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Risk assessment for fertility preservation
• Intrinsic factors
• Health status of patient
• surgical risk, malignant contamination
• Consent (patient/parent)
• Age
• Assessment of ovarian reserve
• Extrinsic factors
• Nature of predicted treatment
• (high/medium/low/uncertain risk) • Expertise/funding available
Wallace WH, Critchley HO and Anderson RA MRC Centre for Reproductive Health at the University of Edinburgh Optimizing reproductive outcome in children and young people with cancer. J Clin Oncol 2012; 30: 3-5.
Chemotherapy and damage to fertility
High Risk
Cyclophosphamide Ifosfamide Mustine Busulphan Melphalan Procarbazine Chlorambucil
Medium risk
Cisplatinum Carboplatinum Adriamycin
Low Risk
Vincristine Methotrexate Actinomycin D Bleomycin
6 mercaptopurine Vinbastine
BUT usually in combination, new regimens all the time.....
MRC Centre for Reproductive Health at the University of Edinburgh
Wallace, Anderson and Irvine, Lancet Oncology 2005
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PRECONGRESS COURSE 05 I VIENNA, AUSTRIA – 23 JUNE 2019 11