Wednesday, 30 July 2014

ISSUES OF FERTILITY FOR CANCER PATIENTS

This is synopsis of lecture by Dr. Sharda Jain presented as public lecture series at DMA (July 2014).
Advances in cancer treatment and improved prospects of survival after cancer treatment call for greater importance to be laid on patients quality of life & an aspect of Fertility Preservation in both sexes.
Cancer treatment has significant association with future fertility of patients as it causes testicular / ovarian dysfunction which is as the most common side effect of chemo therapy.
Gonadal toxicity was first reported in 1948, involving testicular damage by nitrogen mustard (Chemotherapeutical drugs).  The first report of Gonadal toxicity in women was in 1956 and this was associated with busalfan treatment of chroninc myeloid leukemia.
Freezing sperm become a practical proposition only after the discovery of the cryoprotective property of glycerol, 53 years ago. The first infants born from frozen semen is now over 50 year old.

Recently significant progress has occurred in female fertility preservation using embryo cryopreservation, human oocyte cryopreservation, and gonadal tissue cryopreservation. Perhaps most significantly, all these developments, along with the rapid development in the field of IVF , have found human application in day today practice without any clinical trials, giving an added urgency to the public awareness &  need to be involved in the issues surrounding social , ethical, moral and legal debate on fertility preservation.
Clinicians need to be aware of the importance of offering sperm banking facilities, as denial can result in litigation. It is good that the practitioners do understand not just the technical and clinical aspects of procedures, but also to develop a deep sense of social responsibility towards children, adolescent & young adult with cancer together with an equivalent level of understanding of the legal, moral and ethical issues related to it.

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