Fertiprotekt

The Fertiprotekt network is a cooperation of university centres, hospitals and practices. It was founded in Germany in 2006.[1] The network now extends to all German-speaking countries and currently units ca. 100 institutions in Germany, Austria and Switzerland.

Aims

The aim of the network is to offer men and women the possibility of seeking advice about scientific information regarding their fertility before and after Chemo- or radiotherapy, and to undergo procedures to protect their fertility. The advice about and the performance of fertility-conserving procedures according to the network’s code of ethics is non-profit oriented.[2]

Background

As a result of today’s significantly improved prognosis for patients with cancer, quality of life is increasingly important after overcoming treatment of the disease. Fears about fertility preservation play an important role for young men and women. The most common types of cancer diagnosed under the age of 40 years are breast cancer, melanoma, cervical cancer, non-Hodgkin’s lymphoma and leukaemia. One of the biggest problems in women who have to undergo chemo- or radiotherapy is premature ovarian failure (premature ovarian insufficiency) and its associated infertility.[3] For breast cancer alone, it is assumed that there are ca. 200 patients a year in Germany who wish to conceive. In men, chemotherapy can result in permanent damage to the testicular tissue. Due to advances in reproductive medicine, a variety of fertility-protective methods are now available. These techniques include administration of GnRH-agonists,[4] ovarian stimulation with cryoconservation of fertilised or unfertilised oocytes, as well as cryoconservation of ovarian tissue.[5] Relocation of the ovaries by surgically moving them out of the pelvis (ovarian transposition) to protect them from damage caused by radiotherapy is also possible.[6]

Activity

The Fertiprotekt network has carried out international pioneering work in four areas:

Network seminars take place annually. The centres involved are obliged to regularly take part in these annual conferences.

Problems

Some methods, such as cryoconservation of sperm and in-vitro fertilisation (IVF) are well established. Others have only been introduced over the last few years, such as cryoconservation of ovarian tissue prior to chemotherapy for later transplantation and the cryoconservation of unfertilized egg cells. These services are therefore not fully covered by statutory health insurance in Germany.[12]

References

  1. 1 2 Michael von Wolff, Markus Montag: 6 Jahre FertiPROTEKT – Eine Zwischenbilanz. Gynäkologische Endokrinologie. 2 (2012), 86-90, doi:10.1007/s10304-011-0454-6. (in German language)
  2. ↑ Fertiprotekt network’s code of ethics (in German language)
  3. ↑ Matthias W. Beckmann, Helge Binder, Ralf Dittrich, Klaus Friese, Bernd Gerber, Gerald Gitsch, Walter Jonat, Manfred Kaufmann, Marion Kiechle, Rolf Kreienberg, Klaus Diedrich, Diethelm Wallwiener, Martin Wilhelm, Wolfgang Würfel, Olaf Ortmann: Konzeptpapier zur Ovarprotektion. Frauenarzt 47 (2006), p. 604-616, online (PDF; 214 kB) (in German language)
  4. ↑ Del Mastro, Lucia; Ceppi, Marcello; Poggio, Francesca; Bighin, Claudia; Peccatori, Fedro; Demeestere, Isabelle; Levaggi, Alessia; Giraudi, Sara; Lambertini, Matteo; D'Alonzo, Alessia; Canavese, Giuseppe; Pronzato, Paolo; Bruzzi, Paolo (Jun 2014). "Gonadotropin-releasing hormone analogues for the prevention of chemotherapy-induced premature ovarian failure in cancer women: Systematic review and meta-analysis of randomized trials.". Cancer Treat Rev. 40 (5): 675–83. doi:10.1016/j.ctrv.2013.12.001. PMID 24360817.
  5. ↑ Donnez, Jacques; Dolmans, Marie-Madeleine; Pellicer, Antonio; Diaz-Garcia, Cesar; Sanchez Serrano, Maria; Tryde Schmidt, Kristen; Ernst, Erik; Luyckx, Valérie; Yding Andersen, Claus (2013). "Restoration of ovarian activity and pregnancy after transplantation of cryopreserved ovarian tissue: a review of 60 cases of reimplantation.". Fertil Steril. 99: 1503–13. doi:10.1016/j.fertnstert.2013.03.030.
  6. ↑ Irtan, Sabine; Orbach, Daniel; Helfre, Sylvie; Sarnacki, Sabine (2013). "Ovarian transposition in prepubescent and adolescent girls with cancer.". Lancet Oncol. 14: 601–8. doi:10.1016/S1470-2045(13)70288-2.
  7. ↑ Michael von Wolff, Markus Montag, Ralf Dittrich, Dominik Denschlag, Frank Nawroth, Barbara Lawrenz: Fertility preservation in women - a practical guide to preservation techniques and therapeutic strategies in breast cancer, Hodgkin's lymphoma and borderline ovarian tumours by the fertility preservation network FertiPROTEKT. Archives of Gynecology and Obstetrics, 284 (2011), pp. 427-435, doi:10.1007/s00404-011-1874-1.
  8. ↑ Michael von Wolff, Christian J. Thaler, Torsten Frambach, Cosima Zeeb, Barbara Lawrenz, Roxana M. Popovici, Thomas Strowitzki: Ovarian stimulation to cryopreserve fertilized oocytes in cancer patients can be started in the luteal phase. Fertil Steril. 92 (2009), pp. 1360-5, doi:10.1016/j.fertnstert.2008.08.011.
  9. ↑ Cosima Huober-Zeeb, Barbara Lawrenz, Roxana M. Popovici, Thomas Strowitzki, Ariane Germeyer, Petra Stute, Michael von Wolff: Improving fertility preservation in cancer, ovarian tissue cryobanking followed by ovarian stimulation can be efficiently combined. Fertil Steril. 95 (2011), pp. 342-4, doi:10.1016/j.fertnstert.2010.07.1074.
  10. ↑ Ralf Dittrich, Laura Lotz, Gudrun Keck, Inge Hoffmann, Andreas Mueller, Matthias W. Beckmann, Hans van der Ven, Markus Montag: Live birth after ovarian tissue autotransplantation following overnight transportation before cryopreservation. Fertil Steril. 97 (2012), pp. 387-90, doi:10.1016/j.fertnstert.2011.11.047.
  11. ↑ Andreas Müller, Katja Keller, Jennifer Wacker, Ralf Dittrich, Gudrun Keck, Markus Montag, Hans van der Ven, David Wachter, Matthias W. Beckmann, Wolfgang Distler: Retransplantation of Cryopreserved Ovarian Tissue: the First Live Birth in Germany. Dtsch Arztebl Int 109 (2012), pp. 8-13, doi:10.3238/arztebl.2012.0008.
  12. ↑ Kinderwunsch und Krebs. In: Die blauen Ratgeber. 49, brochure of the German Cancer Aid (Deutsche Krebshilfe), p. 37, ISSN 0946-4816, online (PDF; 1,44 MB) (in German language)

Further reading

External links

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