Female fertility preservation: Practical and ethical considerations of an underused procedure

Purpose: Cancer treatments for young women can permanently or temporarily affect fertility. The purpose of this retrospective analysis was to present the clinical experience and ethical considerations of fertility preservation in female oncology patients in a tertiary gynaecological department. Methods: Since 2002, in 37 patients fertility preservation was performed according to an institutional review board approved protocol in a University hospital in the Netherlands; 33 patients were not treated. Results: Embryo cryopreservation was performed in 10 patients, ovarian tissue cryopreservation in 24, and an ovarian transposition was performed in 3 patients; in one patient combined with an ovarian transplantation and in one patient with ovarian tissue cryopreservation. Discussion: Approved protocols and timing are essential in performing female fertility preservation. Referral for ovarian tissue and embryo cryopreservation is minimal in the Netherlands. Future research focuses on the psychosocial aspects of fertility preservation and explores patients' and professionals' expectations and attitudes regarding fertility preservation and aims to be in line with technical developments.