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Printable Handouts
Navigable Slide Index
- Introduction
- Preservation of fertility & gonadotoxic chemotx.
- Fertility preservation (1)
- Fertility preservation (2)
- “An ounce of prevention is worth a pound of cure…“
- Treatment protocol
- Is it helpful?
- LHRH-a inhibits cyclophosphamide
- GnRHa prevents gonadal damage
- Use of LHRHa to preserve ovarian function (1)
- Use of LHRHa to preserve ovarian function (2)
- Use of LHRHa to preserve ovarian function (3)
- GnRHa & ovarian function during chemotherapy
- Summary of randomized clinical trials
- Adjuvant GnRHa & prevention of chemotherapy
- GnRHa for ovarian function preservation
- Ovarian function recovery after chemotherapy (1)
- Ovarian function recovery after chemotherapy (2)
- GnRHa and preservation of ovarian function (1)
- Is it safe?
- Ovarian suppression with Triptorelin
- Goserelin for ovarian protection
- GnRHa and preservation of ovarian function (2)
- GnRHa study in India
- GnRHa study in China
- Results (1)
- Results - summary
- Results (2)
- Toward the end of the debate?
- Fertility and gonadal function in female survivors
- GnRHa and cycliphosphamide gonadotoxicity
- Combined studies on GnRHa in SLE/CTD
- Pregnancy and delivery after BMT and GnRHa
- Pregnancies and deliveries after SCT & GnRHa
- Pregnancies after BMT?
- Pregnancy after BMT
- GnRHa minimizes POF
- Pro vs Con GnRH agonist studies
- Cancer and fertility preservation: recommendations
- Levels of evidence & grades of recommendation
- Temporary ovarian suppression
- Temporary ovarian suppression & LHRHa
- ASCO clinical practice guideline update
- International consensus guidelines for BCY
- ESO-ESMO international guidelines for BCY
- GnRHa debate- why?
- GnRHa & hematopoietic SCT
- Protecting ovaries during chemotherapy
- GnRHa for the prevention of chemotherapy
- Triptorelin to prevent chemotherapy
- Why?
- GnRha and ovarian function in lymphoma survivors
- Suboptimal compliance in randomized trials
- No protection of ovarian function by LHRHa
- Why is the discrepancy?
- GnRHa for protection against ovarian toxicity
- LHRHa in premenopausal early breast cancer
- GnRHa use preserves fertility during chemotherapy
- Chemotx- assoc. gonadotoxicity & GnRH “rescue”
- FSH stimulates preantral follicles
- mRNA for FSH-r & LH-r in human oocytes
- Chronically elevated LH depletes follicles (1)
- Chronically elevated LH depletes follicles (2)
- Deletion of Rb leads to POF
- FSH modulates ovarian SC through FSH-R3 (1)
- FSH modulates ovarian SC through FSH-R3 (2)
- FSH modulates ovarian SC through FSH-R3 (3)
- TGF-β superfamily & ovarian follicle development
- Chemotherapeutic agents and ovary damage
- Possible mechanisms
- Chemotherapy induced gonadotoxicity
- Does GnRHa protect GSC?
- Antral follicle count recovery after GnRHa
- Immune effect of GnRHa
- Conclusions
- Oncofertility: the long way to success
- Thank you
Topics Covered
- Preservation of fertility in women undergoing gonadotoxic chemotx.
- Methods of fertility preservation
- The rationale of ovarian suppression by GnRHa for fertility preservation
- The efficacy of GnRHa
- The safety of GnRHa
- The GnRHa debate (why?)
- Possible mechanisms of GnRHa beneficial effect(s) for fertility preservation
Links
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Talk Citation
Blumenfeld, Z. (2019, September 26). GnRH agonist use for fertility preservation despite gonadotoxic chemotherapy [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 6, 2024, from https://doi.org/10.69645/GXGX6404.Export Citation (RIS)
Publication History
Financial Disclosures
- Professor Zeev Blumenfeld has no commercial/financial relationships to disclose
GnRH agonist use for fertility preservation despite gonadotoxic chemotherapy
Published on September 26, 2019
66 min
Other Talks in the Series: The Female Reproductive System: from Basic Science to Fertility Treatments
Transcript
Please wait while the transcript is being prepared...
0:00
Hello everybody. My name is Zeev Blumenfeld.
I'm Associate Professor at the Technion Faculty of Medicine in Haifa, Israel.
I'm going to talk to you about the "GNRH Agonist Use for
Fertility Preservation Despite Gonadotoxic Chemotherapy".
0:18
The next slide shows the main three avenues of fertility preservation.
The first of them,
which is clinically accepted and no argument about it,
is using ART/IVF with freezing of embryos or unfertilized ova.
The second one is ovarian cryopreservation with either whole ovary autotransplantation,
ovarian slices autotransplantation, xenotransplantation of nude mice,
and thawing and I.V.M.
However, this is still investigational.
The third avenue, the one I'm going to elaborate on,
is to decrease or arrest follicular loss by GnRH agonist adjuvant co-treatment.
1:10
Next slide shows that the first avenue of IVF and
cryopreservation of embryo or ova is efficient, it's clinically available.
However, it may be possibly dangerous in
estrogen aggravated situations and diseases
such as breast cancer and systemic lupus erythematosus.
The second avenue for ovarian cryopreservation and autotransplantation,
the potential is very high.
It has been shown to be effective in sheep, mice, and human.
Up to now, over 130 newborns worldwide have been reported.
However, it's still investigational.
It main induce ovarian antibodies, and most importantly,
there is a risk of cancer cellular institution mainly in leukemia.
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