Quinapyramine : The Ultimate Comfort!

Such drugs would allow patients to retain their natural fertility, eliminating the need for invasive fertility preservation MS-275 cell line procedures. Additionally, other distressing side effects of POF could be avoided. Consideration has to be given to the fact that such agents should not interfere with the efficacy of cancer treatment. Gonadotropin-releasing hormone agonist is frequently used in conjunction with chemotherapy; however, contradictory results have been reported regarding loss of the follicular pool. Though menstrual cyclicity and even ovulation may resume, benefits in terms of fertility outcome are controversial. GnRH agonist causes suppression of the gonadotropin levels to prepubertal levels and decreases utero-ovarian perfusion,[40] these actions are believed to protect the follicles from destruction. GnRH analogs may also up-regulate anti-apoptotic molecules such as S1P.[41] Cochrane database review of 2011[42] concludes that the ��use of GnRH agonists should be considered in women of reproductive age receiving chemotherapy. Intramuscular or subcutaneous GnRH analogs seem to be effective in protecting ovaries during chemotherapy and should be given before or during treatment, although no significant difference in PRs was seen.�� Del Mastro et al. 2013[43] did a systemic review and meta-analysis of 9 studies (765 patients) and reported a significant protective effect of GnRH analogs in young cancer patients. The pooled OR estimate indicated GDC 0449 a highly significant reduction in the risk of POF (OR = 0.43; 95% confidence interval: 0.22�C0.84; P = 0.013) in patients receiving GnRHa. There was statistically significant heterogeneity among studies, and further studies are required to reach a conclusion. Gonadotropin-releasing hormone-a administration should begin at least 10 days before the beginning of chemotherapy because of the initial flare-up effect and should continue till 2 weeks after the end of chemotherapy. In the case of estrogen-sensitive tumors, a tamoxifen therapy can be initiated after the GnRH-a treatment. GnRH analogs are not currently Food and Drug Administration approved for Quinapyramine fertility preservation, but may be used ��off label.�� FERTILITY PRESERVATION TECHNIQUES IN FEMALES Embryo cryopreservation Oocyte cryopreservation Ovarian tissue cryopreservation (OTC) In vitro maturation (IVM). Embryo cryopreservation This requires the patient to go through IVF. Since a sperm sample is required for oocyte fertilization, the woman must be married or should have a partner. Embryo cryopreservation is an established technology that provides a good success rate depending on the number and quality of embryos stored. Data on pregnancy and live birth rates in cancer patients after frozen embryo transfer are limited. A live birth rate of 38.7% per embryo transfer is reported for frozen embryo transfer in nononcological patients