Fertility Preservation: Multidisciplinary Approaches in Women's Reproductive Health

Dear Colleagues,

Fertility preservation consists of a set of medical, surgical and cryopreservation techniques that aim to protect gonadal tissue and gametes from gonadotoxic noxa. It includes techniques such as oocyte vitrification, cryopreservation of the ovarian cortex, gonadoprotection with drugs, and conservative surgical treatments for certain gynecological neoplasms, amongst others. Over the past decade, the number of such procedures has increased progressively, and many assisted reproduction centers now have fertility preservation programs.

There are multiple reasons for the increased use of procedures for fertility preservation. One is the improved survival of cancer patients and the better quality of life in patients with chronic diseases involving treatments that are harmful for the gonads. In vitro fertilization laboratories have also achieved qualitative improvements through optimization of techniques and results. In addition, the age at first pregnancy has increased in many countries as women postpone their gestational plans due to socioeconomic factors.

Currently, there are several important points of interest regarding fertility preservation. These include systematic consolidation of fertility preservation advice to all women before starting treatments that reduce their fertility, long-term follow-up relating to the use of this cryopreserved material and its effectiveness, and the creation of international registries to share this information. The status of experimental technique of ovarian cortex cryopreservation should be reassessed in some countries. Finally, further knowledge of new techniques is required, as well as a better understanding of the mechanisms of gonadotoxicity with various treatments. This in turn should result in greater knowledge of ovarian physiology.

Thus, fertility preservation is a topic of special interest and relevance in the care of women. Technological advances in cryopreservation together with multidisciplinary work will allow quality care for women's reproductive health.

Prof. Dr. Dolors Manau, Prof. Dr. Camil Castelo-Branco and Prof. Dr. Maria Antonietta Castaldi 
Guest Editors

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