Geburtshilfe Frauenheilkd 2015; 75(12): 1243-1249
DOI: 10.1055/s-0035-1558184
Review
GebFra Science
Georg Thieme Verlag KG Stuttgart · New York

Fertility Protection in Female Oncology Patients: How Should Patients Be Counseled?

Fertilitätsprotektion von onkologischen Patientinnen: Wie sollten die Patientinnen beraten werden?
S. Findeklee
1   Gynecology and Obstetrics, Universitätsklinikum Erlangen, Erlangen
,
L. Lotz
1   Gynecology and Obstetrics, Universitätsklinikum Erlangen, Erlangen
,
K. Heusinger
1   Gynecology and Obstetrics, Universitätsklinikum Erlangen, Erlangen
,
I. Hoffmann
2   Gynecologic Endocrinology and Reproductive Medicine, Universitätsklinikum Erlangen, Erlangen
,
R. Dittrich
2   Gynecologic Endocrinology and Reproductive Medicine, Universitätsklinikum Erlangen, Erlangen
,
M. W. Beckmann
1   Gynecology and Obstetrics, Universitätsklinikum Erlangen, Erlangen
› Author Affiliations
Further Information

Publication History

received 21 July 2015
revised 22 August 2015

accepted 25 August 2015

Publication Date:
21 December 2015 (online)

Abstract

Protecting the fertility of patients with oncologic disease is becoming more and more important, as fulfilling the wish to have children is increasingly occurring at a later stage in life and long-term survival rates after cancer are continuing to improve. A number of fertility-preserving options exist. In addition to techniques which have been around for some time such as medical ovarian suppression, ovarian transposition, and organ-preserving surgery, there are other, more recent, innovative methods which have developed over the last few years such as cryopreservation of oocytes or ovarian tissue transplantation after completing cancer therapy. As every procedure has its specific advantages and disadvantages, informed patient consent is essential. The physicianʼs aim must be to select the optimal procedure for each patient. The extent of patientsʼ information about the options to preserve fertility in women with oncologic disease remains limited. One of the main reasons for this is that clinicians are not sure how to inform patients about existing procedures and methods. The aim of this review article is to provide help in clinical practice.

Zusammenfassung

Dem Fertilitätserhalt bei Krebserkrankungen kommt eine immer größere Bedeutung zu, da sich die Erfüllung des Kinderwunschs zunehmend in spätere Lebensphasen verschiebt und das Langzeitüberleben bei Krebs steigt. Es steht eine Vielzahl fertilitätsprotektiver Maßnahmen zur Verfügung. Neben den seit längerer Zeit praktizierten Verfahren der medikamentösen Ovarsuppression, der Transposition der Eierstöcke und der organerhaltenden Chirurgie haben sich in den letzten Jahren die innovativen Methoden Kryokonservierung von Eizellen und Eierstockgewebe mit der späteren Transplantation nach Therapieabschluss etabliert. Jedes Vorgehen hat seine spezifischen Vor- und Nachteile, über die ärztlicherseits aufgeklärt werden muss. Letztendlich geht es darum, für jede Patientin das optimale Verfahren auszuwählen. Immer noch ist die Aufklärungsrate bez. Fertilitätserhalt bei Frauen mit onkologischen Erkrankungen sehr gering. Als wesentlicher Grund hierfür gilt auch, dass bei den Behandelnden eine Unsicherheit darüber besteht, wie sie Patientinnen über Methoden aufklären sollen. Der hier vorgestellte Review-Artikel soll eine Unterstützung im klinischen Alltag bieten.

Supporting Information

 
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