primates and mice?Reprod Biol Endocrinol 2004;2:24.CrossRefGoogle ScholarPubMed
Telfer, EE, Gosden, RG, Byskov, AG, et al. On regenerating the ovary and generating controversy. Cell 2005;122(6):821–2.CrossRefGoogle ScholarPubMed
Manger, K, Wildt, L, Kalden, JR, Manger, B. Prevention of gonadal toxicity and preservation of gonadal function and fertility in young women with systemic lupus erythematosus treated by cyclophosphamide: the PREGO-Study. Autoimmun Rev 2006; 5(4):269–72.CrossRefGoogle ScholarPubMed
Schilsky, RL, Sherins, RJ, Hubbard, SM, Wesley, MN, Young, RC, DeVita, VT. Long-term follow up of ovarian function in women treated with MOPP chemotherapy for Hodgkin's disease. Am J Med 1981;71(4):552–6.CrossRefGoogle ScholarPubMed
Blumenfeld, Z, Avivi, I, Linn, S, Epelbaum, R, Ben-Shahar, M, Haim, N. Prevention of irreversible chemotherapy-induced ovarian damage in young women with lymphoma by a gonadotrophin-releasing hormone agonist in parallel to chemotherapy. Hum Reprod 1996;11(8):1620–6.CrossRefGoogle Scholar
BFS. MWGcbt. A strategy for fertility services for survivors of childhood cancer. Hum Fertil 2003;6:A1–40.
Bath, , Tydeman, G, Critchley, HO, Anderson, RA, Baird, DT, Wallace, WH. Spontaneous conception in a young woman who had ovarian cortical tissue cryopreserved before chemotherapy and radiotherapy for a Ewing's sarcoma of the pelvis: case report. Hum Reprod 2004;19(11):2569–72.CrossRefGoogle Scholar
Meirow, D, Nugent, D. The effects of radiotherapy and chemotherapy on female reproduction. Hum Reprod Update 2001;7(6):535–43.CrossRefGoogle ScholarPubMed
Husseinzadeh, N, Nahhas, WA, Velkley, , Whitney, CW, Mortel, R. The preservation of ovarian function in young women undergoing pelvic radiation therapy. Gynecol Oncol 1984;18(3):373–9.CrossRefGoogle ScholarPubMed
Gaetini, A, Simone, M, Urgesi, A, et al. Lateral high abdominal ovariopexy: an original surgical technique for protection of the ovaries during curative radiotherapy for Hodgkin's disease. J Surg Oncol 1988;39(1):22–8.CrossRefGoogle ScholarPubMed
Williams, RS, Littell, RD, Mendenhall, NP. Laparoscopic oophoropexy and ovarian function in the treatment of Hodgkin disease. Cancer 1999;86(10):2138–42.3.0.CO;2-V>CrossRefGoogle ScholarPubMed
Meirow, D, Schenker, JG, Rosler, A. Ovarian hyperstimulation syndrome with low oestradiol in non-classical 17 alpha-hydroxylase, 17,20-lyase deficiency: what is the role of oestrogens?Hum Reprod 1996;11(10):2119–21.CrossRefGoogle ScholarPubMed
Gosden, RG, Wade, JC, Fraser, HM, Sandow, J, Faddy, MJ. Impact of congenital or experimental hypogonadotrophism on the radiation sensitivity of the mouse ovary. Hum Reprod 1997;12(11):2483–8.CrossRefGoogle ScholarPubMed
Wallace, WH, Thomson, AB, Kelsey, TW. The radiosensitivity of the human oocyte. Hum Reprod 2003;18(1):117–21.CrossRefGoogle ScholarPubMed
Bath, , Wallace, WH, Shaw, MP, Fitzpatrick, C, Anderson, RA. Depletion of ovarian reserve in young women after treatment for cancer in childhood: detection by anti-Mullerian hormone, inhibin B and ovarian ultrasound. Hum Reprod 2003;18(11):2368–74.CrossRefGoogle ScholarPubMed
Crofton, PM, Thomson, AB, Evans, AE, et al. Is inhibin B a potential marker of gonadotoxicity in prepubertal children treated for cancer?Clin Endocrinol (Oxf) 2003;58(3):296–301.CrossRefGoogle ScholarPubMed
Feyereisen, E, Mendez Lozano, DH, Taieb, J, Hesters, L, Frydman, R, Fanchin, R. Anti-Mullerian hormone: clinical insights into a promising biomarker of ovarian follicular status. Reprod Biomed Online 2006;12(6):695–703.CrossRefGoogle ScholarPubMed
Weir, HK, Thun, MJ, Hankey, BF, et al. Annual report to the nation on the status of cancer, 1975-2000, featuring the uses of surveillance data for cancer prevention and control. J Natl Cancer Inst 2003;95(17):1276–99.CrossRefGoogle ScholarPubMed
Jemal, A, Murray, T, Samuels, A, Ghafoor, A, Ward, E, Thun, MJ. Cancer statistics, 2003. CA Cancer J Clin 2003;53(1):5–26.CrossRefGoogle ScholarPubMed
Chiarelli, AM, Marrett, LD, Darlington, G. Early menopause and infertility in females after treatment for childhood cancer diagnosed in 1964-1988 in Ontario, Canada. Am J Epidemiol 1999; 150(3):245–54.CrossRefGoogle ScholarPubMed
Tangir, J, Zelterman, D, Ma, W, Schwartz, PE. Reproductive function after conservative surgery and chemotherapy for malignant germ cell tumors of the ovary. Obstet Gynecol 2003;101(2):251–7.Google ScholarPubMed
Blumenfeld, Z, Dann, E, Avivi, I, Epelbaum, R, Rowe, JM. Fertility after treatment for Hodgkin's disease. Ann Oncol 2002;13(Suppl. 1):138–47.CrossRefGoogle ScholarPubMed
Pereyra Pacheco, B, Mendez Ribas, JM, Milone, G, et al. Use of GnRH analogs for functional protection of the ovary and preservation of fertility during cancer treatment in adolescents: a preliminary report. Gynecol Oncol 2001;81(3):391–7.CrossRefGoogle ScholarPubMed
Fox KR, BJ, Mik, R, Moore, HC. Prevention of chemotherapy-associated amenorrhea (CRA) with leuprolide in young women with early stage breast cancer (Abstract). Proc Ann Soc Clin Oncol 2001(20):25a.Google Scholar
Waxman, JH, Ahmed, R, Smith, D, et al. Failure to preserve fertility in patients with Hodgkin's disease. Cancer Chemother Pharmacol 1987;19(2):159–62.CrossRefGoogle ScholarPubMed
Howell, SJ, Shalet, SM. Fertility preservation and management of gonadal failure associated with lymphoma therapy. Curr Oncol Rep 2002;4(5):443–52.CrossRefGoogle ScholarPubMed
Covens, AL, Putten, HW, Fyles, AW, et al. Laparoscopic ovarian transposition. Eur J Gynaecol Oncol 1996;17(3):177–82.Google ScholarPubMed
Hadar, H, Loven, D, Herskovitz, P, Bairey, O, Yagoda, A, Levavi, H. An evaluation of lateral and medial transposition of the ovaries out of radiation fields. Cancer 1994;74(2):774–9.3.0.CO;2-H>CrossRefGoogle ScholarPubMed
Howard, FM. Laparoscopic lateral ovarian transposition before radiation treatment of Hodgkin disease. J Am Assoc Gynecol Laparosc 1997;4(5):601–4.CrossRefGoogle ScholarPubMed
Anderson, B, LaPolla, J, Turner, D, Chapman, G, Buller, R. Ovarian transposition in cervical cancer. Gynecol Oncol 1993;49(2):206–14.CrossRefGoogle ScholarPubMed
Treissman, MJ, Miller, D, McComb, PF. Laparoscopic lateral ovarian transposition. Fertil Steril 1996;65(6):1229–31.CrossRefGoogle ScholarPubMed
Yarali, H, Demirol, A, Bukulmez, O, Coskun, F, Gurgan, T. Laparoscopic high lateral transposition of both ovaries before pelvic irradiation. J Am Assoc Gynecol Laparosc 2000;7(2):237–9.CrossRefGoogle ScholarPubMed
Clough, KB, Goffinet, F, Labib, A, et al. Laparoscopic unilateral ovarian transposition prior to irradiation: prospective study of 20 cases. Cancer 1996;77(12):2638–45.3.0.CO;2-R>CrossRefGoogle ScholarPubMed
Feeney, DD, Moore, DH, Look, KY, Stehman, FB, Sutton, GP. The fate of the ovaries after radical hysterectomy and ovarian transposition. Gynecol Oncol 1995;56(1):3–7.CrossRefGoogle ScholarPubMed
Chambers, SK, Chambers, JT, Holm, C, Peschel, RE, Schwartz, PE. Sequelae of lateral ovarian transposition in unirradiated cervical cancer patients. Gynecol Oncol 1990;39(2):155–9.CrossRefGoogle ScholarPubMed
Magistrini, M, Szollosi, D. Effects of cold and of isopropyl-N-phenylcarbamate on the second meiotic spindle of mouse oocytes. Eur J Cell Biol 1980;22(2):699–707.Google ScholarPubMed
Stachecki, JJ, Cohen, J, Willadsen, S. Detrimental effects of sodium during mouse oocyte cryopreservation. Biol Reprod 1998;59(2):395–400.CrossRefGoogle ScholarPubMed
Porcu, E, Fabbri, R, Damiano, G, Fratto, R, Giunchi, S, Venturoli, S. Oocyte cryopreservation in oncological patients. Eur J Obstet Gynecol Reprod Biol 2004;113 (Suppl. 1):S14–16.CrossRefGoogle ScholarPubMed
Ovarian tissue and oocyte cryopreservation. Fertil Steril 2004;82(4):993–8.
Oktay, K, Cil, AP, Bang, H. Efficiency of oocyte cryopreservation: a meta-analysis. Fertil Steril 2006;86(1):70–80.CrossRefGoogle ScholarPubMed
Jain, JK, Paulson, RJ. Oocyte cryopreservation. Fertil Steril 2006;86 (Suppl. 4):1037–46.CrossRefGoogle ScholarPubMed
Assisted reproductive technology in the United States: 1998 results generated from the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology Registry. Fertil Steril 2002;77(1):18–31.
Wang, JX, Yap, YY, Matthews, CD. Frozen-thawed embryo transfer: influence of clinical factors on implantation rate and risk of multiple conception. Hum Reprod 2001;16(11):2316–19.CrossRefGoogle ScholarPubMed
Son, WY, Yoon, SH, Yoon, HJ, Lee, SM, Lim, JH. Pregnancy outcome following transfer of human blastocysts vitrified on electron microscopy grids after induced collapse of the blastocoele. Hum Reprod 2003;18(1):137–9.CrossRefGoogle ScholarPubMed
Meniru, GI, Craft, I. In vitro fertilization and embryo cryopreservation prior to hysterectomy for cervical cancer. Int J Gynaecol Obstet 1997;56(1):69–70.CrossRefGoogle ScholarPubMed
Pena, JE, Chang, PL, Chan, LK, Zeitoun, K, Thornton, MH 2nd, Sauer, MV. Supraphysiological estradiol levels do not affect oocyte and embryo quality in oocyte donation cycles. Hum Reprod 2002;17(1):83–7.CrossRefGoogle Scholar
Pelinck, MJ, Hoek, A, Simons, AH, Heineman, MJ. Efficacy of natural cycle IVF: a review of the literature. Hum Reprod Update 2002;8(2):129–39.CrossRefGoogle ScholarPubMed
Oktay, K, Buyuk, E, Davis, O, Yermakova, I, Veeck, L, Rosenwaks, Z. Fertility preservation in breast cancer patients: IVF and embryo cryopreservation after ovarian stimulation with tamoxifen. Hum Reprod 2003;18(1):90–5.CrossRefGoogle ScholarPubMed
Oktay, K, Buyuk, E, Akar, Z, Rosenwaks, N, Libertella, N. Fertility preservation in breast cancer patients: a prospective controlled comparison of ovarian stimulation with tamoxifen and letrozole for embryo cryopreservation. Fertil Steril 2004;82(2):s1(Abstract).CrossRefGoogle Scholar
Oktay, K. Further evidence on the safety and success of ovarian stimulation with letrozole and tamoxifen in breast cancer patients undergoing in vitro fertilization to cryopreserve their embryos for fertility preservation. J Clin Oncol 2005;23(16):3858–9.CrossRefGoogle ScholarPubMed
Mazur, P. The role of intracellular freezing in the death of cells cooled at supraoptimal rates. Cryobiology 1977;14(3):251–72.CrossRefGoogle ScholarPubMed
Gosden, RG, Baird, DT, Wade, JC, Webb, R. Restoration of fertility to oophorectomized sheep by ovarian autografts stored at -196 degrees C. Hum Reprod 1994;9(4):597–603.CrossRefGoogle ScholarPubMed
Baird, DT, Webb, R, Campbell, BK, Harkness, LM, Gosden, RG. Long-term ovarian function in sheep after ovariectomy and transplantation of autografts stored at −196 C. Endocrinology 1999;140(1):462–71.CrossRefGoogle ScholarPubMed
Almodin, CG, Minguetti-Camara, VC, Meister, H, Ceschin, AP, Kriger, E, Ferreira, JO. Recovery of natural fertility after grafting of cryopreserved germinative tissue in ewes subjected to radiotherapy. Fertil Steril 2004;81(1):160–4.CrossRefGoogle Scholar
Israely, T, Nevo, N, Harmelin, A, Neeman, M, Tsafriri, A. Reducing ischaemic damage in rodent ovarian xenografts transplanted into granulation tissue. Hum Reprod 2006;21(6):1368–79.CrossRefGoogle ScholarPubMed
Jeremias, E, Bedaiwy, MA, Nelson, D, Biscotti, CV, Falcone, T. Assessment of tissue injury in cryopreserved ovarian tissue. Fertil Steril 2003;79(3):651–3.CrossRefGoogle ScholarPubMed
Hussein, MR, Bedaiwy, MA, Falcone, T. Analysis of apoptotic cell death, Bcl-2, and p53 protein expression in freshly fixed and cryopreserved ovarian tissue after exposure to warm ischemia. Fertil Steril 2006;85 (Suppl. 1):1082–92.CrossRefGoogle ScholarPubMed
Jeremias, E, Bedaiwy, MA, Gurunluoglu, R, Biscotti, CV, Siemionow, M, Falcone, T. Heterotopic autotransplantation of the ovary with microvascular anastomosis: a novel surgical technique. Fertil Steril 2002;77(6):1278–82.CrossRefGoogle ScholarPubMed
Bedaiwy, MA, Jeremias, E, Gurunluoglu, R, et al. Restoration of ovarian function after autotransplantation of intact frozen-thawed sheep ovaries with microvascular anastomosis. Fertil Steril 2003;79(3):594–602.CrossRefGoogle ScholarPubMed
Wang, X, Chen, H, Yin, H, Kim, SS, Lin Tan, S, Gosden, RG. Fertility after intact ovary transplantation. Nature 2002; 415(6870):385.CrossRefGoogle ScholarPubMed
Bedaiwy, MA, Falcone, T. Harvesting and autotransplantation of vascularized ovarian grafts: approaches and techniques. RBM Online 2007;14(3):360–71.Google ScholarPubMed
Imhof, M, Bergmeister, H, Lipovac, M, Rudas, M, Hofstetter, G, Huber, J. Orthotopic microvascular reanastomosis of whole cryopreserved ovine ovaries resulting in pregnancy and live birth. Fertil Steril 2006;85(Suppl. 1):1208–15.CrossRefGoogle ScholarPubMed
Dittrich, R, Maltaris, T, Mueller, A, et al. Successful uterus cryopreservation in an animal model. Horm Metab Res 2006; 38(3):141–5.CrossRefGoogle Scholar
Chen, CH, Chen, SG, Wu, GJ, Wang, J, Yu, CP, Liu, JY. Autologous heterotopic transplantation of intact rabbit ovary after frozen banking at −196 degrees C. Fertil Steril 2006;86(Suppl. 4):1059–66.CrossRefGoogle ScholarPubMed
Sonmezer, M, Oktay, K. Fertility preservation in female patients. Hum Reprod Update 2004;10(3):251–66.CrossRefGoogle ScholarPubMed
Oktay, K, Buyuk, E, Veeck, L, et al. Embryo development after heterotopic transplantation of cryopreserved ovarian tissue. Lancet 2004;363(9412):837–40.CrossRefGoogle ScholarPubMed
Donnez, J, Dolmans, MM, Demylle, D, et al. Livebirth after orthotopic transplantation of cryopreserved ovarian tissue. Lancet 2004;364(9443):1405–10.CrossRefGoogle ScholarPubMed
Meirow, D, Levron, J, Eldar-Geva, T, et al. Pregnancy after transplantation of cryopreserved ovarian tissue in a patient with ovarian failure after chemotherapy. N Engl J Med 2005;353(3):318–21.CrossRefGoogle Scholar
Oktay, K, Nugent, D, Newton, H, Salha, O, Chatterjee, P, Gosden, RG. Isolation and characterization of primordial follicles from fresh and cryopreserved human ovarian tissue. Fertil Steril 1997;67(3):481–6.CrossRefGoogle ScholarPubMed
Aubard, Y. Ovarian tissue graft: from animal experiment to practice in the human. Eur J Obstet Gynecol Reprod Biol 1999;86(1):1–3.CrossRefGoogle ScholarPubMed
Silber, SJ, Lenahan, KM, Levine, DJ, et al. Ovarian transplantation between monozygotic twins discordant for premature ovarian failure. N Engl J Med 2005;353(1):58–63.CrossRefGoogle ScholarPubMed
Del Priore, G, Stega, J, Sieunarine, K, Ungar, L, Smith, JR. Human uterus retrieval from a multi-organ donor. Obstet Gynecol 2007;109(1):101–4.CrossRefGoogle ScholarPubMed
Gook, DA, Edgar, DH, Borg, J, Archer, J, Lutjen, PJ, McBain, JC. Oocyte maturation, follicle rupture and luteinization in human cryopreserved ovarian tissue following xenografting. Hum Reprod 2003;18(9):1772–81.CrossRefGoogle ScholarPubMed
Smitz, JE, Cortvrindt, RG. The earliest stages of folliculogenesis in vitro. Reproduction 2002;123(2):185–202.CrossRefGoogle ScholarPubMed
Abir, R, Fisch, B, Nitke, S, Okon, E, Raz, A, Ben Rafael, Z. Morphological study of fully and partially isolated early human follicles. Fertil Steril 2001;75(1):141–6.CrossRefGoogle ScholarPubMed
Rao, GD, Chian, RC, Son, WS, Gilbert, L, Tan, SL. Fertility preservation in women undergoing cancer treatment. Lancet 2004;363(9423):1829–30.CrossRefGoogle ScholarPubMed
Rao, GD, Tan, SL. In vitro maturation of oocytes. Semin Reprod Med 2005;23(3):242–7.CrossRefGoogle ScholarPubMed
Howell, SJ, Shalet, SM. Spermatogenesis after cancer treatment: damage and recovery. J Natl Cancer Inst Monogr 2005(34):12–17.CrossRefGoogle ScholarPubMed
Meistrich, ML, Shetty, G. Suppression of testosterone stimulates recovery of spermatogenesis after cancer treatment. Int J Androl 2003;26(3):141–6.CrossRefGoogle ScholarPubMed
Ishiguro, H, Yasuda, Y, Tomita, Y, et al. Gonadal shielding to irradiation is effective in protecting testicular growth and function in long-term survivors of bone marrow transplantation during childhood or adolescence. Bone Marrow Transplant 2007.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×