(Nicola Simonetti) In the last 10 years, 3.519 were the Italian cancer patients who wanted to preserve their fertility, deciding to have a child, after having shelved the cancer episode. Of these, 2.148 used ice preservation of oocytes (for a total of 17.181 oocytes) and 1.371 those that, instead, used cryopreservation of ovarian tissue (census from the National Registry of PMA of the Istituto Superiore di Sanità).
Every year, in Italy, about 5.000 women under 40 are affected by cancer and it is estimated that the five-year survival rate is around 65% exceeding 85% for some neoplasms such as lymphomas and breast cancer, unthinkable goals in the past.
"Faced with these data - said Giacomo Corrado, gynecologist oncologist of the" Agostino Gemelli "IRCCS University Polyclinic Foundation in Rome at the Conference of the Valencian Institute of Infertility with the participation of the Italian Association of Cancer Patients and the ISS - it is clear how the oncologist should take charge not only of the patient's survival but also of her quality of life, with a careful look at her future and, for the younger ones, at the possibility of having children. Furthermore, the scientific data show that most of the drugs used for chemotherapy treatments in pregnant patients in the second and third trimesters do not create a risk both to the product of developing conception and to the child in its late development ".
Preserving fertility, through the cryopreservation of oocytes and ovarian tissue performed at the specific request of the interested party, becomes, therefore, a fundamental moment of the therapeutic process after a diagnosis of cancer, especially in a country like ours where it is more and more advanced. average age of women seeking their first child.
"Scientific research into the preservation of fertility has achieved incredible results, which bode well for the future. A technique that uses vitrified oocytes rather than fresh ones - said Antonio Pellicer, IVI president and professor of obstetrics and gynecology, University of Valencia - first shown by the IVI group (from 2017 L 2017 over 1.200 women have used free at IVI), does not change the success rates in assisted reproduction protocols; the percentages of fertilization, of embryo quality, of implantation and of pregnancy between eggs in fresh and in vitro are, in fact, superimposable ".
"For over ten years - said Giulia Scaravelli, head of the Register of Medically Assisted Procreation of the Istituto Superiore di Sanità (ISS) - we have launched training initiatives throughout Italy to promote correct information on the potential risks of anticancer therapies on the reproductive system .
The Registry - promotes knowledge on the different techniques of preservation of fertility and, at the same time, encourages the creation of "networks", real networks of professional oncologists, reproduction doctors, haematologists, radiologists, pediatricians, psychologists, nurses, midwives, general practitioners, patient associations, and all the different caregivers who have to take care of cancer patients, guaranteeing them the best possible quality of life, once the disease is overcome ".
The ISS engages in training and data collection on all available techniques and collaborates with numerous patient associations, including the Italian Association of Cancer Patients (AIMaC), which for years has brought to the attention of the press the fertility protection, a right too often denied to women and men who get cancer. "Always - said the lawyer. Elisabetta Iannelli, vice president of AIMaC - oncological voluntary service strongly supports the right to motherhood and fatherhood because even the hope of being able to become parents, despite a diagnosis of cancer, is a hope for life. It is crucial to address the issue of fertility preservation immediately after the diagnosis of cancer and before starting treatment. "
With vitrification of the oocytes it is possible to cryopreserve the mature ovules obtained by ovarian stimulation to use them later, when the patient decides, with the same chances of success present at the time of vitrification. Given the absence of ice crystal formation that this technique allows, the survival rates of the oocytes are high and therefore allow to postpone maternity with reasonable guarantees.
Thanks to the cryopreservation of ovarian tissue (experimental technique, aimed at patients with ovarian function at risk or in predicate to undergo repeated surgery of the endometriosis type of ovary), it is instead possible to restore the ovarian function, allowing to obtain spontaneous parts, reporting in addition, hormone levels at normal values and avoiding the secondary effects typical of early menopause. This type of procedure is safe in all types of cancer except for leukemia, where there is a high risk of malignant cell transfer from the previously cryopreserved ovarian cortex.
