In the last years, thanks to the improvement in the prognosis of cancer patients, a growing attention has been given to the fertility issues. International guidelines on fertility preservation in ...cancer patients recommend that physicians discuss, as early as possible, with all patients of reproductive age their risk of infertility from the disease and/or treatment and their interest in having children after cancer, and help with informed fertility preservation decisions. As recommended by the American Society of Clinical Oncology and the European Society for Medical Oncology, sperm cryopreservation and embryo/oocyte cryopreservation are standard strategies for fertility preservations in male and female patients, respectively; other strategies (e.g. pharmacological protection of the gonads and gonadal tissue cryopreservation) are considered experimental techniques. However, since then, new data have become available, and several issues in this field are still controversial and should be addressed by both patients and their treating physicians.In April 2015, physicians with expertise in the field of fertility preservation in cancer patients from several European countries were invited in Genova (Italy) to participate in a workshop on the topic of "cancer and fertility preservation". A total of ten controversial issues were discussed at the conference. Experts were asked to present an up-to-date review of the literature published on these topics and the presentation of own unpublished data was encouraged. On the basis of the data presented, as well as the expertise of the invited speakers, a total of ten recommendations were discussed and prepared with the aim to help physicians in counseling their young patients interested in fertility preservation.Although there is a great interest in this field, due to the lack of large prospective cohort studies and randomized trials on these topics, the level of evidence is not higher than 3 for most of the recommendations highlighting the need of further research efforts in many areas of this field. The participation to the ongoing registries and prospective studies is crucial to acquire more robust information in order to provide evidence-based recommendations.
Cryopreservation is the most efficient method for long-term preservation of mammalian sperm. However, freeze-thawing procedures may strongly impair the sperm function and survival and thus decrease ...the reproductive performance. In addition, the sperm resilience to withstand cryopreservation, also known as freezability, presents a high individual variability. The present work summarizes the principles of cryoinjury and the relevance of permeating and nonpermeating cryoprotective agents. Descriptions about sperm cryodamage are mainly focused on boar sperm, but reference to other mammalian species is also made when relevant. Main cryoinjuries not only regard to sperm motility and membrane integrity, but also to the degradation effect exerted by freeze-thawing on other important components for sperm fertilizing ability, such as mRNAs. After delving into the main differences between good and poor freezability boar ejaculates, those protein markers predicting the sperm ability to sustain cryopreservation are also mentioned. Moreover, factors that may influence sperm freezability, such as season, diet, breed, or ejaculate fractions are discussed, together with the effects of different additives, like seminal plasma and antioxidants. After briefly referring to the effects of long-term sperm preservation in frozen state and the reproductive performance of frozen-thawed boar sperm, this work speculates with new research horizons on the preservation of boar sperm, such as vitrification and freeze-drying.
Background
Advances in vitrification techniques have enabled planned oocyte cryopreservation (‘Planned OC’).
Objectives
To explore the cost‐efficiency and utilisation of planned OC, as well as ...patients’ perspectives on the process.
Search strategy
A systematic search in PubMed/MEDLINE, Embase, Cochrane Database and PsychINFO, for all relevant studies published between January 2007 and December 2019.
Selection criteria
The protocol followed PRISMA guidelines in PECO format, and was registered with PROSPERO.
Data collection and analysis
Two independent reviewers evaluated all manuscripts for inclusion eligibility. Authors were contacted for missing data. Included studies were assessed for risk of bias and for heterogeneity. Weighted effects were measured and plotted.
Main results
The search yielded 12 545 records, of which 43 were included. Planned OC is cost‐efficient at 35, assuming 60% utilisation; and at 37 assuming utilising donor sperm when necessary. At 38 it is cost‐efficient to defer planned OC in favour of undergoing 2 IVF cycles. Currently, utilisation of banked‐oocytes within 22–58 months, is up to 15%. Nine percent of warmed banked oocytes result in life births. Online resources and treating physicians are equally important sources of information regarding planned OC. Most patients think planned OC is ideal before age 35 and are not fully aware of what the process entails and tend to overestimate the success rates. The main barrier to wider endorsement of planned OC is being wary of potential health implications or of limited success.
Conclusion
Planned OC is an adequate method for preserving fertility. However, knowledge gaps result in under‐utilisation leading to reduced cost‐efficiency.
Tweetable
Identifying facilitators and barriers for wider adoption of banking oocytes can enhance the cost‐efficiency of this modality.
Tweetable
Identifying facilitators and barriers for wider adoption of banking oocytes can enhance the cost‐efficiency of this modality.
Welcomed as liberation and dismissed as exploitation, egg
freezing (oocyte cryopreservation) has rapidly become one of the
most widely-discussed and influential new reproductive technologies
of this ...century. In Freezing Fertility, Lucy van de Wiel takes us
inside the world of fertility preservation-with its egg freezing
parties, contested age limits, proactive anticipations and equity
investments-and shows how the popularization of egg freezing has
profound consequences for the way in which female fertility and
reproductive aging are understood, commercialized and politicized.
Beyond an individual reproductive choice for people who may want to
have children later in life, Freezing Fertility explores
how the rise of egg freezing also reveals broader cultural,
political and economic negotiations about reproductive politics,
gender inequities, age normativities and the financialization of
healthcare. Van de Wiel investigates these issues by analyzing a
wide range of sources-varying from sparkly online platforms to
heart-breaking court cases and intimate autobiographical
accounts-that are emblematic of each stage of the egg freezing
procedure. By following the egg's journey, Freezing
Fertility examines how contemporary egg freezing practices
both reflect broader social, regulatory and economic power
asymmetries and repoliticize fertility and aging in ways that
affect the public at large. In doing so, the book explores how the
possibility of egg freezing shifts our relation to the beginning
and end of life.
This work explored whether a well-characterized recombinant human interleukin-6 (hIL6) protein will influence in vitro produced (IVP) bovine embryo development and survival after cryopreservation. ...Cumulus oocyte complexes were collected from abattoir derived ovaries, matured for 24 h, and fertilized using pooled semen from Holstein bulls. Embryos were treated with 0, 25, 50, or 100 ng/mL hIL6 on day 5 post-fertilization. An increase in ICM cell numbers was observed in each hIL6 treatment, with the lowest hIL6 treatment having the same magnitude of response as the middle and highest hIL6 concentration. No effects on TE cell numbers were observed. The second study involved cryopreserving (via slow freezing) of hIL6-treated blastocysts, then examining post-thaw blastocyst survival by incubating for 24 h in the absence of hIL6 treatments. Blastocyst re-expansion and hatching rates were unaffected by any of the IL6 treatments, however, increases in both ICM and TE cell numbers were detected at 24 h post-thawing in blastocysts exposed to 100 ng/mL hIL6 but not lower concentrations before freezing. A reduction in the percentage of TUNEL-positive TE cells was observed after thawing in blastocysts exposed to 25, 50 and 100 ng/mL hIL6 before cryopreservation. No treatment-dependent changes in TUNEL-positive ICM cells were observed. In summary, hIL6 supplementation improves ICM cell numbers in bovine blastocysts to a degree that is commensurate with what has been observed when using bovine recombinant IL6. This positive effect of hIL6 on ICM cell numbers is maintained after freezing and thawing, and a novel improvement in post-thaw TE cell numbers occur in hIL6 treated embryos. This positive effect on TE cell numbers is attributed, at least in part, to an hIL6-dependent reduction in TE cell apoptosis.
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•Increases in inner cell mass cell numbers are achieved by supplementing recombinant human interleukin-6.•Positive effects of human interleukin-6 supplementation on both the inner cell mass and trophectoderm were detected after embryo cryopreservation.•Human interleukin-6 may is effective in bovine embryos.
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