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Update on fertility preservation from the Barcelona International Society for Fertility Preservation-ESHRE-ASRM 2015 expert meeting: indications, results and future perspectives.
Hum Reprod 2017; 32(9):1802-1811HR

Abstract

STUDY QUESTION

What progress has been made in fertility preservation (FP) over the last decade?

SUMMARY ANSWER

FP techniques have been widely adopted over the last decade and therefore the establishment of international registries on their short- and long-term outcomes is strongly recommended.

WHAT IS KNOWN ALREADY

FP is a fundamental issue for both males and females whose future fertility may be compromised. Reproductive capacity may be seriously affected by age, different medical conditions and also by treatments, especially those with gonadal toxicity. There is general consensus on the need to provide counselling about currently available FP options to all individuals wishing to preserve their fertility.

STUDY DESIGN, SIZE, DURATION

An international meeting with representatives from expert scientific societies involved in FP was held in Barcelona, Spain, in June 2015.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Twenty international FP experts belonging to the American Society of Reproductive Medicine, ESHRE and the International Society of Fertility Preservation reviewed the literature up to June 2015 to be discussed at the meeting, and approved the final manuscript. At the time this manuscript was being written, new evidence considered relevant for the debated topics was published, and was consequently included.

MAIN RESULTS AND THE ROLE OF CHANCE

Several oncological and non-oncological diseases may affect current or future fertility, either caused by the disease itself or the gonadotoxic treatment, and need an adequate FP approach. Women wishing to postpone maternity and transgender individuals before starting hormone therapy or undergoing surgery to remove/alter their reproductive organs should also be counselled accordingly. Embryo and oocyte cryopreservation are first-line FP methods in post-pubertal women. Metaphase II oocyte cryopreservation (vitrification) is the preferred option. Cumulative evidence of restoration of ovarian function and spontaneous pregnancies after ART following orthotopic transplantation of cryopreserved ovarian tissue supports its future consideration as an open clinical application. Semen cryopreservation is the only established method for FP in men. Testicular tissue cryopreservation should be recommended in pre-pubertal boys even though fertility restoration strategies by autotransplantation of cryopreserved testicular tissue have not yet been tested for safe clinical use in humans. The establishment of international registries on the short- and long-term outcomes of FP techniques is strongly recommended.

LIMITATIONS, REASONS FOR CAUTION

Given the lack of studies in large cohorts or with a randomized design, the level of evidence for most of the evidence reviewed was three or below.

WIDER IMPLICATIONS OF THE FINDINGS

Further high quality studies are needed to study the long-term outcomes of FP techniques.

STUDY FUNDING/COMPETING INTEREST(S)

None.

TRIAL REGISTRATION NUMBER

N/A.

Authors+Show Affiliations

Hospital Universitario Dexeus, Gran Via Carlos III, 71-75, 08208 Barcelona, Spain.

Pub Type(s)

Journal Article
Practice Guideline

Language

eng

PubMed ID

29117320

Citation

Martinez, Francisca. "Update On Fertility Preservation From the Barcelona International Society for Fertility Preservation-ESHRE-ASRM 2015 Expert Meeting: Indications, Results and Future Perspectives." Human Reproduction (Oxford, England), vol. 32, no. 9, 2017, pp. 1802-1811.
Martinez F. Update on fertility preservation from the Barcelona International Society for Fertility Preservation-ESHRE-ASRM 2015 expert meeting: indications, results and future perspectives. Hum Reprod. 2017;32(9):1802-1811.
Martinez, F. (2017). Update on fertility preservation from the Barcelona International Society for Fertility Preservation-ESHRE-ASRM 2015 expert meeting: indications, results and future perspectives. Human Reproduction (Oxford, England), 32(9), pp. 1802-1811. doi:10.1093/humrep/dex218.
Martinez F. Update On Fertility Preservation From the Barcelona International Society for Fertility Preservation-ESHRE-ASRM 2015 Expert Meeting: Indications, Results and Future Perspectives. Hum Reprod. 2017 09 1;32(9):1802-1811. PubMed PMID: 29117320.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Update on fertility preservation from the Barcelona International Society for Fertility Preservation-ESHRE-ASRM 2015 expert meeting: indications, results and future perspectives. A1 - Martinez,Francisca, PY - 2017/03/27/received PY - 2017/05/19/accepted PY - 2017/11/9/entrez PY - 2017/11/9/pubmed PY - 2018/6/28/medline KW - embryo cryopreservation KW - fertility preservation KW - fertoprotection KW - non-oncological fertility preservation KW - oncological fertility preservation KW - oocyte cryopreservation KW - ovarian tissue cryopreservation KW - semen cryopreservation KW - testicular tissue cryopreservation SP - 1802 EP - 1811 JF - Human reproduction (Oxford, England) JO - Hum. Reprod. VL - 32 IS - 9 N2 - STUDY QUESTION: What progress has been made in fertility preservation (FP) over the last decade? SUMMARY ANSWER: FP techniques have been widely adopted over the last decade and therefore the establishment of international registries on their short- and long-term outcomes is strongly recommended. WHAT IS KNOWN ALREADY: FP is a fundamental issue for both males and females whose future fertility may be compromised. Reproductive capacity may be seriously affected by age, different medical conditions and also by treatments, especially those with gonadal toxicity. There is general consensus on the need to provide counselling about currently available FP options to all individuals wishing to preserve their fertility. STUDY DESIGN, SIZE, DURATION: An international meeting with representatives from expert scientific societies involved in FP was held in Barcelona, Spain, in June 2015. PARTICIPANTS/MATERIALS, SETTING, METHODS: Twenty international FP experts belonging to the American Society of Reproductive Medicine, ESHRE and the International Society of Fertility Preservation reviewed the literature up to June 2015 to be discussed at the meeting, and approved the final manuscript. At the time this manuscript was being written, new evidence considered relevant for the debated topics was published, and was consequently included. MAIN RESULTS AND THE ROLE OF CHANCE: Several oncological and non-oncological diseases may affect current or future fertility, either caused by the disease itself or the gonadotoxic treatment, and need an adequate FP approach. Women wishing to postpone maternity and transgender individuals before starting hormone therapy or undergoing surgery to remove/alter their reproductive organs should also be counselled accordingly. Embryo and oocyte cryopreservation are first-line FP methods in post-pubertal women. Metaphase II oocyte cryopreservation (vitrification) is the preferred option. Cumulative evidence of restoration of ovarian function and spontaneous pregnancies after ART following orthotopic transplantation of cryopreserved ovarian tissue supports its future consideration as an open clinical application. Semen cryopreservation is the only established method for FP in men. Testicular tissue cryopreservation should be recommended in pre-pubertal boys even though fertility restoration strategies by autotransplantation of cryopreserved testicular tissue have not yet been tested for safe clinical use in humans. The establishment of international registries on the short- and long-term outcomes of FP techniques is strongly recommended. LIMITATIONS, REASONS FOR CAUTION: Given the lack of studies in large cohorts or with a randomized design, the level of evidence for most of the evidence reviewed was three or below. WIDER IMPLICATIONS OF THE FINDINGS: Further high quality studies are needed to study the long-term outcomes of FP techniques. STUDY FUNDING/COMPETING INTEREST(S): None. TRIAL REGISTRATION NUMBER: N/A. SN - 1460-2350 UR - https://www.unboundmedicine.com/medline/citation/29117320/Update_on_fertility_preservation_from_the_Barcelona_International_Society_for_Fertility_Preservation_ESHRE_ASRM_2015_expert_meeting:_indications_results_and_future_perspectives_ L2 - https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/dex218 DB - PRIME DP - Unbound Medicine ER -