فهرست نشریات علمی دسترسی آزاد ایران

Although ovarian tissue cryopreservation is still considered as an experimental technique, several authors fromaround the world have reported successful and promising results. Currently, oocyte cryopreservation seems to be themost feasible technique for fertility preservation when there’s some kind of a time constraint in adolescents and adults.However, it has been estimated that a young woman would be expected to have a 94% likelihood of having a live birthwith 20 mature frozen oocytes (1). At age 34 years, however, this expectation is decreased to 90% with 20 mature frozenoocytes. In addition to age-related limitations, an immediate obstacle for obtaining oocytes in cancer patients is the factthat only one controlled ovarian hyperstimulation (COH) cycle can usually be performed in these women because oftime constraints, yielding a relatively low number of oocytes and/or embryos. For this reason, results from egg donationprograms cannot be extrapolated to cancer patients, nor can the quality of oocytes be guaranteed. Hence, a combinedfertility preservation technique can be of valuable in increasing the chances of successful future pregnancies followinggonadotoxic cancer therapies. Previously, Dolmans et al. (2) suggested that cryopreservation of bilateral ovarian cortexfollowed by COH is a feasible and safe approach to preserve fertility before gonadotoxic treatment, and that the numberof cryopreserved embryos was similar to the controls.We have been offering the option of the combined technique to fertility preservation patients for a couple of years andhave performed it in a series of eight candidate patients. All patients had enough time for COH before oncology treatments. We first performed laparoscopic ovarian resection for ovarian tissue cryopreservation and then started COH onpostoperative day 0 or 1 in each patient (Table 1). The main point in our findings is that ovarian resection is performedfrom the side with less antral follicle count of the patients. We suggest that this approach can increase the oocyte yield ina single available COH cycle.The data is limited on the effectiveness of combined technique and more long-term follow-up studies are needed inlarger groups with appropriate controls. According to our clinical experience, we believe that combined technique isa valid approach, which is expanding beyond the experimental stage and has become a clinical technique for fertility preservation. We particularly suggest selecting the ovary with a low antral follicle count for wedge resection toincrease oocyte yield. The information gathered from large international multicenter reports would encourage physicians to agree that the method should complete the experimental phase and be ready for wider clinical use in femalefertility preservation.