Dados do Trabalho

Title

Fertility preservation in oncological patients: methods and applications.

Objective

Conduct an overview of the existing fertility preservation techniques for characterize the most frequently used in cancer patients and the benefits applied to the clinical condition of each patient, differentiating between men and women. It was aimed tracking the success rates of germ cells and tissues reimplanted in patients after preservation of fertility and finished the oncological treatment, as well as providing subsidies for assisted human reproduction professionals to select the most appropriate technique for each patient.

Methods

A integrative review of literature was made by using two databases, PubMed and Web of Science, selecting clinical studies through two search strategies: “Fertility preservation” OR oncofertility AND “ovar*” for female patients, and "Fertility preservation" OR "oncofertility" OR "cancer" AND "sperm*" OR "testicle" for male patients, resulting in 9 and 6 selected results, respectively. The PRISMA method was used to select the articles, including only clinical studies, reporting oncological patients.

Results

The results pointed to oocyte cryopreservation as the most cited technique for female patients, with breast cancer being the one with the highest incidence in the studies; and semen cryopreservation as the most cited technique for male patients, with testicular cancer having the highest incidence in the evaluated patients. It is also highlighted the importance of hormonal stimulation previously to the capture of oocytes, despite also drawing attention to possible adverse effects on patients with hormone-dependent cancers.

Conclusion

Finally, the importance of associating assisted reproduction techniques with the preservation of fertility and well-being of cancer patients was concluded, aiming to reduce the impacts suffered by gonadotoxic treatment and provide positive future perspectives to patients. It is also important to highlight the difficulty in following up the patients for a long time, which may explain the occurrence of different outcomes in the face of the application of different techniques, when trying to track their success rates in obtaining a pregnancy at the end of the oncological treatment. It is evident, therefore, the importance of associating assisted reproduction techniques with fertility preservation, aiming to reduce the impacts suffered by the cancer patient during a potentially gonadotoxic treatment and to provide well-being and positive future perspectives to these patients, regarding the desire to constitute a family from their own gametes. The progress being made in gonadal tissue cryopreservation techniques represent a good outlook principally about young pre pubertal kids, demonstrating the responsibility to improve de research and consolidate protocols to use widely.

Keywords

assisted human reproduction; cancer; oncofertility; cryopreservation; gonadotoxic treatments.