Challenges of fertility preservation in non-oncological diseases

Acta Obstet Gynecol Scand. 2019 May;98(5):638-646. doi: 10.1111/aogs.13577. Epub 2019 Mar 12.

Abstract

Clinicians should provide fertility counseling to all patients receiving gonadotoxic treatment. International scientific societies have mainly focused on oncological patients, and fewer efforts have been made to apply these recommendations to women diagnosed with benign disease (eg benign hematological diseases, autoimmune diseases, and gynecological or genetic disorders). However, these indications account for 8%-13% of the demand for fertility preservation. The risk of premature ovarian failure due to treatment, or to the disease itself, can be considered fairly high for many young women. Counseling and adequate management of these women require particular attention due to the severe health conditions that are associated with some of these diseases. In this review, we address specific issues related to providing adequate fertility counseling and management for women who have been diagnosed with the major non-oncological indications, based on the literature and on our clinical experience.

Keywords: autoimmune disease; benign diseases; fertility counseling; fertility preservation; genetic disorder; gynecological disorder; hematological disease.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Autoimmune Diseases / drug therapy
  • Counseling* / methods
  • Counseling* / standards
  • Female
  • Fertility Preservation / methods*
  • Genetic Diseases, Inborn / drug therapy
  • Genital Diseases, Female / drug therapy
  • Hematologic Diseases / drug therapy
  • Humans
  • Infertility, Female* / chemically induced
  • Infertility, Female* / prevention & control
  • Medication Therapy Management / standards*