Fertility preservation strategies for rectal cancer in reproductive-age women

Samuel Khiat (1) , Pauline Bottin (1) , Jacqueline Saias-Magnan (1) , Mohamed Gasmi (2, 3) , Pierre Orsoni (2, 3) , Blandine Courbiere (4, 5, 1)

1 Centre Clinico-Biologique d’Assistance Médicale à la Procréation - CECOS [Hôpital de la Conception - APHM]
2 Hôpital Nord [CHU - APHM]
3 AMU - Aix Marseille Université
4 Service de Gynécologie et Obstétrique [Marseille]
5 IMBE - Institut méditerranéen de biodiversité et d'écologie marine et continentale

Despite rectal cancer being unusual before 40, fertility preservation (FP) remains a major concern for these reproductive-age women. Treatment usually involves pelvic radiotherapy, neoadjuvant chemotherapy, and surgery of rectum and mesorectum resection, at high risk of impairing fertility in women with risks of premature ovarian failure and radio-induced uterus damage. To date, there is no consensus on FP strategy for rectal cancer. We shared experiences between oncofertility experts from a French research network Groupe de Recherche et d'Etude en Cryoconservation Ovarienne et Testiculaire about a case of rectal cancer in a young woman. Indications, advantages and disadvantages of different FP strategies were discussed: ovarian transposition, cryopreservation of ovarian cortex and oocyte vitrification. This case was the starting point that led to the development of a French multidisciplinary e-meeting for sharing experiences and for suggesting the best strategy when faced with a complex oncofertility case.

Mots clés: ovarian transposition; rectal cancer; fertility preservation; oocyte vitrification; ovarian tissue cryopreservation

Domaines: Cancer; Gynécologie et obstétrique

Samuel Khiat, Pauline Bottin, Jacqueline Saias-Magnan, Mohamed Gasmi, Pierre Orsoni, et al.. Fertility preservation strategies for rectal cancer in reproductive-age women. Future Oncology, 2019, 15 (22), pp.2635-2643. ⟨10.2217/fon-2019-0083⟩. ⟨hal-02293178⟩