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LIST OF CONTENTS

LIST OF CONTENTS

Summary……… pag.1 Introduction……… pag.3 Chapter 1: Cancer epidemiology…..…….……… pag.5 1.1 Cancer prevalence in men and women………..……… pag.6 1.2 Cancer prevalence in child and young adults…..…………..………. pag.8 Chapter 2: Effect of cancer treatment on female reproductive system…..……..…. pag.10 2.1 Normal ovarian development and follicular depletion………. pag.11 2.2 Clinical detection of ovarian damage induced by anticancer therapy … pag.13 2.3 Chemotherapy and infertility……… pag.14 2.4 Radiotherapy and infertility ……… pag.17 Chapter 3: Fertility preservation strategies………. pag.19 3.1 Fertility preservation techniques………. pag.20 3.1.1 Embryo cryopreservation……… pag.20 3.1.2 Oocyte cryopreservation……… pag.21

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3.1.3 Ovarian tissue cryopreservation………..………. pag.24 3.1.4 Ovarian suppression………. pag.26 3.1.5 Ovarian transposition……….….. pag.28 3.1.6 Fertility “sparing” surgery……….……… pag.28 3.2 Future development ………pag.29 3.2.1 Immature oocytes cryopreservation ...……… pag.30 3.2.2 In vitro follicle maturation ……….. pag.31 Chapter 4: Ovarian stimulation protocols in oncological patients. ……… pag.32 4.1 Cancer patient’s response to ovarian stimulation ………. pag.33 4.2 Ovarian stimulation protocol ……….. pag.34 4.1.1 Conventional controlled ovarian stimulation ……..…………. pag.34 4.1.2 “Random-start” controlled ovarian stimulation ………... pag.35 4.1.3 Controlled ovarian stimulation&breast cancer ………pag.36 4.3 Medical consideration in cancer patient undergoing controlled ovarian

stimulation……… pag.38 Chapter 5: Study design ……… pag.40 5.1 Purpose ………. pag.40 5.2 Material and methods ………. pag.40 5.3 Results ……… pag.42 5.4 Discussion ……… pag.47 5.5 Conclusion ………. pag.49 References ……… pag.50 Thanks to ……….. pag.58

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