Fertility preservation problem in oncohematological patients of reproductive age

Abstract

Yu.E. Dobrokhotova1, M.A. Lysenko1,2, V.M. Grabovsky2, N.A. Shevchenko1,2, I.M. Grashchenko2 1Pirogov Russian National Research Medical University, Moscow, Russian Federation 2City Clinical Hospital No.52, Moscow, Russian Federation Modern advances in the early diagnosis and treatment of oncological, in particular oncohematological, diseases have led to an increase in the reproductive-aged life expectancy. The use of effective, but aggressive from the standpoint of gonadotoxic treatment, chemotherapy regimens in the treatment of female patients of reproductive age with hematologic malignancies can lead to iatrogenic premature ovarian insufficiency with reduced fertility. All female patients of reproductive age who are scheduled for chemotherapy courses should be informed in a timely manner about the possible ovarian insufficiency and consulted about modern methods of preserving fertility, taking into account both medical and social factors. Cryopreservation procedures (cryopreservation of oocytes, embryos, ovarian tissue) create a large financial burden, being a significant social problem. However, the accumulated experience of using a financially affordable medical method for preserving ovarian function (gonadotropin-releasing hormone agonist drugs) during chemotherapy allows to widely use it in everyday practice. Further trials are needed to study the use of combined oral contraceptives in oncohematological female patients, which include innovative components that provide minimal effect on the hemostatic system and a favorable safety profile for venous thromboembolism. Keywords: hematological malignancies, fertility preservation, gonadotropin-releasing hormone agonists, oocyte cryopreservation, embryo cryopreservation, ovarian tissue cryopreservation, assisted reproductive technologies. For citation: Dobrokhotova Yu.E., Lysenko M.A., Grabovsky V.M., Shevchenko N.A., Grashchenko I.M. Fertility preservation problem in oncohematological patients of reproductive age. Russian Journal of Woman and Child Health. 2023;6(4):362–367 (in Russ.). DOI: 10.32364/2618-8430-2023-6-4-6.