Fertility Preservation :A Big Dilemma For Patients With Breast Cancer

Introduction : Breast cancer is one of the most common malignancies in women. Cytotoxic chemotherapy or drugs exert a negative effect on fertility potential. Techniques,such as ovarian suppression, oocyte and embryo freezing, InVitro Maturation, and ovarian tissue freezing, are necessary to preserve fertility. Methods: To conduct this study, a query was conducted on Persian and English sources databases as Scoupus, Google Scholar, Pub Med, and Science Direct during the last 24 years using the following keywords: breast cancer, infertility, fertility preservation, oocyte freezing, and embryo freezing. Results: Based on the result15% to 25% of patients are young premenopausal women. Chemotherapy or radiation therapy can lead to infertility or early menopause. As suggested by evidence, the success rate of embryo freezing is much higher than oocyte freezing and In Vitro Maturation. Among the fertility preservation methods, ovarian tissue freezing and 3D bioprinting are in the laboratory research stage and have received much attention. Correct counseling and providing accurate information to patients and their timely referral have have a marked impact on improving their mental and physical condition and treating their underlying disease. Conclusion: As evidence by the result of this study, early diagnosis of breast cancer and timely referral to a fertility specialist enable , breast cancer patients to maintain their fertility and experience their biological child after aggressive cancer treatments

Drug-free in vitro activation and autologous transplantation in infertile women with diminished ovarian reserve: An experimental pilot study

Background: Poor ovarian response and diminished ovarian reserves (DOR) significantly contribute to female infertility. Previous attempts have been made to enhance follicular growth and improve pregnancy outcomes in these participants. Objective: This study aimed to assess the efficacy of the in vitro drug-free activation technique of the ovarian reservation and in vitro fertilization stimulation cycle outcomes in DOR participants. Materials and Methods: This pilot phase study investigated the impact of in vitro activation (IVA) on ovarian reservation and in vitro fertilization outcome in 10 infertile women with DOR from May to December 2023 at Taleghani Infertility Center, Tehran, Iran. Participants underwent general surgery and laparoscopy, involving the removal of a portion of one ovary, immediate transfer to the laboratory, dissection into small cubes, and subsequent re-implantation into the cases’s ovary. The primary outcomes, include the count of retrieved oocytes, the number of oocytes reaching metaphase, and the secondary outcomes were the quantity and the number of embryos transferred, implantation rate, and occurrence of clinical pregnancy. Results: The study revealed a significant increase in the antral follicle count before and after IVA (p = 0.033). Before IVA, the median estradiol level was 93.5 (57.0), which reduced to 79.0 (35.0) after IVA, indicating a statistically significant difference. On average, 2.3 (0.8) oocytes were retrieved, among which 1.5 (0.7) were metaphase II oocytes. The observed pregnancy rate among the 2 cases was 22.2%. Conclusion: The current study suggests that IVA may positively impact follicular growth and pregnancy outcomes among women with DOR