Ovarian stimulation and oocyte cryopreservation in females and transgender males aged 18 years or less: a systematic review
BackgroundFertility preservation is an important healthcare focus in the paediatric and adolescent population when gonadotoxic treatments are required. Ovarian stimulation (OS) resulting in oocyte cryopreservation is a well-established fertility preservation option in the adult population. It’s util...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1146476/full |
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| author | Marnie Slonim Michelle Peate Kira Merigan Daniel Lantsberg Richard A. Anderson Kate Stern Kate Stern Debra Gook Debra Gook Yasmin Jayasinghe Yasmin Jayasinghe |
| author_facet | Marnie Slonim Michelle Peate Kira Merigan Daniel Lantsberg Richard A. Anderson Kate Stern Kate Stern Debra Gook Debra Gook Yasmin Jayasinghe Yasmin Jayasinghe |
| author_sort | Marnie Slonim |
| collection | DOAJ |
| description | BackgroundFertility preservation is an important healthcare focus in the paediatric and adolescent population when gonadotoxic treatments are required. Ovarian stimulation (OS) resulting in oocyte cryopreservation is a well-established fertility preservation option in the adult population. It’s utility, however, is little known in young patients. The purpose of this review was to synthesise the available literature on OS in patients ≤18 years old, to identify gaps in current research and provide suggestions for future research directions.MethodsUsing PRISMA guidelines, a systematic review of the literature was performed for all relevant full-text articles published in English in Medline, Embase, the Cochrane Library and Google Scholar databases. The search strategy used a combination of subject headings and generic terms related to the study topic and population. Two reviewers independently screened studies for eligibility, extracted data and assessed the risk of bias. Characteristics of the studies, objectives and key findings were extracted and summarised in a narrative synthesis.ResultsDatabase search and manual review identified 922 studies, 899 were eliminated based on defined exclusion criteria. Twenty-three studies were included and comprised 468 participants aged ≤18 years who underwent OS (median 15.2, range 7-18 years old). Only three patients were premenarchal, and four patients were on treatment to suppress puberty. Patients had OS for a broad range of indications including oncology treatment, transgender care and Turner syndrome. A total of 488 cycles of OS were completed, with all but 18 of these cycles (96.3%) successfully resulting in cryopreserved mature oocytes (median 10 oocytes, range 0-35). Fifty-three cycles (9.8%) were cancelled. Complications were rare (<1%). One pregnancy was reported from a female who had OS aged 17 years old.ConclusionThis systematic review demonstrates that OS and oocyte cryopreservation is achievable in young females however there are only a few cases in the literature describing OS in premenarcheal children or those who have suppressed puberty. There is little proof that OS can lead to pregnancy in adolescents, and no proof that this can be achieved in premenarchal girls. Therefore it should be regarded as an innovative procedure for adolescents and experimental for premenarcheal girls.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=265705, identifier CRD42021265705. |
| first_indexed | 2024-03-13T04:33:28Z |
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| id | doaj.art-c827ec5b29a940959bbc3fd779b2227d |
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| language | English |
| last_indexed | 2024-03-13T04:33:28Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-c827ec5b29a940959bbc3fd779b2227d2023-06-19T08:03:32ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-06-011410.3389/fendo.2023.11464761146476Ovarian stimulation and oocyte cryopreservation in females and transgender males aged 18 years or less: a systematic reviewMarnie Slonim0Michelle Peate1Kira Merigan2Daniel Lantsberg3Richard A. Anderson4Kate Stern5Kate Stern6Debra Gook7Debra Gook8Yasmin Jayasinghe9Yasmin Jayasinghe10Oncofertility Program and Department of Gynaecology, Royal Children’s Hospital, Melbourne, VIC, AustraliaDepartment of Obstetrics and Gynaecology, Royal Women's Hospital, The University of Melbourne, Melbourne, VIC, AustraliaDepartment of Obstetrics and Gynaecology, Royal Women’s Hospital, Melbourne, VIC, AustraliaMelbourne IVF, Melbourne, VIC, AustraliaMRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, United KingdomDepartment of Obstetrics and Gynaecology, Royal Women’s Hospital, Melbourne, VIC, AustraliaMelbourne IVF, Melbourne, VIC, AustraliaDepartment of Obstetrics and Gynaecology, Royal Women's Hospital, The University of Melbourne, Melbourne, VIC, AustraliaMelbourne IVF, Melbourne, VIC, AustraliaOncofertility Program and Department of Gynaecology, Royal Children’s Hospital, Melbourne, VIC, AustraliaDepartment of Obstetrics and Gynaecology, Royal Women's Hospital, The University of Melbourne, Melbourne, VIC, AustraliaBackgroundFertility preservation is an important healthcare focus in the paediatric and adolescent population when gonadotoxic treatments are required. Ovarian stimulation (OS) resulting in oocyte cryopreservation is a well-established fertility preservation option in the adult population. It’s utility, however, is little known in young patients. The purpose of this review was to synthesise the available literature on OS in patients ≤18 years old, to identify gaps in current research and provide suggestions for future research directions.MethodsUsing PRISMA guidelines, a systematic review of the literature was performed for all relevant full-text articles published in English in Medline, Embase, the Cochrane Library and Google Scholar databases. The search strategy used a combination of subject headings and generic terms related to the study topic and population. Two reviewers independently screened studies for eligibility, extracted data and assessed the risk of bias. Characteristics of the studies, objectives and key findings were extracted and summarised in a narrative synthesis.ResultsDatabase search and manual review identified 922 studies, 899 were eliminated based on defined exclusion criteria. Twenty-three studies were included and comprised 468 participants aged ≤18 years who underwent OS (median 15.2, range 7-18 years old). Only three patients were premenarchal, and four patients were on treatment to suppress puberty. Patients had OS for a broad range of indications including oncology treatment, transgender care and Turner syndrome. A total of 488 cycles of OS were completed, with all but 18 of these cycles (96.3%) successfully resulting in cryopreserved mature oocytes (median 10 oocytes, range 0-35). Fifty-three cycles (9.8%) were cancelled. Complications were rare (<1%). One pregnancy was reported from a female who had OS aged 17 years old.ConclusionThis systematic review demonstrates that OS and oocyte cryopreservation is achievable in young females however there are only a few cases in the literature describing OS in premenarcheal children or those who have suppressed puberty. There is little proof that OS can lead to pregnancy in adolescents, and no proof that this can be achieved in premenarchal girls. Therefore it should be regarded as an innovative procedure for adolescents and experimental for premenarcheal girls.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=265705, identifier CRD42021265705. https://www.frontiersin.org/articles/10.3389/fendo.2023.1146476/fulloocyte cryopreservationfertility preservationovarian hyperstimulationovarian stimulation (OS)paediatric and adolescent gynaecologyoocyteretrieval |
| spellingShingle | Marnie Slonim Michelle Peate Kira Merigan Daniel Lantsberg Richard A. Anderson Kate Stern Kate Stern Debra Gook Debra Gook Yasmin Jayasinghe Yasmin Jayasinghe Ovarian stimulation and oocyte cryopreservation in females and transgender males aged 18 years or less: a systematic review Frontiers in Endocrinology oocyte cryopreservation fertility preservation ovarian hyperstimulation ovarian stimulation (OS) paediatric and adolescent gynaecology oocyteretrieval |
| title | Ovarian stimulation and oocyte cryopreservation in females and transgender males aged 18 years or less: a systematic review |
| title_full | Ovarian stimulation and oocyte cryopreservation in females and transgender males aged 18 years or less: a systematic review |
| title_fullStr | Ovarian stimulation and oocyte cryopreservation in females and transgender males aged 18 years or less: a systematic review |
| title_full_unstemmed | Ovarian stimulation and oocyte cryopreservation in females and transgender males aged 18 years or less: a systematic review |
| title_short | Ovarian stimulation and oocyte cryopreservation in females and transgender males aged 18 years or less: a systematic review |
| title_sort | ovarian stimulation and oocyte cryopreservation in females and transgender males aged 18 years or less a systematic review |
| topic | oocyte cryopreservation fertility preservation ovarian hyperstimulation ovarian stimulation (OS) paediatric and adolescent gynaecology oocyteretrieval |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1146476/full |
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