title: Female fertility loss and preservation: threats and opportunities.
abstract: BACKGROUND
  Ovarian aging and cytotoxic treatments are the most common causes for fertility loss in women. With increasing numbers of young female survivors following cytotoxic cancer treatments, the issue of fertility preservation has assumed greater importance.
  
  
  METHODS
  We review the literature on the causes of female fertility loss as well as the recent advances in fertility preservation options and strategies that might be of interest to oncologists. Currently, several methods and techniques exist for fertility preservation of female patients with cancer including embryo freezing, ovarian protection techniques, oocyte cryopreservation, ovarian tissue cryopreservation followed by autotransplantation, and recently in vitro culture of ovarian tissue, follicles, and oocytes. Each method or technique has advantages and disadvantages related to current success rate, required delay in cancer treatment, sperm requirement, and risk of reintroducing cancer cells.
  
  
  RESULTS
  To date, embryo freezing is the only established method successfully and widely used for fertility preservation of female patients with cancer. The other methods are promising but still considered experimental.
  
  
  CONCLUSIONS
  Patient awareness, physician knowledge, early counseling, costs management, international registry, interdisciplinary networks, and research development are necessary to improve the current care in the field of female fertility preservation.
authors.affiliation: Department of Gynecological Endocrinology and Reproductive Medicine, Innsbruck Medical University, A-6020 Innsbruck, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Salama
authors.forename: K
authors.initials: K
authors.lastname: Winkler
authors.forename: K F
authors.initials: KF
authors.lastname: Murach
authors.forename: B
authors.initials: B
authors.lastname: Seeber
authors.forename: S C
authors.initials: SC
authors.lastname: Ziehr
authors.forename: L
authors.initials: L
authors.lastname: Wildt
mesh_terms: D000375:Aging; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001755:Blastocyst; D015925:Cryopreservation; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D006801:Humans; D007247:Infertility, Female / Q000139:chemically induced / Q000517:prevention & control*; D009369:Neoplasms / Q000188:drug therapy; D009865:Oocytes; D010053:Ovary / Q000473:pathology / Q000503:physiopathology / Q000637:transplantation; D046509:Tissue Culture Techniques
chemical_list: D000970:Antineoplastic Agents