Q.Who should be offered fertility preservation in case of both males and females?
Ideally anyone at risk of loss of ovarian function in females and or loss of reproductive potential in case of males.
Causes of loss of ovarian function:–
• All forms of cancer patients requiring radiotherapy /chemotherapy.
• Mutation carrier for certain types of cancer.
Non oncogenic causes:-
• Autoimmune diseases
• Any surgery on the reproductive tract —ovarian cystectomy etc.
• Social /iatrogenic —wanting to postpone childbirth.
• Patients undergoing bone marrow or stem cell transplantation.
• MS patients receiving new generation treatments.
• Patients with genetic mutations leading to loss of fertility and early menopause.
Fertility preservation program requirements:-
• Rapid access
• Interdisciplinary medical team –oncologists,reproductive endocrinologists,urologists,reproductive surgeons trained in FP techniques.
• Lab requirements—Experienced ART programs—embryo cryopreservation/oocyte cryopreservation/cryopreservation of ovarian and testicular tissues
• Counsellors –
Mental—to navigate them for a difficult decision making process.
Genetic —risk of transmission to offspring /genetic testing like PGT .
Financial—cost due to lack of insurance coverage.
Medical considerations to be discussed:-
• All methods of FP.
• Give alternative options of donor gametes,donor embryos and adoption.
• Given state of the patient capable of undergoing the procedure.
• Potential safety of future pregnancy after cancer should be addressed especially after pelvic irradiation.
• Infectious disease testing for all patients banking.
• All those who elect to cryopreserve —disposition in the event of death should be discussed and documented.
Chemotherapy –the impact is mostly on ovaries .Degree of damage is dependant on:
• Type of agent .
• Dose given.
• Age of patient
• Baseline ovarian reserve .
The pre pubertal ovary is less susceptible to ovarian failure as contrast to older women.
Radiotherapy-affects ovaries and uterus.
Human oocyte is sensitive to radiation with estimated lethal dose of <2Gy.Pre pubertal uterus is more susceptible to irradiation.
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Thank you so so much Dr. Suparna mam for your continuous support and encouragement to both of us…your treatment and care for us is unparallel and unconditional…It really meant a lot..Now we are blessed with a baby boy and a girl….All credit goes to you and God mam….With all your support encouragement,care, now we r extremely happy and everything seems so brightened all around…Need your blessings forever and thank you so so much for fulfilling all our dreams🙏🙏🙏. Regards Dr.Atanu and Dr.Archita.
;Dear Dr Suparna madam,
We can’t even begin to thank you enough for helping us to have family we have always dreamed of.you all have been so kind and dedicated to every step that we have been through.we feel so blessed to have met you and you will be forever in our heart .You are the best doctor and more than that a great person and I recommend you every chance I get .Words cannot express the love and joy you have brought in our lives.
We are expressing our special regards to Dr. Suparna Madam . She is so much polite and gentle that she never be irritated to us. We have repeatedly asked her many questions. But she has never been annoyed , rather she has given us the replies in smiling face. Whenever we think her face , our eyes are moistened. She is so much kindhearted. Only you and she have realized our agony. Till death , we shall remember you. Any volume of words may not be sufficient to express our gratitude to you. We havebecome parents. It is a coveted title to the couples. We have enjoyed it awaiting long time.
Akhane ase ami khub Khub khusi.amar wife Dr. Suparna Bhattachayar under a treatment a thekey pregnancy aseche..thank u mam….all staff khub valo…khub helpful..thank u Motherhood
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