Cancer survivors are increasing because of advances in early detection and treatment options. Fertility preservation in cancer patients gives hope to have a family later in life. Spread the awareness about fertility preservation to fulfill the dream of parenthood..!!!
Advance in diagnosis & treatment of cancers has led to high cure rate & longer survival.
Nearly 1 in 12 cases detected before 40 years age.
Survivors have to face infertility or early menopause.
SHARE Presentation: Having Children after Cancerbkling
Dr. Diana Chavkin, Reproductive Endocrinology and Infertility (REI) specialist at Genesis Fertility and Reproductive Medicine, made this presentation at SHARE about fertility preservation options before and after cancer treatment.
If you'd like to hear the audio, visit www.sharecancersupport.org/chavkin
The information in this presentation is not intended to be a substitute for professional medical advice, diagnosis or treatment. The presentation was given on May 15, 2014.
Advance in diagnosis & treatment of cancers has led to high cure rate & longer survival.
Nearly 1 in 12 cases detected before 40 years age.
Survivors have to face infertility or early menopause.
SHARE Presentation: Having Children after Cancerbkling
Dr. Diana Chavkin, Reproductive Endocrinology and Infertility (REI) specialist at Genesis Fertility and Reproductive Medicine, made this presentation at SHARE about fertility preservation options before and after cancer treatment.
If you'd like to hear the audio, visit www.sharecancersupport.org/chavkin
The information in this presentation is not intended to be a substitute for professional medical advice, diagnosis or treatment. The presentation was given on May 15, 2014.
Fertility preservation in Cancer patientsArunSharma10
The need for fertility preservation
Chemotherapeutic drugs according to gonadotoxicity level
Fertility preservation: subject of continuous review by experts
Non-oncological conditions requiring fertility preservation
Delayed childbearing
AVAILABLE PROCEDURES FOR FP
Embryo and oocyte cryopreservation
Increase incidence of cancer during the reproductive age. Survival and cure rates of cancer are improving. Resulting in Increasing demand for fertility preserving interventions.
May occur very early on during the attachment or migration stages (No objective evidence e.g. –ve hCG)
May also occur at a later stage (+ve hCG) but process becomes disrupted
Definition: Refers to the failure of the embryo to reach a stage when an intrauterine gestational sac is recognized by ultrasonography.
Implantation failure can apply to patients undergoing ART and patients trying to conceive without any fertility treatment.
It is a separate entity from RPL
Orvieto et al - 3 failed IVF-ET cycles with good quality embryos transferred .
Zeyneloglu et al. - 3 unsuccessful IVF specifically with two embryos of high quality
Simon and Laufer - embryo & endometrium can both play an active role in RIF
Coughlan et al. suggest a more complete working definition taking into account maternal age, number of embryos transferred, and number of cycles completed.
They define RIF as the failure of clinical pregnancy after 4 good quality embryo transfers, with at least three fresh or frozen IVF cycles, and in women under the age of 40
RIF is a complex problem with a wide variety of etiologies / mechanisms/ treatment options.
Recommendations vary depending on the source of their problem. Perhaps the best and yet most complex answer is personalized medicine, a personal approach to each patient depending on her unique set of characteristics.
It would help to establish a set of standardized tests to use, in order to do a preliminary evaluation on each patient, which would then hopefully direct the approach of treatment for each individual couple.
This can be implemented when we have well designed studies that will help us to establish new protocols.
In gynecologic cancers, fertility preservation strategies include fertility-sparing surgical approaches and assisted reproductive technologies (ART). Fertility preservation can be considered in women with early stage I epithelial ovarian cancer and most borderline tumors, stages I–III
SHARE, in partnership with Reproductive Medicine Associates of NY, FORCE, and Sharsheret, hold a presentation on fertility and family planning for patients recently diagnosed with cancer and those who are predisposed to hereditary cancer syndromes due to a genetic mutation. The presenter, Dr. Matthew Lederman, is a board-certified reproductive endocrinologist and infertility specialist.
Fertility preservation in Cancer patientsArunSharma10
The need for fertility preservation
Chemotherapeutic drugs according to gonadotoxicity level
Fertility preservation: subject of continuous review by experts
Non-oncological conditions requiring fertility preservation
Delayed childbearing
AVAILABLE PROCEDURES FOR FP
Embryo and oocyte cryopreservation
Increase incidence of cancer during the reproductive age. Survival and cure rates of cancer are improving. Resulting in Increasing demand for fertility preserving interventions.
May occur very early on during the attachment or migration stages (No objective evidence e.g. –ve hCG)
May also occur at a later stage (+ve hCG) but process becomes disrupted
Definition: Refers to the failure of the embryo to reach a stage when an intrauterine gestational sac is recognized by ultrasonography.
Implantation failure can apply to patients undergoing ART and patients trying to conceive without any fertility treatment.
It is a separate entity from RPL
Orvieto et al - 3 failed IVF-ET cycles with good quality embryos transferred .
Zeyneloglu et al. - 3 unsuccessful IVF specifically with two embryos of high quality
Simon and Laufer - embryo & endometrium can both play an active role in RIF
Coughlan et al. suggest a more complete working definition taking into account maternal age, number of embryos transferred, and number of cycles completed.
They define RIF as the failure of clinical pregnancy after 4 good quality embryo transfers, with at least three fresh or frozen IVF cycles, and in women under the age of 40
RIF is a complex problem with a wide variety of etiologies / mechanisms/ treatment options.
Recommendations vary depending on the source of their problem. Perhaps the best and yet most complex answer is personalized medicine, a personal approach to each patient depending on her unique set of characteristics.
It would help to establish a set of standardized tests to use, in order to do a preliminary evaluation on each patient, which would then hopefully direct the approach of treatment for each individual couple.
This can be implemented when we have well designed studies that will help us to establish new protocols.
In gynecologic cancers, fertility preservation strategies include fertility-sparing surgical approaches and assisted reproductive technologies (ART). Fertility preservation can be considered in women with early stage I epithelial ovarian cancer and most borderline tumors, stages I–III
SHARE, in partnership with Reproductive Medicine Associates of NY, FORCE, and Sharsheret, hold a presentation on fertility and family planning for patients recently diagnosed with cancer and those who are predisposed to hereditary cancer syndromes due to a genetic mutation. The presenter, Dr. Matthew Lederman, is a board-certified reproductive endocrinologist and infertility specialist.
IVF will remain the solution for infertile couples. But its future will dramatically be directed to fertile couples !!!! This talk will discuss these issues
Mark Perloe, MD Atlanta, 404-843-2229 Learn about the factors that can adversely affect fertility and the tests that can help pinpoint problems. Fertility treatment options including IVF and other high tech options are presented.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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Early detection of Cervical Cancer & Fertility Preservation
1. Early Detection of Cervical Cancer
& Fertility Preservation
DR GEETANJALI GARIEMA
M.B.B.S., M.S. (OBST. & GYNEC), F.MAS,
DRM (Dip. Reproductive Medicine, Germany),
Dip. Advanced Gynec Endoscopy (D.A.G.E.),D.MAS
Medical Director & Fertility Consultant – GlobalStar Fertility & Women Care Centre
https://globlstarivf.com
2. CERVICAL CANCER - INTRODUCTION
• Malignant tumour derived from the cells of “cervix uteri” which is
the lower part of the uterus
• begins with precancerous condition known as “DYSPLASIA”
• Easily detected in routine PAP Smear
• Completely Treatable
GlobalStar Fertility
https://Globalstarivf.com
3. INCIDENCE
• 2nd most common cancer in women worldwide
• Most Common women related cancer in India
• Occurs in 1 in 53 Indian women during their lifetime
• India accounts for 1/4th of Global Burden of cervical cancer
GlobalStar Fertility
https://Globalstarivf.com
4. Normal Cervix Vs Cervical Cancer
GlobalStar Fertility
https://Globalstarivf.com
5. Cervical Cancer & HPV
Human Papilloma Virus (HPV)
• The prevalence of HPV in cervical tumours is 99.7%
• High-risk HPV types include 16,18,31 and 41
• High risk HPV infection is necessary but insufficient for
cervical cancer
GlobalStar Fertility
https://Globalstarivf.com
6. Human Papilloma Virus (HPV)
• Most common virus infecting the
reproductive tract.
• Cervical cancer is by far the most
common HPV- related disease.
GlobalStar Fertility
https://Globalstarivf.com
7. Additional Risk Factors
• Early Onset of Sexual Activity
• Multiple sexual partners
• High-risk sexual partner
• History of sexually transmitted infection
• Use of oral contraceptives
• Immunosuppression
• Previous history of vulvar, vaginal or cervical squamous
dysplasia
GlobalStar Fertility
https://Globalstarivf.com
8. Symptoms of Cervical Cancer
Early Stage Disease –
• Often no symptoms!
• Abnormal Vaginal discharge
• Abnormal bleeding
- Post-coital bleeding
- Abnormal menses
- Post-menopausal bleeding
Late Stage Disease –
• Pelvic or lower back pain
• Sciatica
• Weight loss
• Bowel or bladder fistula
GlobalStar Fertility
https://Globalstarivf.com
9. Diagnosis of Cervical Cancer
• Cervical cytology (PAP Smear) – results may suggest
invasive cancer
• Abnormal cytology is an indication of colposcopic
evaluation & directed biopsy
• Diagnosis must be confirmed by biopsy
GlobalStar Fertility
https://Globalstarivf.com
10. Screening Tests
Most common & effective screening for early diagnosis –
• PAP Test
- Conventional Slide Method
- Liquid Based Cytology (Thin Prep)
• HPV DNA Test
GlobalStar Fertility
https://Globalstarivf.com
11. PAP Smear
When To Do –
• 3 years after the onset of sexual
intercourse
• No later than age 21
• Every 3 years until age 30
• After 30, repeat every 5 years
• Stop after age 65, if test is
negative in last 10 years
• Annual screening for women at high
risk
( As per American Cancer Society Guidelines)
GlobalStar Fertility
https://Globalstarivf.com
12. HPV DNA TEST
• HPV DNA test also involves collecting cells from the cervix for lab
testing
• Sensitivity of Pap Test is 71%
• Sensitivity of HPV DNA test is 95%
• Collective sensitivity of Pap Test & HPV DNA test is 100%
• So between the age of 30 to 65, Cytology + HPV test is preferred
GlobalStar Fertility
https://Globalstarivf.com
13. PREVENTION
This is one of the most preventable types of cancer
• Human Papilloma Virus (HPV) Vaccine – Bivalent (Cervarix) &
Quadrivalent (Gardasil)
• Safe sexual practice
• Routine Cervical Screening
• No smoking
• Healthy lifestyle & balanced diet to boost your immunity
GlobalStar Fertility
https://Globalstarivf.com
15. Reasons for Increased Demand
In recent times –
• Increase incidence of cancer during the reproductive age
• Improved Survival & cure rates of cancer
• Increasing awareness & demand of fertility preservation interventions
• More women delaying motherhood to the age of 30s & 40s
GlobalStar Fertility
https://Globalstarivf.com
16. Evaluation of Basic Factors
• Desire of patient to retain fertility potential
• Age, Obstetrical history, family history, history of infertility
• Extent of the patient’s cancer
ALWAYS REMEMBER –
Optimal cancer therapy should always supersede fertility preservation
GlobalStar Fertility
https://Globalstarivf.com
17. Issues to be considered
• Overall prognosis of the patient
• The risk of sterility with the proposed treatment plan
• The potential risks of delaying chemotherapy
• The impact of future pregnancy upon the risk of tumour recurrence
• Impact of any hormonal manipulation on tumour itself
• The possibility of tumour contamination of the harvested tissues GlobalStar Fertility
https://Globalstarivf.com
18. The forgotten Female
• Only half of the oncologists discuss fertility preservation with patients
• ASRM offers guidelines for oncologists & fertility specialists
• Cancer specialist should inform patients about all the available options
• Refer them to fertility specialist
GlobalStar Fertility
https://Globalstarivf.com
19. Effect of chemotherapy
In Females -
• Follicular destruction
• Ovarian fibrosis
• Premature ovarian failure
• Reduced E2 & P4 levels
In Males -
• Genetic & morphological damage of sperms
GlobalStar Fertility
https://Globalstarivf.com
20. Chemotherapy Induced Gonadotoxicity
• Type, Duration & Dose
• Gonadotoxicity is almost irreversible
• Amenorrhea – ranges 0 - 100% , can be temporary or permanent
Younger age group – upto 71%
Older age group – upto 100%
• Risk of gonadal damage increases with age (less no of oocytes)
GlobalStar Fertility
https://Globalstarivf.com
21. Radiotherapy Induced Gonadotoxicity
• Patient’s Age
• Dose of Radiation (Breaking point 300 cGy)
• Extent
• Type of Radiation (Abdominal, Pelvic external beam, Brachytherapy)
GlobalStar Fertility
https://Globalstarivf.com
22. Dose of Radiation
• Breaking point is 300 cGy
• 11 – 13% had POF (premature ovarian failure) <300cGy
• 60 -63% had POF >300cGy
• >6Gy = Irreversible ovarian failure
• <2Gy = 50% of oocyte population is destroyed
GlobalStar Fertility
https://Globalstarivf.com
23. Post Chemo/Radiotherapy Infertility Rate
In Females –
40 - 80% chance of loosing fertility during reproductive years
In Males –
30 -75% of male cancer patients become sterile after cancer treatment
GlobalStar Fertility
https://Globalstarivf.com
24. Options for Preserving Fertility
In Females –
• Embryo Cryopreservation
• Oocyte Cryopreservation
• Ovarian tissue cryopreservation & Transplantation
• In vitro oocyte maturation
• Ovarian Transposition
• Pharmacological protection (GnRHa)
• Fertility – sparing surgical procedures
In Males –
• Sperm Cryopreservation – is the gold standard
GlobalStar Fertility
https://Globalstarivf.com
25. Treatment options for Males
Post chemotherapy sperm sample holds high risk of genetic or
morphological sperm damage
• Sperm Cryopreservation is the only established & effective fertility
preservation method.
• Hormonal gonadal suppression is not recommended
• Gonadal shielding during radiation therapy
• Testicular tissue preservation and re-implantation is performed as
clinical trials
GlobalStar Fertility
https://Globalstarivf.com
27. EMBRYO CRYOPRESERVATION
• Process of harvesting eggs, followed by In Vitro Fertilization of oocytes with
the sperms in lab & Freezing of all the resulting embryos for later
implantation.
• Requires 10-14 days of ovarian stimulation with gonadotropins from the
beginning of menstrual cycle.
• It is a short surgical procedure & requires partner sperms / donor sperm.
• Most established technique for fertility preservation in women
GlobalStar Fertility
https://Globalstarivf.com
29. OOCYTE CRYOPRESERVATION
• Process of harvesting & Freezing of unfertilized eggs/oocytes.
• Requires 10-14 days of ovarian stimulation from the beginning of menstrual
cycle.
• Advised for women who do not have a partner or do not wish to use donor
sperm
• Success rate is 3-4 times lower than standard IVF & embryo cryopreservation.
GlobalStar Fertility
https://Globalstarivf.com
31. IN VITRO MATURATION ( IVM ) of Oocytes
• Freezing immature oocytes (primordial follicles)
• More oocytes become available for clinical treatment
• Gonadotropic hormones not required for stimulation
• Eliminates risk of ovarian stimulation
GlobalStar Fertility
https://Globalstarivf.com
32. OVARIAN CRYOPRESERVATION & TRANSPLANTATION
• Freezing of ovarian tissue & reimplantation after cancer treatment.
• Ovarian stimulation not required.
• Does not require sexual maturity, so it is preferred in children.
• Not suitable when risk of ovarian involvement is high.
GlobalStar Fertility
https://Globalstarivf.com
33. Ovarian Cortical Tissue Freezing
Slow-Freeze Protocol is more effective
GlobalStar Fertility
https://Globalstarivf.com
34. Screening of ovarian tissue
• Best screening is under Light Microscopy
• Molecular markers can be used in rare cancers
• Test tissue before freezing & after thawing
GlobalStar Fertility
https://Globalstarivf.com
35. Ovarian transplantation techniques
Orthotopic (Pelvic) Transplant
• Resumption of ovarian functions
• Spontaneous conception
• Sometimes require IVF
Heterotopic (subcutaneous)Transplant
• Requires IVF
• Embryo Transfer
GlobalStar Fertility
https://Globalstarivf.com
36. OVARIAN SUPRESSION
• Done with GnRh analogues
• Insufficient evidence of effectiveness of GnRHa
• Offered in Ca Breast & Hodgkin’s lymphoma
GlobalStar Fertility
https://Globalstarivf.com
37. OVARIAN TRANSPOSITION (OOPHOROPEXY)
• Ovaries are surgically moved away from radiation field & repositioned
• It minimises exposure & damage by radiation
• Technique not always successful due to many factors
• It prevents premature menopause & preserves fertility
• Pregnancy rates = 50 -75% spontaneously & 11% conception by IVF
GlobalStar Fertility
https://Globalstarivf.com
38. CONCLUSION
• Assessment of risk of infertility in cancer patient
• Communication with patient
• Patient at risk of treatment induced infertility
• Patient interested in fertility preservation options
Refer to fertility specialist
Fertility preservation must be offered as early as possible after the
diagnosis of cancer & before starting any treatment
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39. CONCLUSION
In Females –
• Embryo cryopreservation is most successful followed by oocyte
cryopreservation.
• Laparoscopic ovarian transposition is good option before pelvic
radiotherapy – technique not always successful due to many factors
• Ovarian suppression with GnRHa has insufficient evidence of effectiveness
• Ovarian tissue cryopreservation & transplantation – only method used in
children
In Males –
• Sperm Cryopreservation is the most effective method
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