Update on Female Fertility Preservation

Author(s): Elsa Labrune, Bruno Salle, Jacqueline Lornage

Cancer is the second leading cause of death for women under 40. Survival rates are increasing due to earlier diagnosis and advanced treatment. One of the side effects of treatment is premature ovarian failure. This is why fertility preservation is part of the initial care of patients, allowing for a better quality of life after the disease. The main causes of premature ovarian failure are iatrogenic (mainly chemotherapy and radiotherapy) in more than a third of cases, idiopathic, genetic and autoimmune. This preservation of fertility should be offered as soon as possible, ideally before gonadotoxic treatments. The same is true when the cause is non-iatrogenic because the age of the woman has a determining role on the quality of the gametes obtained and therefore on the results. The different techniques are embryo vitrification, oocyte vitrification and freezing of ovarian tissue, to be combined when possible with ovarian blockage and/or ovarian transposition. The most common technique is oocyte vitrification, which allows oocytes to be conserved, although this is not possible in pre-pubescent girls and in cases of urgent treatment. In these cases the freezing of the ovarian tissue is the solution.