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Ovarian suppression through,gonadotropin-releasing hormone (GnRH), agonist or antagonist treatment during, chemotherapy is an investigational ,approach to maintain fertility. Use of thesehormonal therapies protect ovarian tissue, during chemotherapy by suppressing ovulation.
Because GnRH analogs are readily ,available, this strategy has been used
widely without clear evidence for efficacy, or full understanding of the potential risks
and benefits, especially in women with hormone sensitive tumors.
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OOCYTE CRYOPRESERVATION
Cryopreservation of unfertilized oocytes is another option for fertility preservation. The
oocytes are thawed later and fertilized in vitro. Ovarian stimulation and harvesting
requirements are identical to those of, embryo cryopreservation, and thus this
technique is associated with similar concerns regarding short-term exposure to
high hormonal levels in patients with, hormone sensitive tumors. As with embryo
cryopreservation, letrozole or tamoxifen can be used. Research indicates that
unfertilized oocytes are more prone to damage during cryopreservation
procedures than embryos, and as a result, the overall pregnancy rates may be lower
than embryo cryopreservation.
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OVARIAN CRYOPRESERVATION AND REIMPLANTATION
Ovarian tissue cryopreservation is an investigational method of fertility
preservation but has the advantage of requiring neither a sperm donor nor
ovarian stimulation. Ovarian tissue is removed laparoscopically, a one hour outpatient procedure that requires general anesthesia, and frozen. At a later date, the ovarian tissue is thawed and reimplanted.
Ovarian tissue cryopreservation has been performed in humans for less than a
decade, and the first successful ovarian
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