Ovarian stimulation protocols for in vitro fertilization

Neplodnost je bolest reprodukcijskog sustava. Svjetska zdravstvena organizacija je definirala neplodnost kao izostanak trudnoće nakon 12 mjeseci redovitih nezaštićenih odnosa. Uzroci neplodnosti mogu biti u muškom, ženskom ili u oba partnera. Postoje slučajevi kada se uzrok ne može prepoznati te se govori o idiopatskoj neplodnosti. Kada se sumnja na neplodnost oba partnera se moraju podvrgnuti nizu pretraga koji će otkriti uzrok neplodnosti i uputiti na najbolje metode liječenja. Ovisno o uzroku neplodnosti različite su metode liječenja. Za korektivne operacije oštećenog reprodukcijskog sustava danas se primjenjuju endoskopske kirurške tehnike, laparoskopija i histeroskopija. Unatoč snažnom napretku endoskopske kirurgije danas će više od 70% neplodnih parova neplodnost liječiti metodama medicinski potpomognute oplodnje (MPO), posebno postupcima izvantjelesne oplodnje (IVF). Izvantjelesna oplodnja je metoda medicinski potpomognute oplodnje kojom se liječe teži oblici muške neplodnosti, te neplodnosti žena zbog oštećenih ili nepostojećih jajovoda, ali i neplodnost kojoj može biti uzrok endometrioza ili nepoznati uzrok, tzv. idiopatska neplodnost. Postupak izvantjelesne oplodnje može se raditi s jajnim stanicama dobivenim u prirodnom ili stimuliranom ciklusu. Prirodni ciklus može biti čisti prirodni ili modificirani prirodni ciklus. Stimulirani ciklus za IVF može biti blago stimulirani ili se mogu koristiti konvencionalni ili standardni protokoli stimulacije ovulacije. Premda su prve trudnoće pomoću oplodnje izvan tijela bile iz prirodnih ciklusa, zbog poboljšanja rezultata IVF-a tijekom povijesti više su korišteni konvencionalni protokoli ovarijske stimulacije s višim dozama gonadotropina, poput tzv. dugog protokola.Zbog učestalog ovarijskog hiperstimulacijskog sindroma, te učestalih višeplodnih trudnoća u takvim protokolima stimulacije ovulacije, danas se više koriste blaži protokoli.Danas je moguće prije ulaska u postupak in vitro fertilizacije procijeniti rezerve jajnika u pacijentice i izabrati za nju najprikladniji protokol stimulacije ovulacije. Stoga danas možemo govoriti o potpunoj individualizaciji stimulacije ovulacije u žena koje liječe neplodnost oplodnjom izvan tijela.Infertility is a disease of the reproductive tract. World health organization has defined infertilty as an unability to concieve after 12 months of regular unprotected relations. The reasons of infertility can be in the male, female partner or both. Also there are some cases when the cause of infertility remains unknown and then it is referred to as idiopathic infertility. Whenever there is doubt of infertilty or a couple is struggling to concieve both partners need to undergo series of test that will reveal the reason of infertilty and point to the best treatment. Depending on the reason of inferitilty there are different ways of treating. The treatment always begins from the less invasive methods. Despite the strong development of endoscopic surgery, 70% of couples with infertilty will be treated with medically induced conception, especially n vitro fertilization. IVF is a medical method to treat severe cases of male infertility, and female infertilty caused by damaged or unexisting fallopian tubes, but also infertilty cause by edomethrioisis or idiopathic infertilty. In vitro fertilzation is divided into two basic groups: natural cycli and stimulated cycli. If a stimulation drug is used early in the menstrual cyclus then that cyclus is stimulated. Throught the history doctors gave advantage to protocols with high dosage of stimulation drugs which resulted in higher number of oocytes for implantation. However high doses of hormones can have bad outcome on the women, worst of which is hyperstimulation sydrome. That is why today in vitro fertilization is developing in a way that patients are treated with lower dosed of hormones that still enable an adequate number and quality of oocytes. The choice of protocol to be used is still very individual and depends on the characteristics of the patient

Ovarian stimulation protocols for in vitro fertilization

Neplodnost je bolest reprodukcijskog sustava. Svjetska zdravstvena organizacija je definirala neplodnost kao izostanak trudnoće nakon 12 mjeseci redovitih nezaštićenih odnosa. Uzroci neplodnosti mogu biti u muškom, ženskom ili u oba partnera. Postoje slučajevi kada se uzrok ne može prepoznati te se govori o idiopatskoj neplodnosti. Kada se sumnja na neplodnost oba partnera se moraju podvrgnuti nizu pretraga koji će otkriti uzrok neplodnosti i uputiti na najbolje metode liječenja. Ovisno o uzroku neplodnosti različite su metode liječenja. Za korektivne operacije oštećenog reprodukcijskog sustava danas se primjenjuju endoskopske kirurške tehnike, laparoskopija i histeroskopija. Unatoč snažnom napretku endoskopske kirurgije danas će više od 70% neplodnih parova neplodnost liječiti metodama medicinski potpomognute oplodnje (MPO), posebno postupcima izvantjelesne oplodnje (IVF). Izvantjelesna oplodnja je metoda medicinski potpomognute oplodnje kojom se liječe teži oblici muške neplodnosti, te neplodnosti žena zbog oštećenih ili nepostojećih jajovoda, ali i neplodnost kojoj može biti uzrok endometrioza ili nepoznati uzrok, tzv. idiopatska neplodnost. Postupak izvantjelesne oplodnje može se raditi s jajnim stanicama dobivenim u prirodnom ili stimuliranom ciklusu. Prirodni ciklus može biti čisti prirodni ili modificirani prirodni ciklus. Stimulirani ciklus za IVF može biti blago stimulirani ili se mogu koristiti konvencionalni ili standardni protokoli stimulacije ovulacije. Premda su prve trudnoće pomoću oplodnje izvan tijela bile iz prirodnih ciklusa, zbog poboljšanja rezultata IVF-a tijekom povijesti više su korišteni konvencionalni protokoli ovarijske stimulacije s višim dozama gonadotropina, poput tzv. dugog protokola.Zbog učestalog ovarijskog hiperstimulacijskog sindroma, te učestalih višeplodnih trudnoća u takvim protokolima stimulacije ovulacije, danas se više koriste blaži protokoli.Danas je moguće prije ulaska u postupak in vitro fertilizacije procijeniti rezerve jajnika u pacijentice i izabrati za nju najprikladniji protokol stimulacije ovulacije. Stoga danas možemo govoriti o potpunoj individualizaciji stimulacije ovulacije u žena koje liječe neplodnost oplodnjom izvan tijela.Infertility is a disease of the reproductive tract. World health organization has defined infertilty as an unability to concieve after 12 months of regular unprotected relations. The reasons of infertility can be in the male, female partner or both. Also there are some cases when the cause of infertility remains unknown and then it is referred to as idiopathic infertility. Whenever there is doubt of infertilty or a couple is struggling to concieve both partners need to undergo series of test that will reveal the reason of infertilty and point to the best treatment. Depending on the reason of inferitilty there are different ways of treating. The treatment always begins from the less invasive methods. Despite the strong development of endoscopic surgery, 70% of couples with infertilty will be treated with medically induced conception, especially n vitro fertilization. IVF is a medical method to treat severe cases of male infertility, and female infertilty caused by damaged or unexisting fallopian tubes, but also infertilty cause by edomethrioisis or idiopathic infertilty. In vitro fertilzation is divided into two basic groups: natural cycli and stimulated cycli. If a stimulation drug is used early in the menstrual cyclus then that cyclus is stimulated. Throught the history doctors gave advantage to protocols with high dosage of stimulation drugs which resulted in higher number of oocytes for implantation. However high doses of hormones can have bad outcome on the women, worst of which is hyperstimulation sydrome. That is why today in vitro fertilization is developing in a way that patients are treated with lower dosed of hormones that still enable an adequate number and quality of oocytes. The choice of protocol to be used is still very individual and depends on the characteristics of the patient

Increased plasma level of lipoprotein(a) and homocysteine is a marker of increased cardiovascular risk

Introduction. Recent molecular research regards Lp(a) as the “third cholesterol” which should be treated in the same way like the total and LDL-cholesterol in reduction of total cardiovascular risk. Although early data on the relationship between elevated blood homocysteine concentrations and CAD and stroke have been somewhat inconsistent, hyperhomocystinemia has been suggested as an indicator of an increased risk of cardiovascular disease. In light of this, our study objective was to provide answers to the following questions: 1. Is serum Lp(a) concentration a risk factor for coronary artery disease in Croatian population; 2. What are the frequencies of various apo(a) isoforms in elevated serum Lp(a) concentrations; 3. Is there a relation between elevated serum homocysteine and Lp(a) concentration; 4. Investigate the relation of Lp(a) to other lipid disorders and other cardiovascular risk factors. Methods. This study was performed in Dubrava University Hospital in Zagreb, Croatia. 87 patients participated with no known preliminary coronary or peripheral vascular disease. The patient groups were stratified according to increased and normal Lp(a) levels measured from serum. Extensive medical history was obtained, blood biochemistry was evaluated and all patients underwent exercise stress testing. Results. In the group with increased concentration of Lp(a) in serum (> 0.30 g/L) there were 53 patients (average age 55 years, 32 males and 21 females), and normal concentration of Lp(a) in serum (< 0.30 g/L) was found in 34 patients (average age 52 years, 20 males and 14 females). The patients with increased Lp(a) levels were significantly older than the patients with normal Lp(a) levels (p = 0.020). The average concentration of Lp(a) in patients with negative exercise stress testing results was 0.38g/L, and in those with positive exercise stress testing results it was 0.51 g/L, with this difference among groups being significant (p = 0.049). The correlation of homocysteine and Lp(a) levels was statistically significant (r = 0.57, p < 0.01). Frequencies of phenotype Lp(a) were determined with the predominance of S4 phenotype (in 34 patients, 39.10%). Conclusions. Lp(a) concentration is a statistically significant risk factor for coronary artery disease. Homocysteine and Lp(a) seem to interact to increase the risk of CAD. No significant association was observed between Lp(a) levels and conventional risk factors for CAD

Liječenje mladih žena s ranim stadijem raka dojke - važnost očuvanja plodnosti

Management of young women with breast cancer is complex and has several particularities, one of which is fertility preservation, a very important quality of life issue for young breast cancer survivors. Chemotherapy can be gonadotoxic and significantly reduce woman`s reproductive potential and cause premature ovarian insufficiency while endocrine therapy requires a delay of pregnancy and indirectly affects fertility. Therefore every woman of reproductive age diagnosed with breast cancer should be informed about potential gonadotoxic effect of cancer treatment, the risk of premature ovarian insufficiency and associated symptoms, available fertility preservation methods, delay of cancer treatment and chances of subsequent pregnancy. If interested in fertility preservation breast cancer patients should be referred as early as possible to a reproductive specialist to further discuss the risk of infertility and available fertility preservation options. Currently established methods for fertility preservation are embryo and oocyte cryopreservation, while ovarian tissue cryopreservation, cryopreservation of immature oocytes and ovarian suppression with gonadotropin-releasing hormone agonists are still considered experimental. The aim of this review is to highlight the importance of fertility preservation as an important quality of life issue for young breast cancer survivors.Liječenje mladih žena s rakom dojke je složeno i ima nekoliko posebnosti, jedna od kojih je očuvanje plodnosti, vrlo bitan čimbenik kvalitete života mladih žena koje su preboljele rak dojke. Kemoterapija može štetno utjecati na jajnike i značajno smanjiti reprodukcijski potencijal žene i uzrokovati prijevremenu ovarijsku insuficijenciju, dok endokrina terapija zahtijeva odgodu trudnoće i tako posredno utječe na plodnost. Stoga bi svaka žena, kojoj je rak dojke dijagnosticiran u reprodukcijskoj dobi, trebala biti informirana o mogućem gonadotoksičnom učinku antineoplastičke terapije, riziku prijevremene ovarijske insuficijencije i povezanim simptomima, dostupnim metodama očuvanja plodnosti, odgodi sustavne antineoplastičke terapije, kao i o mogućnostima ostvarenja trudnoće nakon provedenog liječenja. Ukoliko je bolesnica s rakom dojke zainteresirana za očuvanje plodnosti, treba je što ranije uputiti subspecijalistu humane reprodukcije, koji će joj dodatno objasniti rizike za neplodnost i dostupne metode očuvanja plodnosti. Krioprezervacija embrija i oocita su trenutno jedine etablirane metode očuvanja plodnosti, dok se krioprezervacija tkiva jajnika, krioprezervacija nezrelih oocita i ovarijska supresija još uvijek smatraju eksperimentalnima. Cilj ovoga preglednog rada je istaknuti važnost očuvanja plodnosti kao bitnog čimbenika kvalitete života mladih žena koje su preboljele rak dojke

THE ROLE AND APPLICATION OF CORPORATE SOCIAL RESPONSIBILITY AS A PUBLIC RELATIONS TECHNIQUE: EXAMPLES OF INTERNET CAMPAIGNS

U radu se konceptu društveno odgovornoga poslovanja pristupa kao tehnici u odnosima s javnošću koja se provodi s dvojakim ciljem (Tench, 2009, str. 111). S jedne strane društvena odgovornost očituje se preko odabranih i planiranih aktivnosti s obzirom na dobrobit društva unutar kojega organizacija djeluje, a s druge strane društveno odgovorno poslovanje provodi se i da bi se (u konačnici) pozitivno utjecalo na imidž i reputaciju organizacije i svih čimbenika iz društvenoga okoliša organizacije, koji eksplicitno utječu na njezinu (tržišnu) opstojnost. Cilj ovoga empirijskog rada jest ispitati navedeno te prikazati ulogu i mogućnosti primjene tehnike društveno odgovornoga poslovanja u suvremeno strateški organiziranim odnosima s javnošću. U radu su preko dvije studije slučaja prikazani primjeri kampanja iz prakse: hrvatska kampanja Ožujskog piva Počeši s razlogom, čija je primarna uloga društvene odgovornosti bila osvijestiti rizičnu skupinu o mogućnostima ranoga otkrivanja raka testisa i načinima liječenja te francuska kampanja portala Addict Aide sa svjetskim dosegom Like My Addiction, koja nastoji ukazati na problem alkoholizma među mladima. Analizom objavljenoga virtualnoga sadržaja utvrđeno je, između ostaloga, da je u provedbi navedenih kampanja bio upotrijebljen drugačiji pristup korištenja društvenih mreža – komunikacijskih platformi na kojima su ostvarene – premda su ključne poruke kampanja bile slične, ali usmjerene prema različitim ciljnim javnostima. Konačno, utvrđivanjem učinaka interneta u odnosu na offline okruženje, u radu su prezentirane i mogućnosti konvergencije suvremenih medija i odnosa s javnošću te istraženo jesu li internetske kampanje diversificirale ili ostvarile pozitivne komunikacijske rezultate u društvu u kojemu su provedene.The paper deals with the concept of corporate social responsibility as a public relations technique implemented with the two goals (Tench, 2009, p.111): a) the responsibility of an organization to act for the benefit of the society within which it operates, b) to impact positively on an organization’s image and reputation on the societies point of view, and/or more specifically, engaged stakeholders – in order to gain profit. The goal of this paper is to present/visualize the role of corporate social responsibility and ways how to be applied in contemporary public relations. Two case studies show examples of such campaigns: a) Croatian campaign by Ožujsko beer, Počeši s razlogom, aiming to raise awareness among the tar - get audience on the ways of early detection of testicular cancer and its treatment, and the other one is French campaign by an online portal Addict Aide that became popular worldwide, called Like my Addiction, aiming to raise awareness on alcoholism among young generations. A content analysis conducted on published social media posts determined different approaches of using social media platforms, although their key messages were similar. By presenting advantages and disadvantages of the Internet, in comparison to the offline (virtual) media, this paper illustrates the opportunities enabled by contemporary public relations, as well as whether the communication results of both campaigns were substantial for the society

Pharmacovigilance from the Perspective of a Pharmaceutical Company

Farmaceutska industrija aktivno prati sigurnosni profil lijekova kako bi na vrijeme spriječila ili smanjila mogućnost nastanka nuspojava. Farmakovigilancijske aktivnosti u farmaceutskoj kompaniji sastoje se od aktivnog prikupljanja prijava o štetnim učincima lijekova, njihovoj obradi, koja uključuje medicinsku analizu, trajno pohranjivanje i prijavu agencijama za lijekove te sustavne i periodičke analize svih prikupljenih podataka. Farmakovigilancija je vrlo uređen sustav s jasnim zahtjevima pa je tako, primjerice, radi lakše i točnije izmjene podataka i njihove analize, uveden jedinstveni medicinski rječnik za regulatorne poslove – MedDRA (Medical Dictionary for Regulatory Activities). Jedna od najvažnijih aktivnosti prilikom praćenja sigurnosnog profila lijekova jest i otkrivanje novih informacija i rizika od primjene lijeka putem praćenja sigurnosnih signala. Radi toga se rabe statističke metode i stručna analiza podataka o kvaliteti, klinički i neklinički podatci, farmakovigilancijska i farmakoepidemiološka saznanja, kao i podatci iz objavljene znanstvene literature.Pharmaceutical companies actively monitor the safety profiles of their marketed medicines as well as those under development, with the purpose of timely detection, prevention or minimization of adverse drug reaction risks. Pharmacovigilance activities in a pharmaceutical company include the collection of adverse event reports in the company safety database, medical analysis of the reports, their reporting to the medicines agencies, as well as systematic and periodic analysis and review of cumulative data. Since pharmacovigilance requirements are clearly defined, with special emphasis on global timely data exchange, tools were designed to make this more efficient and precise; for example the Medical Dictionary for Regulatory Activities (MedDRA). One of the most important pharmacovigilance purposes is detecting new information and risks related to medicines, a process called safety signal detection. This is done by statistical methods and scientific analysis of data on quality, clinical and non-clinical information, pharmacovigilance and pharmacoepidemiological data and published scientific literature

Fizikalne i kemijske karakteristike i senzoričko ocjenjivanje plodova šipka (Punica granatum L.) sorte "Glavaš"

Physical, chemical and sensory characteristics of pomegranate fruits of cultivar ‘Glavaš’ were investigated. External and internal fruit quality was assessed by standard parameters (fruit and aril weight and dimensions, soluble solids, total acid) and sensorial quality by panel tests (fruit size, shape and colour; juiciness, sweet/acid taste). Among locations ‘Stolac3’ and ‘Buna 3’ have significantly distinct physical characteristics. The highest fruit weight was at ‘Buna 3’. Location ‘Stolac 1’had significantly higher values of total soluble solid content (17,63 ºBrix) and acidity of fruit juice (3,16 g/L). Large differences in sensory scores for fruit taste were found between locations.Istraživane su fizikalne, kemijske i senzoričke karakteristike plodova šipka sorte ‘Glavaš’. Vanjska i unutarnja kakvoća ploda ocijenjena je standardnim parametrima (masa ploda i arilusa, dimenzije ploda i arilusa, suha tvar, ukupne kiseline) i senzoričkim ocjenjivanjem panel testom (krupnoća ploda, oblik i boja ploda i arilusa, sočnost, slatkoća/kiselost). Između istraživanih lokacija statistički značajne razlike u fizikalnim karakteristikama ploda javljaju se na lokacijama ‘Stolac 3’ i ‘Buna 3’. Najveća masa ploda izmjerena je na lokaciji ‘Buna 3’. Lokacija ‘Stolac 1’ značajno se razlikuje u sadržaju suhe tvari (17,63 ºBrix) i ukupnih kiselina (3,16 g/L). Senzoričkim ocjenjivanjem utvrđene su razlike u okusu između plodova na različitim lokacijama

Fizikalne i kemijske karakteristike i senzoričko ocjenjivanje plodova šipka (Punica granatum L.) sorte "Glavaš"

Physical, chemical and sensory characteristics of pomegranate fruits of cultivar ‘Glavaš’ were investigated. External and internal fruit quality was assessed by standard parameters (fruit and aril weight and dimensions, soluble solids, total acid) and sensorial quality by panel tests (fruit size, shape and colour; juiciness, sweet/acid taste). Among locations ‘Stolac3’ and ‘Buna 3’ have significantly distinct physical characteristics. The highest fruit weight was at ‘Buna 3’. Location ‘Stolac 1’had significantly higher values of total soluble solid content (17,63 ºBrix) and acidity of fruit juice (3,16 g/L). Large differences in sensory scores for fruit taste were found between locations.Istraživane su fizikalne, kemijske i senzoričke karakteristike plodova šipka sorte ‘Glavaš’. Vanjska i unutarnja kakvoća ploda ocijenjena je standardnim parametrima (masa ploda i arilusa, dimenzije ploda i arilusa, suha tvar, ukupne kiseline) i senzoričkim ocjenjivanjem panel testom (krupnoća ploda, oblik i boja ploda i arilusa, sočnost, slatkoća/kiselost). Između istraživanih lokacija statistički značajne razlike u fizikalnim karakteristikama ploda javljaju se na lokacijama ‘Stolac 3’ i ‘Buna 3’. Najveća masa ploda izmjerena je na lokaciji ‘Buna 3’. Lokacija ‘Stolac 1’ značajno se razlikuje u sadržaju suhe tvari (17,63 ºBrix) i ukupnih kiselina (3,16 g/L). Senzoričkim ocjenjivanjem utvrđene su razlike u okusu između plodova na različitim lokacijama

Očuvanje plodnosti u mladih žena s ranim rakom dojke

Although breast cancer (BC) occurs more often in older women, it is the most commonly diagnosed malignancy in women of childbearing age. Owing to the overall advancement of modern medicine and the growing global trend of delaying childbirth until later age, we find ever more younger women diagnosed and treated for BC who have not yet completed their family. Therefore, fertility preservation has emerged as a very important quality of life issue for young BC survivors. This paper reviews currently available options for fertility preservation in young women with earlystage BC and highlights the importance of a multidisciplinary approach to fertility preservation as a very important quality of life issue for young BC survivors. Pregnancy after BC treatment is considered not to be associated with an increased risk of BC recurrence; therefore, it should not be discouraged for those women who want to achieve pregnancy after oncologic treatment. Currently, it is recommended to delay pregnancy for at least 2 years after BC diagnosis, when the risk of recurrence is highest. However, BC patients of reproductive age should be informed about the potential negative effects of oncologic therapy on fertility, as well as on the fertility preservation options available, and if interested in fertility preservation, they should be promptly referred to a reproductive specialist. Early referral to a reproductive specialist is an important factor that increases the likelihood of successful fertility preservation. Embryo and mature oocyte cryopreservation are currently the only established fertility preservation methods but they require ovarian stimulation (OS), which delays initiation of chemotherapy for at least 2 weeks. Controlled OS does not seem to increase the risk of BC recurrence. Other fertility preservation methods (ovarian tissue cryopreservation, cryopreservation of immature oocytes and ovarian suppression with gonadotropin-releasing hormone agonists) do not require OS but are still considered to be experimental techniques for fertility preservation.Premda se karcinom dojke češće javlja u starijoj životnoj dobi, to je i najučestaliji malignitet u žena reproduktivne dobi. Zbog sveukupnog napretka moderne medicine i rastućeg globalnog trenda odgađanja rađanja djece za kasniju dob suočavamo se sa sve više mladih žena s dijagnosticiranim i liječenim karcinomom dojke koje još nisu kompletirale obitelj. Stoga je područje očuvanja plodnosti postalo jako bitno u očuvanju kvalitete života mladih žena koje su preboljele karcinom dojke. Ovaj rad iznosi trenutno dostupne metode za očuvanje plodnosti u mladih žena s ranim karcinomom dojke i ističe važnost multidisciplinarnog pristupa u očuvanju plodnosti kao bitnog čimbenika kvalitete života tih žena. Smatra se da trudnoća nakon karcinoma dojke nije povezana s povišenim rizikom od recidiva pa stoga ne treba obeshrabriti žene koje žele ostvariti trudnoću nakon provedenog onkološkog liječenja. Danas se preporuča pričekati s trudnoćom barem 2 godine nakon postavljene dijagnoze za vrijeme kada je rizik od povrata bolesti najveći. No, isto tako bi bolesnice reproduktivne dobi trebalo obavijestiti o mogućem negativnom učinku onkološke terapije na plodnost te o dostupnim metodama očuvanja plodnosti i u slučaju zainteresiranosti za očuvanje plodnosti bolesnice treba žurno uputiti reproduktivnom specijalistu. Rano upućivanje reproduktivnom specijalistu je bitan čimbenik koji povećava izglede za uspješno očuvanje plodnosti. Krioprezervacija embrija i zrelih oocita su trenutno jedine standardne metode očuvanja plodnosti koje zahtijevaju stimulaciju ovarija kojom se odgađa početak kemoterapijskog liječenja barem 2 tjedna. Smatra se da kontrolirana stimulacija ovarija ne povećava rizik od povrata karcinoma dojke. Druge metode očuvanja plodnosti (krioprezervacija tkiva jajnika, krioprezervacija nezrelih oocita, ovarijska supresija GnRH agonistima) ne zahtijevaju primjenu ovarijske stimulacije, ali se i dalje smatraju eksperimentalnim metodama za očuvanje plodnosti