Fertility management in young generation

Having children or completing a family is no longer considered a social necessity, but an event that can be considered a convenience.

Young fertile woman

People want children, but a career comes first.

This pursuit of comfort causes infertility to rise on a large scale without realizing what we are focusing on in our desire to achieve our goals.

When trying to summarize the reasons why a few people visit an infertility specialist, the most common reasons are:

  • Polycystic ovary syndrome (PCOS).
  • Male cause.
  • My ovarian reserve (even in childhood).
  • Unexplained infertility.
  • Tubal cause.
  • Loss of libido or sexual desire.

Other factors include increased mobility, late marriages, financially independent women, and overall well-being.

These may be conditions of diagnosis, but the most important thing is to know how they exist and how they are evolving today.

Some of them may have a genetic predisposition, but many are the result of a bad lifestyle.

The way we live has a huge impact on our health.

In addition, the survival rate of adolescents and young adults with a diagnosis of hematological malignancies is now more than 70%.

It is important that high quality of life, including measures to protect future fertility, is considered and discussed with patients and their families.

Although the debate over the impact of planned cancer treatment on fertility is a standard of concern, knowledge of possible infertility treatment options and when hematologic malignancies are offered is not always clear.

In any case, recommendations for appropriate fertility maintenance depend on a complex interaction of factors, an assessment of the risk of future infertility versus the risk of infertility treatment, and recommendations should be made on a case-by-case basis.

Maintaining fertility is important for adolescents and young adults who have survived cancer and who are at further risk of developing infertility.

Many survivors will continue to reach their fertile potential upon successful completion of cancer treatment.

However, whole-body irradiation, gonadal irradiation, and high-dose alkylator regimens may expose women to acute ovarian failure or premature menopause, and men to a temporary or permanent risk of azoospermia. 

The most effective and established way to maintain the fertility of this population is cryopreservation of embryos in women and cryopreservation of sperm in men before initiating cancer therapy.

However, cryopreservation is not only beneficial for cancer patients who need radiation therapy or chemotherapy, but also for other conditions such as pelvic diseases and inflammatory diseases.

 Abnormal chromosomal conditions, such as Mosaic Turner syndrome, also require cryopreservation technology to maintain fertility.

Cryopreservation of adult oocytes has become more common as digestion methods have become more sophisticated.

The use of in vitro fertilization and intracytoplasmic sperm injection increased sperm viability and cryopreservation of oocytes.

Cryopreservation and gonadal tissue transplantation in men and women remain experimental but remain unexplored.

Hormonal suppression does not efficacious for men but is promising in women.

References:

https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(20)30324-0/fulltext 

https://www.onlymyhealth.com/declining-fertility-in-younger-generation-reasons-factors-need-for-awareness-1623226984 

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