Fertiprotekt network

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Fertiprotekt Logo 2014.png

The Fertiprotekt network is a cooperation between university centers, clinics and practices that was founded in Germany in 2006 . The network has meanwhile been expanded to the entire German-speaking area and currently unites around 100 institutions from Germany , Austria and Switzerland .

aims

The aim of the network is to offer women and men the opportunity, before and after chemotherapy or radiotherapy , to obtain advice on their fertility based on scientific findings and, if necessary, to take measures to protect their fertility. Advice on and the implementation of fertility-preserving measures according to the network's code is not profit-oriented.

backgrounds

Due to the significantly better chances of recovery from cancer today, the quality of life after treatment of the disease is becoming increasingly important. The fears about the preservation of fertility in young men and women play an important role. The most common cancers diagnosed under 40 years of age are breast cancer , melanoma , cervical cancer , non-Hodgkin lymphoma, and leukemia . One of the biggest problems facing women who have had chemotherapy or radiation therapy is premature ovarian fatigue and the associated infertility . In the case of breast cancer alone, it is assumed that there are around 200 patients per year in Germany who still want to have children. In men, chemotherapy can cause permanent damage to the testicular tissue. Due to the advances in reproductive medicine , a large number of fertility-protective , i.e. fertility-protecting methods are now available. Techniques include the administration of GnRH agonists, ovarian stimulation with the cryopreservation of fertilized or unfertilized oocytes and the cryopreservation of ovarian tissue. It is also possible to move the ovaries out of the pelvis ( ovarian transposition) to protect against damage caused by radiation therapy .

activities

The Fertiprotekt network has done international pioneering work in five areas:

  • National, comprehensive supply structures in the field of fertility protection were created, which are considered to be models for other countries.
  • Treatment recommendations were developed that enable a standardized and scientific approach.
  • The so-called luteal phase stimulation was introduced, which allows the start of hormone stimulation to obtain egg cells at any point in the menstrual cycle . This significantly shortens the time required for egg retrieval and chemotherapy can be started earlier.
  • The combination of a removal of ovarian tissue for cryopreservation followed directly by hormone stimulation to obtain egg cells was carried out for the first time by centers of the network. This technique allows a significant increase in the chance of birth.
  • The first birth after a transplant of ovarian tissue, which was transported overnight to a central cryobank after harvesting , was achieved by the network. This proved that removed ovarian tissue can be processed and stored centrally in specialized centers.

Working meetings of the network are held annually. The participating centers are obliged to attend these annual meetings on a regular basis.

Problems

Some measures, such as cryopreservation of sperm and in vitro fertilization (IVF) have long been established. Others were introduced only a few years ago, such as the cryopreservation of ovarian tissue prior to chemotherapy for later transplantation and the cryopreservation of unfertilized egg cells. Some of these benefits are therefore not covered by the statutory health insurance funds in Germany .

literature

  • Desire for children and cancer. In: The blue advisors. 49, brochure of the German Cancer Aid , online (PDF file; 1.44 MB)
  • Dominik Denschlag: Fertility prophylaxis. In: Christoph Keck: Fertility treatment in the gynecological practice: Sensible diagnostic and therapeutic strategies for gynecologists. Georg Thieme Verlag, 2013, ISBN 3-131-71681-9 , pp. 286-292
  • Michael von Wolff, Darius Dian: Fertility preservation in women with malignant tumors and gonadotoxic treatments. Dtsch Arztebl Int. 109 (2012), pp. 220–6, doi : 10.3238 / arztebl.2012.0220
  • Michael von Wolff, Petra Stute: FertiPROTEKT network. In: Michael von Wolff, Petra Stute: Gynecological endocrinology and reproductive medicine: The practice book. Chapter 36.5, pp. 399-400, Schattauer Verlag , Stuttgart 2013, ISBN 3-794-52792-5

Web links

Individual evidence

  1. ↑ Michael von Wolff, Markus Montag: Preservation of fertility in oncological patients - status and perspectives: German network for fertility-preserving measures in cytotoxic therapies. Dtsch Arztebl 104 (2007), A-268, online
  2. ^ Matthias W. Beckmann, Helge Binder, Ralf Dittrich, Klaus Friese , Bernd Gerber, Gerald Gitsch, Walter Jonat , Manfred Kaufmann , Marion Kiechle , Rolf Kreienberg , Klaus Diedrich , Diethelm Wallwiener , Martin Wilhelm, Wolfgang Würfel, Olaf Ortmann: Concept paper for Ovarian protection. Frauenarzt 47 (2006), pp. 604–616, online ( memento of the original from September 24, 2015 in the Internet Archive ) Info: The archive link has been inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. (PDF; 214 kB) @1@ 2Template: Webachiv / IABot / www.frauenarzt.de
  3. ↑ Almut Dorn: Psychooncology - Psychosocial Oncology. For whom - by whom?
  4. ↑ Lucia Del Mastro, Marcello Ceppi, Francesca Poggio, Claudia Bighin, Fedro Peccatori, Isabelle Demeestere, Alessia Levaggi, Sara Giraudi, Matteo Lambertini, Alessia D'Alonzo, Giuseppe Canavese, Paolo Pronzato, Paolo Bruzzi: Gonadotropin-releasing hormone analogues Prevention of chemotherapy-induced premature ovarian failure in cancer women: Systematic review and meta-analysis of randomized trials. Cancer Treat Rev. 2013, S0305-7372, doi : 10.1016 / j.ctrv.2013.12.001 , PMID 24360817 .
  5. ↑ Jacques Donnez , Marie-Madeleine Dolmans, Antonio Pellicer, Cesar Diaz-Garcia, Maria Sanchez Serrano, Kristen Tryde Schmidt, Erik Ernst, Valérie Luyckx, Claus Yding Andersen: Restoration of ovarian activity and pregnancy after transplantation of cryopreserved ovarian tissue: a review of 60 cases of reimplantation. Fertil sterile. 99 (2013), 1503-13, doi : 10.1016 / j.fertnstert.2013.03.030 .
  6. ↑ Sabine Irtan, Daniel Orbach, Sylvie Helfre, Sabine Sarnacki: Ovarian transposition in prepubescent and adolescent girls with cancer. Lancet Oncol. 14 (2013), 601-8, doi : 10.1016 / S1470-2045 (13) 70288-2 .
  7. ↑ Michael von Wolff, Markus Montag: 6 years FertiPROTEKT - an interim balance. Gynecological endocrinology. 2 (2012), 86-90, doi : 10.1007 / s10304-011-0454-6 .
  8. ↑ Michael von Wolff, Markus Montag, Ralf Dittrich, Dominik Denschlag, Frank Nawroth, Barbara Lawrenz: Fertility preservation in women - a practical guide to preservation techniques and therapeutic strategies in breast cancer, Hodgkin's lymphoma and borderline ovarian tumors by the fertility preservation network FertiPROTEKT . Archives of Gynecology and Obstetrics, 284 (2011), pp. 427-435, doi : 10.1007 / s00404-011-1874-1 .
  9. ↑ Michael von Wolff, Christian J. Thaler, Torsten Frambach, Cosima Zeeb, Barbara Lawrenz, Roxana M. Popovici, Thomas Strowitzki: Ovarian stimulation to cryopreserve fertilized oocytes in cancer patients can be started in the luteal phase. Fertil sterile. 92 (2009), pp. 1360-5, doi : 10.1016 / j.fertnstert.2008.08.011 .
  10. ↑ Cosima Huober-Zeeb, Barbara Lawrenz, Roxana M. Popovici, Thomas Strowitzki, Ariane Germeyer, Petra Stute, Michael von Wolff: Improving fertility preservation in cancer, ovarian tissue cryobanking followed by ovarian stimulation can be efficiently combined. Fertil sterile. 95 (2011), pp. 342-4, doi : 10.1016 / j.fertnstert.2010.07.1074 .
  11. ↑ Ralf Dittrich, Laura Lotz, Gudrun Keck, Inge Hoffmann, Andreas Mueller, Matthias W. Beckmann, Hans van der Ven, Markus Montag: Live birth after ovarian tissue autotransplantation following overnight transportation before cryopreservation. Fertil sterile. 97 (2012), pp. 387-90, doi : 10.1016 / j.fertnstert.2011.11.047 .
  12. ↑ Andreas Müller, Katja Keller, Jennifer Wacker, Ralf Dittrich, Gudrun Keck, Markus Montag, Hans van der Ven, David Wachter, Matthias W. Beckmann, Wolfgang Distler: Retransplantation of cryopreserved ovarian tissue: First birth in Germany. Dtsch Arztebl Int 109 (2012), pp. 8-13, doi : 10.3238 / arztebl.2012.0008 .
  13. ^ Desire for children and cancer. In: The blue advisors. 49, brochure of the German Cancer Aid , p. 37, ISSN  0946-4816 , online (PDF file; 1.44 MB)