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Printable Handouts
Navigable Slide Index
- Introduction
- Disclosures
- Outline
- ASCO fertility preservation recommendations 2018 update
- Impact of chemotherapy on ovarian reserve & follicles
- Gonadotoxic chemotherapy induces DNA DSBs
- Cyclophosphamide-induced DNA damage & apoptotic death
- How does chemo damage ovarian reserve?
- Chemotherapy-induced ovarian aging
- Why preserve fertility in young women with breast cancer?
- Fertility preservation strategies
- A modified strategic approach to fertility preservation in breast cancer
- Ovarian stimulation & oocyte retrieval
- Standard antagonist protocol for embryo or egg freezing
- Tamoxifen was originally a “fertility drug”
- Aromatase inhibition results in increased serum FSH
- Tamoxifen vs. Letrozole
- Letrozole-FSH results
- FPR with Letrozole protocol
- Comparison of ET success rates
- Evolved Letrozole-FSH protocol
- Comparison of protocols in cancer patients
- Random start ovarian stimulation
- Random start outcomes similar to conventional
- Impact of Letrozole-IVF on relapse-free survival
- Relapse-free survival after Letrozole-IVF
- Value of early referral to FP in breast cancer
- Early referal outcomes
- Safety of pregnancy after breast cancer
- Conclusion
Topics Covered
- Reproductive Biology
- Fertility
- Chemotherapy
- Ovarian Reserve
- Fertility Preservation Strategies
- Ovarian Stimulation
- Tamoxifen
- Letrozole
Links
Series:
- The Female Reproductive System: from Basic Science to Fertility Treatments
- Periodic Reports: Advances in Clinical Interventions and Research Platforms
Categories:
Therapeutic Areas:
Talk Citation
Oktay, K.H. (2021, August 29). Preservation of fertility in cancer patients: the impact of chemotherapy [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved February 5, 2025, from https://doi.org/10.69645/CJRS7509.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Kutluk H. Oktay has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Preservation of fertility in cancer patients: the impact of chemotherapy
Published on August 29, 2021
35 min
A selection of talks on Gynaecology & Obstetrics
Transcript
Please wait while the transcript is being prepared...
0:00
Hello, I'm Kutluk Oktay,
I'm a professor of obstetrics and gynecology and
reproductive sciences at Yale University School of Medicine.
I'm also the director of the
Laboratory of Molecular Reproduction and Innovation Institute
for Fertility Preservation and IVF.
I'll be talking to you about fertility preservation approaches in cancer patients.
I will give you what's currently known and what's in the future.
0:26
First of all, I have no conflicts pertaining to this presentation.
Some of the research that I will be showing you is
supported by various grants from the National Institutes of Health.
I'm also the co-chair of the American Society of Clinical Oncology Fertility Preservation Guidelines Committee.
0:46
In this talk, we will first be delving into several concepts that are relevant to our talk.
One is ovarian reserve; how chemotherapy affects ovarian reserve.
Because in many cancers, as well as in hematological diseases and other systemic diseases,
cancer drugs are used, and they have irreversible damaging effects on ovarian follicle reserves.
We're going to talk about that and explain it, because that's going to
bring everything into perspective and tie it in to the next section, where we'll
discuss how we justify fertility preservation and how we make
our decisions, in terms of who should get fertility preservation
and what kinds of procedures should be chosen.
If you're a practitioner listening to this, this is a section that could be very practical for you.
I will then get into the practical points about specific fertility preservation procedures.
Firstly embryo cryopreservation, with that we will be focusing on a
specific case, that is, breast cancer, because that is the
most common cancer seen in reproductive age women,
and ovarian stimulation can be tricky in those patients.
Next, we will touch very briefly on egg freezing, I'm not going to spend too much time on that,
and we will talk about ovarian tissue cryopreservation,
which is a new approach but no longer experimental.
We will then go into potential pharmacological methods of fertility preservation;
first ovarian suppression (a controversial approach),
and then into some future potential approaches.
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