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Abstract
Cryopreservation of eggs or ovarian tissue to preserve fertility for patients with
cancer has been studied since 1994 with R G Gosden's paper describing restoration
of fertility in oophorectomised sheep, and for decades previously by others in smaller
mammals. Clinically this approach has shown great success. Many healthy children have
been born from eggs cryopreserved with the Kuwayama egg vitrification technique for
non-medical (social) indications, but until now very few patients with cancer have
achieved pregnancy with cryopreserved eggs. Often, oncologists do not wish to delay
cancer treatment while the patient goes through multiple ovarian stimulation cycles
to retrieve eggs, and the patient can only start using the oocytes after full recovery
from cancer. Ovarian stimulation and egg retrieval is not a barrier for patients without
cancer who wish to delay childbearing, which makes oocyte cryopreservation increasingly
popular to overcome an age-related decline in fertility. Cryopreservation of ovarian
tissue is an option if egg cryopreservation is ruled out. More than 35 babies have
been born so far with cryopreserved ovarian tissue in patients with cancer who have
had a complete return of hormonal function, and fertility to baseline. Both egg and
ovarian tissue cryopreservation might be ready for application to the preservation
of fertility not only in patients with cancer but also in countering the increasing
incidence of age-related decline in female fertility.