Fertility Preservation
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%MRE3ELI s !SHOK!GARWAL Editors
Fertility Preservation %MERGING4ECHNOLOGIES AND#LINICAL!PPLICATIONS &OREWORDBY#HARLES*,OCKWOOD -$
Editors Emre Seli, MD Department of Obstetrics, Gynecology, and Reproductive Sciences Yale University School of Medicine New Haven, CT, USA
[email protected]
Ashok Agarwal, PhD, HCLD (ABB), EMB (ACE) Director Center for Reproductive Medicine Cleveland Clinic
Cleveland, OH, USA
[email protected]
ISBN 978-1-4419-1782-9 e-ISBN 978-1-4419-1783-6 DOI 10.1007/978-1-4419-1783-6 Springer New York Dordrecht Heidelberg London Library of Congress Control Number: 2011936522 © Springer Science+Business Media, LLC 2012 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)
Foreword
Women diagnosed with cancer prior to or during their reproductive period often face both the uncertainty of long-term survival, and the risk of treatment-induced infertility. Treatments for common cancers occurring in younger women often necessitate extirpation of their reproductive organs, radiation therapy, and/or chemotherapy, each of which may partially or completely impair reproductive (and endocrine) function. Fortunately, during the last two decades, cancer survival in the USA has improved. This has resulted in an increased focus on maximizing the quality of life for cancer survivors. Preserving future fertility is a crucial component of the quality of life in prepubertal and reproductive age women. Similarly, cancer can also strike young men, the treatments for which pose comparable risks to future fertility. Thus, clinicians caring for such patients will find this textbook valuable in both counseling and caring for younger women and men with newly diagnosed cancers. However, there is a third group of patients in whom fertility preservation is of increasing relevance, interest, and importance. Women in much of the industrial world have been progressively delaying initiation/completion of childbearing to later in life. More women in their late 30s and early 40s are attempting to conceive for the first time than ever before. Since the incidence of most cancers in the reproductive age group is comparatively low, intentionally postponing childbearing presents a far more common indication for fertility preservation than cancer. The editors are well suited to the purposes of this text. Both are gifted fertility practitioners and physician scientists. Dr. Ashok Agarwal is the Director of the Center for Reproductive Medicine at Cleveland Clinic. He has authored over 150 peer reviewed publications, garnered multiple research grants, and is internationally recognized for his outstanding contributions in scientific and clinical aspects of reproductive medicine. Dr. Emre Seli is an accomplished reproductive scientist and physician at the Yale School of Medicine. Dr. Seli has conducted novel and potentially landmark research regarding basic oocyte mRNA processing, a process relevant to maternal ageassociated infertility. Dr. Seli has also pioneered the development of novel technologies for assessing embryo quality in vitro. Meanwhile, Dr. Seli directs a highly successful oocyte donation program at his home institution. Drs. Agarwal and Seli have assembled an “All Star” cast of authors, each an expert in the topics about which they write. The goal of the text is to pres-
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&OREWORD
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ent strategies for fertility preservation in women and men who require gonadotoxic and other fertility-impairing therapies. In addition, key epidemiologic, ethical, medico-legal, psychologic and social aspects of fertility preservation are discussed. A format that combines a concise scientific background with practical methodological information, including detailed and straightforward algorithms, is utilized. Step-by-step protocols for laboratory procedures are presented. The result is a concise, readable, and highly practical reference guide for reproductive endocrinologists, embryologists, reproductive scientists, and oncologists. This text will also greatly aid the general ob/gyn in counseling both the relatively uncommon younger patient facing fertilitycompromising treatments and the increasingly common woman in her 30s or early 40s who elects to delay fertility for a myriad of professional and personal reasons. For all these reasons, I can enthusiastically recommend this textbook to you. New Haven, CT
Charles J. Lockwood, MD
Preface
Dum spiro, spero [As long as I breathe, I hope] Marcus Tullius Cicero
Cancer is not uncommon in men and women of reproductive age. In the USA alone, over 130,000 men and women below the age of 45 were afflicted with cancer in 2008. The compromised fertility that will be faced by many of these patients can result in significant psychosocial stress and in reduced quality of life; even long after the cancer has been successfully treated. Fortunately, the rapid pace of scientific and technological discovery has increased the options available to men and women in need of fertility preservation. More than 30 years after the birth of the first child conceived by assisted reproductive technologies, we are now able to cryopreserve embryos, spermatozoa, and oocytes as well as testicular and ovarian tissue. In addition, the effect of gonadotoxic treatments on fertility is better defined and the use of medical interventions for fertility preservation is within reach. With increasingly complex modalities available for fertility preservation comes the need for a clear, concise, readable, and practical text to serve as a resource for healthcare providers. This textbook has been written with the aim of providing an update on options for fertility preservation for both men and women. Within this context, this text reviews current therapeutic modalities in great detail and describes the biologic basis for available interventions. A key aspect of this volume is the valuable contributions from oncologists, obstetricians, psychologists, epidemiologists, and ethicists in addition to reproductive scientists and infertility specialists. This thorough resource thus recapitulates the multidisciplinary approach that is required to adequately provide patient care with a view to fertility preservation. Following introductory chapters on the epidemiology and ethics of fertility preservation, this book is divided into two main sections that share a similar overall format while reviewing fertility preservation in female and then male patients. Each section starts with a chapter reviewing the genderspecific biology of the reproductive system within the context of fertility preservation. Then, the impact of gonadotoxic treatment on gonadal function and on the offspring is reviewed. Additional chapters in each section summarize established and experimental methodologies currently available for fertility preservation in both sexes, providing detailed protocols for laboratory
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procedures. The resulting comprehensive text provides cutting edge science and evidence-based suggestions regarding potential interventions directed at fertility preservation. This book is dedicated to our patients who, despite facing potentially lethal diagnoses and compromised quality of life, continue to hope, to live, and to pursue their dreams of parenthood. New Haven, CT Cleveland, OH
Emre Seli Ashok Agarwal
Contents
Part I
Overview of Fertility Preservation: Epidemiologic, Social, Ethical, and Medicolegal Aspects
1
The Epidemiology of Fertility Preservation .............................. William Murk and Emre Seli
2
Ethical Discussions in Approaching Fertility Preservation .................................................................................. Pasquale Patrizio
Part II 3
4
5
3
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Fertility Preservation in Women
Ovarian Follicle Development and Fertility Preservation .................................................................................. Yuichi Niikura and Joshua Johnson
29
Impact of Chemotherapy and Radiotherapy on the Ovary ................................................................................. Maya L. Kriseman and Ertug Kovanci
45
Impact of Chemotherapy and Radiotherapy on the Uterus ................................................................................ Abbie L. Fields, Deleep Kumar Gudipudi, and Giuseppe Del Priore
6
Ovarian Transposition ................................................................. Elena S. Ratner, Dan-Arin Silasi, and Masoud Azodi
7
Embryo Cryopreservation and Alternative Controlled Ovarian Hyperstimulation Strategies for Fertility Preservation .................................................................................. Bulent Urman, Ozgur Oktem, and Basak Balaban
8
Oocyte Cryopreservation............................................................. Andrea Borini and Veronica Bianchi
9
Ovarian Tissue Cryopreservation and Autotransplantation ............................................................. Mohamed A. Bedaiwy, Gihan M. Bareh, Katherine J. Rodewald, and William W. Hurd
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77 89
107
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Contents
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Oocyte In Vitro Maturation: Formidable Obstacles on the Road to Fertility Preservation ......................................... David F. Albertini
11
Whole Ovary Cryopreservation.................................................. Hulusi Bulent Zeyneloglu, Gogsen Onalan, and Cengiz Karakaya
12
Risk of Transplanting Cryopreserved Ovarian Tissue in Women with Malignancies ...................................................... Javier Domingo del Pozo, María Sánchez-Serrano, and Antonio Pellicer
13
Gonadotropin-Releasing Hormone Agonists in Fertility Preservation ............................................................... Hakan Cakmak and Emre Seli
14
Fertility Preservation in Gynecologic Malignancies ................. Christine E. Richter and Peter E. Schwartz
15
Third-Party Reproduction and Adoption After Cancer: Practical and Emotional Considerations .................... Dorothy A. Greenfeld
121 129
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145 159
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16
Pregnancy and Cancer Treatment.............................................. Christine Laky and Mert Ozan Bahtiyar
209
17
Fertility Preservation Strategies in Healthy Women ................ Enrique Soto and Alan B. Copperman
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Approach to Fertility Preservation in Adult and Prepubertal Females............................................................. Kenny A. Rodriguez-Wallberg and Kutluk Oktay
Part III
Fertility Preservation in Men
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Spermatogenesis and Testicular Function ................................. Ciler Celik-Ozenci
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Impact of Radiotherapy and Chemotherapy on the Testis .................................................................................. Carolina Ortega and Herman Tournaye
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Impact of Paternal Exposure to Gonadotoxins on Embryo and Offspring and the Male Evaluation .................................... Kathleen Hwang, Paul Gittens, Desiderio Avila Jr., and Larry I. Lipshultz
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Update on Sperm Banking .......................................................... Pankaj Talwar
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Preservation of Sperm Isolates or Testicular Biopsy Samples ............................................................................. Bhushan K. Gangrade
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Contents
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24
Germ Cell Transplantation and Neospermatogenesis .............. Queenie V. Neri, Zev Rosenwaks, and Gianpiero D. Palermo
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Testicular Tissue Transplantation for Fertility Preservation .................................................................................. Jose R. Rodriguez-Sosa, Stefan Schlatt, and Ina Dobrinski
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Stem Cells and Fertility Preservation in Males ......................... Marcia Riboldi, Ana Isabel Marqués Marí, and Carlos Simón
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Approach to Fertility Preservation in Adult and Pre-pubertal Males ............................................................... Fnu Deepinder and Ashok Agarwal
Part IV
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331 345
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Protocols
Appendix A
Embryo Cryopreservation and Alternative Strategies for Controlled Ovarian Hyperstimulation ................ 367 Bulent Urman, Ozgur Oktem, and Basak Balaban
Appendix B
Oocyte Cryopreservation ............................................ Andrea Borini and Veronica Bianchi
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Appendix C
Ovarian Tissue Cryopreservation .............................. Mohamed A. Bedaiwy, Gihan M. Bareh, Katherine J. Rodewald, William W. Hurd, and Ashok Agarwal
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Appendix D
Sperm Preparation and Freezing for Banking ......... Pankaj Talwar
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Appendix E
Preservation of Sperm Isolates and Testicular Biopsy Samples for Banking.................................................... 387 Bhushan K. Gangrade
Appendix F
Testis Tissue Xenografting .......................................... Jose R. Rodriguez-Sosa, Stefan Schlatt, and Ina Dobrinski
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Index ......................................................................................................
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Contributors
Ashok Agarwal, PhD, HCLD Center for Reproductive Medicine, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA Department of Obstetrics-Gynecology and Women’s Health Institute, Cleveland Clinic, Cleveland, OH, USA David F. Albertini, PhD Hall Professor of Molecular Medicine University of Kansas Cancer Center, Kansas City, KS, USA Desiderio Avila, Jr. MD Resident, Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA Masoud Azodi, MD Associate Professor, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA Mert Ozan Bahtiyar, MD Associate Professor, Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT, USA Basak Balaban, MSc Embryologist Department of Obstetrics and Gynecology, American Hospital, Istanbul, Turkey Gihan M. Bareh, MD, Resident, Department of Obstetrics and Gynecology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA Mohamed A. Bedaiwy, MD, PhD REI Fellow, Department of Obstetrics and Gynecology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA Veronica Bianchi, PhD Senior Embryologist, Tecnobios Procreazione Centre for Reproductive Health, Bologna, Italy Andrea Borini, MD Tecnobios Procreazione Centre for Reproductive Health, Via Dante, Bologna, Italy Clinical and Scientific Director, Tecnobios Procreazione Centre for Reproductive Health, Bologna, Italy Hakan Cakmak, MD Resident, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA xiii
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Ciler Celik-Ozenci, DDS, PhD Associate Professor, Department of Histology and Embryology, School of Medicine, Akdeniz University, Campus, Antalya, Turkey Alan B. Copperman, MD Director, Division of Reproductive Endocrinology and Infertility, Mount Sinai Medical Center, New York, NY, USA Vice-Chairman, Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai Medical Center, New York, NY, USA Clinical Professor, Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, NY, USA Fnu Deepinder, MD Clinical Research Fellow, Department of Endocrinology, Diabetes and Metabolism, Cedars Sinai Medical Center, Los Angeles, CA, USA Giuseppe Del Priore, MD, MPH Director, Division of Gynecologic Oncology, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, USA Javier Domingo del Pozo, MD Gynecologist, Department of Reproductive Medicine, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain Ina Dobrinski, DVM, MVSc, PhD Professor, Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada Abbie L. Fields, MD Medical Director, Division of Gynecologic Oncology, Washington Hospital Center, Washington, DC, USA Bhushan K. Gangrade, PhD Director, IVF Laboratory, Center for Reproductive Medicine, Orlando, FL, USA Paul Gittens, MD Fellow, Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA Dorothy A. Greenfeld, LCSW Clinical Professor, Department of Obstetrics and Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA Deleep Kumar Gudipudi, MBBS, DNB Resident, Department of Radiation Oncology, Basavatarakam Indo-American Cancer Institute and Research Center, Hyderabad, Andhra Pradesh, India William W. Hurd, MD, MSc Professor, Department of Obstetrics and Gynecology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA Director, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA
#ONTRIBUTORS
#ONTRIBUTORS
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Kathleen Hwang, MD Clinical Research Resident, Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA Joshua Johnson, PhD Assistant Professor, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA Cengiz Karakaya, PhD Rector, Department of Obstetrics and Gynecology, IVF Unit, Gazi University, Ankara, Turkey Ertug Kovanci, MD Assistant Professor, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA Maya L. Kriseman, BS Medical Student, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA Christine Laky, MD Fellow, Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT, USA Larry I. Lipshultz, MD Professor and Chair; Lester and Sue Smith Chair in Reproductive Medicine, Baylor College of Medicine, Houston, TX, USA Chief, Division of Male Reproductive Medicine and Surgery, Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA Ana Isabel Marqués Marí, PhD Researcher, Stem Cell Bank, Prince Felipe Research Centre, Valencia, Spain William Murk, BSc, MPH Research Assistant, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA Queenie V. Neri, BSc, MSc Research Associate, The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, NY, USA Yuichi Niikura, PhD Research Assistant Professor, Department of Animal Sciences, Washington State University, Pullman, WA, USA Kutluk Oktay, MD, FACOG Professor of Obstetrics & Gynecology, Medicine, and Cell Biology & Anatomy, Director, Division of Reproductive Medicine & Institute for Fertility Preservation Ozgur Oktem, MD Specialist, Department of Obstetrics and Gynecology, American Hospital, Istanbul, Istanbul, Turkey Gogsen Onalan, MD Associate Professor, Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Baskent University, Ankara, Turkey Carolina Ortega, MD Clinical Fellow, Centre for Reproductive Medicine, University Hospital, Dutch-speaking Brussels Free University, Brussels, Belgium
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Gianpiero D. Palermo, MD, PhD Professor, The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, NY, USA Pasquale Patrizio, MD, MBE, HCLD Professor, Yale Fertility Center and REI Medical Practice, New Haven, CT, USA Director, Yale Fertility Center and REI Medical Practice, New Haven, CT, USA Antonio Pellicer Department of Obstetrics and Gynecology, Hospital Universtario Doctor Peset, Valencia, Spain Department of Obstetrics and Gynecology, Valencia University, Valencia, Spain Elena S. Ratner, MD Assistant Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA Marcia Riboldi Doctoral Student, Stem Cell Bank, Prince Felipe Research Centre, Valencia, Spain Christine E. Richter, MD Instructor, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA Katherine J. Rodewald, MD Attending, Department of Obstetrics and Gynecology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA Jose R. Rodriguez-Sosa, DVM, MAP, PhD Postdoctoral Fellow, Department of Comparative Biology and Experimental Medicine, University of Calgary, Calgary, Canada Kenny A. Rodriguez-Wallberg, MD, PhD Head, Fertility Preservation Programme, Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institute and Karolina University Hospital Huddinge, Stockholm, Sweden Zev Rosenwaks, MD Revlon Distinguished Professor, Reproductive Medicine in Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA Professor, Obstetrics and Gynecology, The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, NY, USA María Sánchez-Serrano, MD Gynecologist, Department of Obstetrics and Gynecology, Hospital Universtario Doctor Peset, Valencia, Spain Stefan Schlatt, PhD Director and Professor, Center of Reproductive Medicine and Andrology, University Hospital of Münster, Münster, Germany
#ONTRIBUTORS
#ONTRIBUTORS
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Peter E. Schwartz, MD John Slade Ely Professor, Vice Chair, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA Emre Seli, MD Associate Professor, Associate Director for Research, Division of Reproductive Endocrinology and Infertility; Director, Oocyte Donation and Gestational Surrogacy Program, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA Dan-Arin Silasi, MD Assistant Professor, Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA Carlos Simón, MD, PhD Stem Cell Bank, Pricne Felipe Research Centre, Camino de las Moreras, Valencia, Spain Enrique Soto, MD Fellow, Minimally Invasive Gynecological Surgery Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Hospital/Mount Sinai School of Medicine, New York, NY, USA Pankaj Talwar, MD Lieutenant Colonel, ART Centre, Army Hospital Research and Referral, Dhaula Kuan, New Delhi, India Herman Tournaye, MD, PhD Professor, Centre for Reproductive Medicine, University Hospital, Dutch-Speaking Brussels Free University, Brussels, Belgium Bulent Urman, MD Associate Professor, Department of Obstetrics and Gynecology, American Hospital, Istanbul, Turkey Hulusi Bulent Zeyneloglu, MD Professor, Department of Obstetrics and Gynecology, Baskent University, Ankara, Turkey
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