Fertility Preservation wwwwwwwwwwwwww (cid:37)(cid:77)(cid:82)(cid:69)(cid:0)(cid:51)(cid:69)(cid:76)(cid:73)(cid:0) (cid:115)(cid:0) (cid:33)(cid:83)(cid:72)(cid:79)(cid:75)(cid:0)(cid:33)(cid:71)(cid:65)(cid:82)(cid:87)(cid:65)(cid:76) Editors Fertility Preservation (cid:37)(cid:77)(cid:69)(cid:82)(cid:71)(cid:73)(cid:78)(cid:71)(cid:0)(cid:52)(cid:69)(cid:67)(cid:72)(cid:78)(cid:79)(cid:76)(cid:79)(cid:71)(cid:73)(cid:69)(cid:83)(cid:0) (cid:65)(cid:78)(cid:68)(cid:0)(cid:35)(cid:76)(cid:73)(cid:78)(cid:73)(cid:67)(cid:65)(cid:76)(cid:0)(cid:33)(cid:80)(cid:80)(cid:76)(cid:73)(cid:67)(cid:65)(cid:84)(cid:73)(cid:79)(cid:78)(cid:83) (cid:38)(cid:79)(cid:82)(cid:69)(cid:87)(cid:79)(cid:82)(cid:68)(cid:0)(cid:66)(cid:89)(cid:0)(cid:35)(cid:72)(cid:65)(cid:82)(cid:76)(cid:69)(cid:83)(cid:0)(cid:42)(cid:14)(cid:0)(cid:44)(cid:79)(cid:67)(cid:75)(cid:87)(cid:79)(cid:79)(cid:68)(cid:12)(cid:0)(cid:45)(cid:36) Editors Emre Seli, MD Ashok Agarwal, PhD, Department of Obstetrics, HCLD (ABB), EMB (ACE) Gynecology, and Reproductive Sciences Director Yale University School of Medicine Center for Reproductive Medicine New Haven, CT, USA Cleveland Clinic [email protected] Cleveland, OH, USA [email protected] ISBN 978-1-4419-1782-9 e-ISBN 978-1-4419-1783-6 DOI 10.1007/978-1-4419-1783-6 Springer New York Dordrecht Heidelberg London Library of Congress Control Number: 2011936522 © Springer Science+Business Media, LLC 2012 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) Foreword Women diagnosed with cancer prior to or during their reproductive period often face both the uncertainty of long-term survival, and the risk of treat- ment-induced infertility. Treatments for common cancers occurring in younger women often necessitate extirpation of their reproductive organs, radiation therapy, and/or chemotherapy, each of which may partially or com- pletely impair reproductive (and endocrine) function. Fortunately, during the last two decades, cancer survival in the USA has improved. This has resulted in an increased focus on maximizing the quality of life for cancer survivors. Preserving future fertility is a crucial component of the quality of life in pre- pubertal and reproductive age women. Similarly, cancer can also strike young men, the treatments for which pose comparable risks to future fertility. Thus, clinicians caring for such patients will find this textbook valuable in both counseling and caring for younger women and men with newly diagnosed cancers. However, there is a third group of patients in whom fertility preservation is of increasing relevance, interest, and importance. Women in much of the industrial world have been progressively delaying initiation/completion of childbearing to later in life. More women in their late 30s and early 40s are attempting to conceive for the first time than ever before. Since the incidence of most cancers in the reproductive age group is comparatively low, inten- tionally postponing childbearing presents a far more common indication for fertility preservation than cancer. The editors are well suited to the purposes of this text. Both are gifted fertility practitioners and physician scientists. Dr. Ashok Agarwal is the Director of the Center for Reproductive Medicine at Cleveland Clinic. He has authored over 150 peer reviewed publications, garnered multiple research grants, and is internationally recognized for his outstanding contributions in scientific and clinical aspects of reproductive medicine. Dr. Emre Seli is an accomplished reproductive scientist and physician at the Yale School of Medicine. Dr. Seli has conducted novel and potentially landmark research regarding basic oocyte mRNA processing, a process relevant to maternal age- associated infertility. Dr. Seli has also pioneered the development of novel technologies for assessing embryo quality in vitro. Meanwhile, Dr. Seli directs a highly successful oocyte donation program at his home institution. Drs. Agarwal and Seli have assembled an “All Star” cast of authors, each an expert in the topics about which they write. The goal of the text is to pres- v vi (cid:38)(cid:79)(cid:82)(cid:69)(cid:87)(cid:79)(cid:82)(cid:68) ent strategies for fertility preservation in women and men who require gonad- otoxic and other fertility-impairing therapies. In addition, key epidemiologic, ethical, medico-legal, psychologic and social aspects of fertility preservation are discussed. A format that combines a concise scientific background with practical methodological information, including detailed and straightforward algorithms, is utilized. Step-by-step protocols for laboratory procedures are presented. The result is a concise, readable, and highly practical reference guide for reproductive endocrinologists, embryologists, reproductive scien- tists, and oncologists. This text will also greatly aid the general ob/gyn in counseling both the relatively uncommon younger patient facing fertility- compromising treatments and the increasingly common woman in her 30s or early 40s who elects to delay fertility for a myriad of professional and per- sonal reasons. For all these reasons, I can enthusiastically recommend this textbook to you. New Haven, CT Charles J. Lockwood, MD Preface Dum spiro, spero [As long as I breathe, I hope] Marcus Tullius Cicero Cancer is not uncommon in men and women of reproductive age. In the USA alone, over 130,000 men and women below the age of 45 were afflicted with cancer in 2008. The compromised fertility that will be faced by many of these patients can result in significant psychosocial stress and in reduced quality of life; even long after the cancer has been successfully treated. Fortunately, the rapid pace of scientific and technological discovery has increased the options available to men and women in need of fertility preser- vation. More than 30 years after the birth of the first child conceived by assisted reproductive technologies, we are now able to cryopreserve embryos, spermatozoa, and oocytes as well as testicular and ovarian tissue. In addition, the effect of gonadotoxic treatments on fertility is better defined and the use of medical interventions for fertility preservation is within reach. With increasingly complex modalities available for fertility preservation comes the need for a clear, concise, readable, and practical text to serve as a resource for healthcare providers. This textbook has been written with the aim of providing an update on options for fertility preservation for both men and women. Within this con- text, this text reviews current therapeutic modalities in great detail and describes the biologic basis for available interventions. A key aspect of this volume is the valuable contributions from oncologists, obstetricians, psy- chologists, epidemiologists, and ethicists in addition to reproductive scien- tists and infertility specialists. This thorough resource thus recapitulates the multidisciplinary approach that is required to adequately provide patient care with a view to fertility preservation. Following introductory chapters on the epidemiology and ethics of fertil- ity preservation, this book is divided into two main sections that share a simi- lar overall format while reviewing fertility preservation in female and then male patients. Each section starts with a chapter reviewing the gender- specific biology of the reproductive system within the context of fertility preservation. Then, the impact of gonadotoxic treatment on gonadal function and on the offspring is reviewed. Additional chapters in each section sum- marize established and experimental methodologies currently available for fertility preservation in both sexes, providing detailed protocols for laboratory vii viii (cid:48)(cid:82)(cid:69)(cid:70)(cid:65)(cid:67)(cid:69) procedures. The resulting comprehensive text provides cutting edge science and evidence-based suggestions regarding potential interventions directed at fertility preservation. This book is dedicated to our patients who, despite facing potentially lethal diagnoses and compromised quality of life, continue to hope, to live, and to pursue their dreams of parenthood. New Haven, CT Emre Seli Cleveland, OH Ashok Agarwal Contents Part I Overview of Fertility Preservation: Epidemiologic, Social, Ethical, and Medicolegal Aspects 1 The Epidemiology of Fertility Preservation .............................. 3 William Murk and Emre Seli 2 Ethical Discussions in Approaching Fertility Preservation .................................................................................. 19 Pasquale Patrizio Part II Fertility Preservation in Women 3 Ovarian Follicle Development and Fertility Preservation .................................................................................. 29 Yuichi Niikura and Joshua Johnson 4 Impact of Chemotherapy and Radiotherapy on the Ovary ................................................................................. 45 Maya L. Kriseman and Ertug Kovanci 5 Impact of Chemotherapy and Radiotherapy on the Uterus ................................................................................ 57 Abbie L. Fields, Deleep Kumar Gudipudi, and Giuseppe Del Priore 6 Ovarian Transposition ................................................................. 71 Elena S. Ratner, Dan-Arin Silasi, and Masoud Azodi 7 Embryo Cryopreservation and Alternative Controlled Ovarian Hyperstimulation Strategies for Fertility Preservation .................................................................................. 77 Bulent Urman, Ozgur Oktem, and Basak Balaban 8 Oocyte Cryopreservation ............................................................. 89 Andrea Borini and Veronica Bianchi 9 Ovarian Tissue Cryopreservation and Autotransplantation ............................................................. 107 Mohamed A. Bedaiwy, Gihan M. Bareh, Katherine J. Rodewald, and William W. Hurd ix x Contents 10 Oocyte In Vitro Maturation: Formidable Obstacles on the Road to Fertility Preservation ......................................... 121 David F. Albertini 11 Whole Ovary Cryopreservation .................................................. 129 Hulusi Bulent Zeyneloglu, Gogsen Onalan, and Cengiz Karakaya 12 Risk of Transplanting Cryopreserved Ovarian Tissue in Women with Malignancies ...................................................... 135 Javier Domingo del Pozo, María Sánchez-Serrano, and Antonio Pellicer 13 Gonadotropin-Releasing Hormone Agonists in Fertility Preservation ............................................................... 145 Hakan Cakmak and Emre Seli 14 Fertility Preservation in Gynecologic Malignancies ................. 159 Christine E. Richter and Peter E. Schwartz 15 Third-Party Reproduction and Adoption After Cancer: Practical and Emotional Considerations .................... 199 Dorothy A. Greenfeld 16 Pregnancy and Cancer Treatment .............................................. 209 Christine Laky and Mert Ozan Bahtiyar 17 Fertility Preservation Strategies in Healthy Women ................ 225 Enrique Soto and Alan B. Copperman 18 Approach to Fertility Preservation in Adult and Prepubertal Females ............................................................. 233 Kenny A. Rodriguez-Wallberg and Kutluk Oktay Part III Fertility Preservation in Men 19 Spermatogenesis and Testicular Function ................................. 245 Ciler Celik-Ozenci 20 Impact of Radiotherapy and Chemotherapy on the Testis .................................................................................. 261 Carolina Ortega and Herman Tournaye 21 Impact of Paternal Exposure to Gonadotoxins on Embryo and Offspring and the Male Evaluation .................................... 271 Kathleen Hwang, Paul Gittens, Desiderio Avila Jr., and Larry I. Lipshultz 22 Update on Sperm Banking .......................................................... 289 Pankaj Talwar 23 Preservation of Sperm Isolates or Testicular Biopsy Samples ............................................................................. 303 Bhushan K. Gangrade