Endocrine Abstracts

With increasing numbers of survivors from cancer at a young age the issue of fertility preservation has assumed greater importance. Female fertility preservation provides significantly different challenges to that for the male. Embryo freezing is now an accepted and well-established procedure in many centres, but is not available for children who do not have a partner. Cryopreservation using vitrification of mature oocytes has become increasingly successful, but requires the patient to go through a course of hormone stimulation and is therefore not appropriate for children and young girls. Ovarian tissue cryopreservation has the potential advantages of preservation of a large number of oocytes within primordial follicles, it does not require hormonal stimulation when time is short, and is appropriate for the pre-pubertal girl. Disadvantages include the need for an invasive procedure, and the uncertain risk of ovarian contamination in haematological and other malignancies. Ovarian tissue cryopreservation in adult women with later re-implantation has resulted in at least 39 live births worldwide. The number of re-implantations is unknown and this invasive approach to fertility preservation remains unproven and experimental in children and adolescents. The majority of young patients treated for cancer will have a window of opportunity for natural fertility if they survive their original cancer. We have published guidelines for patient selection in young female patients with cancer and in this lecture I will report our practise in a single centre that has offered fertility preservation since 1996 (Wallace et al., Lancet Oncology 2014).