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Conceptions of transgender parenthood in fertility care and family planning in Sweden: from reproductive rights to concrete practices
Published in Zeynep B. Gürtin, Charlotte Faircloth, Conceiving Contemporary Parenthood, 2020
Jenny Gunnarsson Payne, Theo Erbenius
Crucially, waiting times for transgender patients are further exacerbated not only as a result of an increase in patients in the clinics, but also because the very extra step of fertility preservation takes time in itself. In addition, fertility preservation has consequences for when hormonal treatments can begin – hormonal treatments that are often urgently needed for psychosocial reasons. Cecilia emphasises that ‘[Waiting lists] are long! I don’t know. Sometimes [my colleague] says that it’s two-three months, but it feels like half a year, at least’, and explains that ‘And then they can’t begin hormonal treatment, so there are a lot of people who decides against [fertility preservation]. Although it is possible to begin hormonal treatment and temporarily stop taking then for fertility preservation, Cecilia points out that there are some uncertainties about how this might impact fertility, but adds that ‘But we don’t know how well they do in the freezer either, to be honest.’
Sperm Banking
Published in Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh, Male Infertility in Reproductive Medicine, 2019
Rakesh Sharma, Alyssa M. Giroski, Ashok Agarwal
Significant challenges were observed in various surveys conducted in the United States, Australia, and New Zealand. A Canadian survey showed that only 17.8% of male adolescents and young adults used fertility preservation options between 1995 and 2000. This was largely attributed to inadequate information on sperm banking options [41]. Similarly, a survey from a North American center showed that only 28.1% of patients ages 13 years and older banked sperm [42]. Some of the barriers preventing young adolescents from sperm banking were urgency of treating cancer, oncologist’s anxiety about discussing fertility and sexuality with young adolescents, poor prognosis, cost, and difficulty in finding sperm banking facilities [43].
Fertility and Cancer
Published in Jane M. Ussher, Joan C. Chrisler, Janette Perz, Routledge International Handbook of Women’s Sexual and Reproductive Health, 2019
Michelle Peate, Lesley Stafford, Yasmin Jayasinghe
The perception and understanding of the success of fertility preservation can influence discussions about fertility preservation (Logan et al., 2017). Ethical considerations: Do the benefits of fertility preservation outweigh the risks, especially considering there is no guarantee of success? Does offering fertility preservation give false hope?
Social freezing of oocytes: a means to take control of your fertility
Published in Upsala Journal of Medical Sciences, 2020
Another important issue is how many eggs to preserve in order to have at least one child. It is challenging to determine the ideal number of oocytes since it depends on many factors, including maternal age and health, ovarian reserve, reproductive goals, and also paternal health. No number of oocytes can offer a guarantee. Many clinics recommend banking around 20 eggs, which for most women means going through the procedure more than once. Two American prediction models, based on IVF/ICSI-treatments, estimate that approximately 20 oocytes are needed, to have around 75% likelihood of achieving at least one child provided that the woman is younger than 38 years (Table 1) (26,27). The models also show that the chance of success is highly age-dependent and confirm that attempting fertility preservation in women at an age of over 40 years is unlikely to succeed.
Endometriosis, the great imitator – a successful case of fertility preservation in a woman receiving sterilizing treatment due to a diagnosis of rectosigmoid carcinoma
Published in Gynecological Endocrinology, 2019
Anna Marklund, Annika Sjövall, Lennart Blomqvist, Joseph Carlson, Kenny A. Rodriguez-Wallberg
Before the start of the neoadjuvant treatment, the patient was referred for emergency counseling on fertility preservation to the Reproductive Medicine clinic. Information on available methods for fertility preservation was provided whereafter the woman and her husband decided to attempt fertility preservation by embryo cryopreservation. Controlled ovarian stimulation with gonadotropins using an antagonist protocol starting on day 2 of the cycle was initiated. After 14 days on stimulation, maturation trigger was induced with hCG 10.000 IU and oocyte retrieval planned 37 h later. The treatment resulted in 5 oocytes aspirated through puncture of the right ovary, which was judged as being unaffected by tumor. Conventional In Vitro Fertilization (IVF) was applied and four embryos were cryopreserved, three of them at cleavage stage with development of four-cells and the remaining one at a two-cells stage.
Recent advances in fertility preservation and counseling for female cancer patients
Published in Expert Review of Anticancer Therapy, 2018
The situation is further compounded by the fact that gonadotoxic treatment must often be started immediately after the cancer diagnosis, leaving patients very little time to make a decision. Patients undergoing fertility preservation are typically preoccupied with cancer-specific concerns about their mortality, disease recurrence, genetic testing, effect of cancer treatment on fertility and sexuality, and the health consequences of delaying cancer treatment to pursue fertility preservation. Counseling may address these unique concerns and enhance the patient–provider relationship, improve feelings of support, and ultimately resolve decisional conflicts and potential regrets [34]. Although infertility may not be life threatening, fertility preservation is life affirming, and consultation with a reproductive specialist can help dispel any long-term misgivings and boost physical and psychological quality of life [24,34].