Obstet Gynecol Sci.  2018 Jul;61(4):443-452. 10.5468/ogs.2018.61.4.443.

Fertility preservation for adolescent and young adult cancer patients in Japan

Affiliations
  • 1Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan. nao@marianna-u.ac.jp

Abstract

Adolescent and young adult (AYA) patients are generally defined as being from 15 to 39 years old. For preservation of fertility in AYA cancer patients, the best-known guideline in this field was released by the American Society of Clinical Oncology (ASCO) in 2006. However, the ASCO guideline is not necessarily applicable to Japanese cancer patients. The Japan Society for Fertility Preservation (JSFP) was formed in 2012, and a system and guideline for fertility preservation in Japanese AYA cancer patients plus children was released in July 2017. According to this guideline, patients should receive psychological and social support from health care providers such as doctors, nurses, psychologists, pharmacists, and social workers. In 2013, the American Society for Reproductive Medicine stated that freezing oocytes is a method that has passed beyond the research stage. However, freezing ovarian tissue is still a research procedure. While slow freezing of ovarian tissue is generally performed, rapid freezing (vitrification) is more popular in Japan. We have developed a new closed technique for ovarian tissue cryopreservation. It has been suggested that optical coherence tomography might be applied clinically to measure the true ovarian reserve and localize follicles in patients undergoing ovarian tissue transplantation. Combining gonadotropin-releasing hormone agonist therapy with anticancer agents might be useful for ovarian protection and it is expected that discussion of such combined treatment will continue in the future. This article outlines practical methods of fertility preservation using assisted reproductive techniques for AYA cancer patients in Japan.

Keyword

Fertility preservation; Cryopreservation; Vitrification; Health care providers; Assisted reproductive techniques

MeSH Terms

Adolescent*
Antineoplastic Agents
Asian Continental Ancestry Group
Child
Cryopreservation
Fertility Preservation*
Fertility*
Freezing
Gonadotropin-Releasing Hormone
Health Personnel
Humans
Japan*
Medical Oncology
Methods
Oocytes
Ovarian Reserve
Pharmacists
Psychology
Reproductive Medicine
Reproductive Techniques, Assisted
Social Work
Social Workers
Tissue Transplantation
Tomography, Optical Coherence
Transplants
Vitrification
Young Adult*
Antineoplastic Agents
Gonadotropin-Releasing Hormone

Figure

  • Fig. 1 Female fertility preservation on young cancer patients in adolescent and young adult generation. FP, fertility preservation; IVM, in vitro maturation; IVFG, in vitro follicle growth; ASAP, as soon as possible.

  • Fig. 2 Male fertility preservation on young cancer patients in adolescent and young adult generation. FP, fertility preservation; IVM, in vitro maturation; IVFG, in vitro follicle growth; ASAP, as soon as possible.


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