title: Applicability of adult techniques for ovarian preservation to childhood cancer patients.
abstract: OBJECTIVE
  To appraise the feasibility of current adult medical and surgical techniques for ovarian preservation in pre-pubertal and adolescent girls with cancer.
  
  
  METHODS
  Literature search using PubMed and SCOPUS up to February 2012. In addition, the reference lists of selected studies and all identified systematic and narrative reviews were scanned for relevant references. Inclusion criteria were ovarian preservation and cancer. Exclusion criteria were non-English publications, letters, personal communications, and ovarian preservation for conditions other than cancer.
  
  
  RESULTS
  Data from the selected publications was interpreted and discussed in the relevant sections. Cryopreservation of ovarian tissue followed by autologous transplant represents the only surgical option available for pre-pubertal girls and adolescents who cannot delay the start of chemotherapy. Few studies report on pre-pubertal and adolescent girls undergoing ovarian preservation surgeries with good harvesting, and no follow-up has been conveyed, to date. Outcomes of ovarian function after ovarian suppression with GnRH-analogs in adults have been controversial and no reports are available for pre-pubertal girls.
  
  
  CONCLUSIONS
  Autologous transplantation of cryopreserved ovarian cortex probably represents the best option for preservation of fertility and hormonal function in childhood cancer females; however, future research needs to address the safety of this technique, especially in patients with blood-borne cancers. Ovarian suppression with GnRH-analogs at the time of chemotherapy treatment has not proven to be superior to non-suppression for fertility preservation purposes in adults. Not enough evidence is presently available in childhood cancer patients.
authors: Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Rout Center, 853 Jefferson Avenue, Memphis, TN 38163, USA. ldetti@uthsc.edu
authors: Laura
authors: L
authors: Detti
authors: Daniel C
authors: DC
authors: Martin
authors: Lucy J
authors: LJ
authors: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D015925:Cryopreservation / Q000379:methods; D016208:Databases, Factual; D005260:Female; D005298:Fertility; D059247:Fertility Preservation / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives*; D006801:Humans; D007247:Infertility, Female / Q000517:prevention & control; D009865:Oocytes / Q000166:cytology; D009926:Organ Preservation; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D010053:Ovary / Q000473:pathology* / Q000637:transplantation; D027724:Reproductive Techniques, Assisted / Q000592:standards*; D012307:Risk Factors; D014182:Transplantation, Autologous
chemical_list: D007987:Gonadotropin-Releasing Hormone