Fertiprotekt
   HOME

TheInfoList



OR:

The Fertiprotekt network is a cooperation of university centres, hospitals and practices. It was founded in
Germany Germany, officially the Federal Republic of Germany, is a country in Central Europe. It lies between the Baltic Sea and the North Sea to the north and the Alps to the south. Its sixteen States of Germany, constituent states have a total popu ...
in 2006.Michael von Wolff, Markus Montag: ''6 Jahre FertiPROTEKT – Eine Zwischenbilanz.'' Gynäkologische Endokrinologie. 2 (2012), 86-90, . (in German language) The network now extends to all German-speaking countries and currently units ca. 100 institutions in Germany,
Austria Austria, formally the Republic of Austria, is a landlocked country in Central Europe, lying in the Eastern Alps. It is a federation of nine Federal states of Austria, states, of which the capital Vienna is the List of largest cities in Aust ...
and
Switzerland Switzerland, officially the Swiss Confederation, is a landlocked country located in west-central Europe. It is bordered by Italy to the south, France to the west, Germany to the north, and Austria and Liechtenstein to the east. Switzerland ...
.


Aims

The aim of the network is to offer men and women the possibility of seeking advice about scientific information regarding their
fertility Fertility in colloquial terms refers the ability to have offspring. In demographic contexts, fertility refers to the actual production of offspring, rather than the physical capability to reproduce, which is termed fecundity. The fertility rate ...
before and after Chemo- or
radiotherapy Radiation therapy or radiotherapy (RT, RTx, or XRT) is a treatment using ionizing radiation, generally provided as part of cancer therapy to either kill or control the growth of malignant cells. It is normally delivered by a linear particle ...
, and to undergo procedures to protect their fertility. The advice about and the performance of fertility-conserving procedures according to the network’s
code of ethics Ethical codes are adopted by organizations to assist members in understanding the difference between right and wrong and in applying that understanding to their decisions. An ethical code generally implies documents at three levels: codes of b ...
is non-profit oriented.


Background

As a result of today’s significantly improved prognosis for patients with
cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...
,
quality of life Quality of life (QOL) is defined by the World Health Organization as "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards ...
is increasingly important after overcoming treatment of the disease. Fears about fertility preservation play an important role for young men and women. The most common types of cancer diagnosed under the age of 40 years are
breast cancer Breast cancer is a cancer that develops from breast tissue. Signs of breast cancer may include a Breast lump, lump in the breast, a change in breast shape, dimpling of the skin, Milk-rejection sign, milk rejection, fluid coming from the nipp ...
,
melanoma Melanoma is the most dangerous type of skin cancer; it develops from the melanin-producing cells known as melanocytes. It typically occurs in the skin, but may rarely occur in the mouth, intestines, or eye (uveal melanoma). In very rare case ...
,
cervical cancer Cervical cancer is a cancer arising from the cervix or in any layer of the wall of the cervix. It is due to the abnormal growth of cells that can invade or spread to other parts of the body. Early on, typically no symptoms are seen. Later sympt ...
,
non-Hodgkin’s lymphoma Non-Hodgkin lymphoma (NHL), also known as non-Hodgkin's lymphoma, is a group of blood cancers that includes all types of lymphomas except Hodgkin lymphomas. Symptoms include enlarged lymph nodes, fever, night sweats, weight loss, and tire ...
and
leukaemia Leukemia ( also spelled leukaemia; pronounced ) is a group of blood cancers that usually begin in the bone marrow and produce high numbers of abnormal blood cells. These blood cells are not fully developed and are called ''blasts'' or '' ...
. One of the biggest problems in women who have to undergo chemo- or radiotherapy is
premature ovarian failure Primary ovarian insufficiency (POI), also called premature ovarian insufficiency and premature ovarian failure, is the partial or total loss of reproductive and hormonal function of the ovaries before age 40 because of follicular ( egg produc ...
(premature ovarian insufficiency) and its associated
infertility In biology, infertility is the inability of a male and female organism to Sexual reproduction, reproduce. It is usually not the natural state of a healthy organism that has reached sexual maturity, so children who have not undergone puberty, whi ...
. For breast cancer alone, it is assumed that there are ca. 200 patients a year in Germany who wish to conceive. In men, chemotherapy can result in permanent damage to the testicular tissue. Due to advances in
reproductive medicine Reproductive medicine is a branch of medicine concerning the male and female reproductive systems. It encompasses a variety of reproductive conditions, their prevention and assessment, as well as their subsequent treatment and prognosis. Reprodu ...
, a variety of fertility-protective methods are now available. These techniques include administration of GnRH-agonists, ovarian stimulation with cryoconservation of fertilised or unfertilised oocytes, as well as cryoconservation of ovarian tissue. Relocation of the
ovaries The ovary () is a gonad in the female reproductive system that produces ova; when released, an ovum travels through the fallopian tube/oviduct into the uterus. There is an ovary on the left and the right side of the body. The ovaries are endocr ...
by surgically moving them out of the
pelvis The pelvis (: pelves or pelvises) is the lower part of an Anatomy, anatomical Trunk (anatomy), trunk, between the human abdomen, abdomen and the thighs (sometimes also called pelvic region), together with its embedded skeleton (sometimes also c ...
(ovarian transposition) to protect them from damage caused by radiotherapy is also possible.


Activity

The Fertiprotekt network has carried out international pioneering work in four areas: * National, comprehensive care structures in the area of fertility conservation have been created, which also serve as a role model for other countries. * Treatment recommendations have been created, which allow a standardised and scientific approach. * So-called
luteal phase The menstrual cycle is on average 28 days in length. It begins with Menstruation, menses (day 1–7) during the follicular phase (day 1–14), followed by ovulation (day 14) and ending with the luteal phase (day 14–28). While historically, medi ...
stimulation Stimulation is the encouragement of development or the cause of activity in general. For example, "The press provides stimulation of political discourse." An interesting or fun activity can be described as "stimulating", regardless of its physic ...
has been introduced, which allows hormonal stimulation to collect
oocyte An oocyte (, oöcyte, or ovocyte) is a female gametocyte or germ cell involved in reproduction. In other words, it is an immature ovum, or egg cell. An oocyte is produced in a female fetus in the ovary during female gametogenesis. The female ger ...
s to be started at any time during the menstrual cycle. The procedure of egg-cell collection is therefore considerably shortened, and chemotherapy can be started earlier. * The combination of
ovarian tissue cryopreservation Ovarian tissue cryopreservation is cryopreservation of tissue of the ovary of a female. Indications Cryopreservation of ovarian tissue is of interest to women who want fertility preservation beyond the natural limit, or whose reproductive potential ...
, directly followed by hormonal stimulation to collect egg cells for
oocyte cryopreservation Oocyte cryopreservation (commonly referred to as OC or egg freezing) is a form of assisted reproductive technology (ART) used to preserve human eggs (oocytes). The technique is often used to delay pregnancy. When pregnancy is desired, the eggs can ...
was first performed by centres in the network. This technique allows a significant increase in the chance of pregnancy. * The first birth after transposition of ovarian tissue, which was transported to a central cryobank by overnight transport immediately after removal, was achieved by the network. This demonstrated that removed ovarian tissue can be centrally prepared and stored in specialised centres. Network seminars take place annually. The centres involved are obliged to regularly take part in these annual conferences.


Problems

Some methods, such as cryoconservation of sperm and in-vitro fertilisation (IVF) are well established. Others have only been introduced over the last few years, such as cryoconservation of ovarian tissue prior to chemotherapy for later transplantation and the cryoconservation of unfertilized egg cells. These services are therefore not fully covered by statutory health insurance in Germany.''Kinderwunsch und Krebs.'' In: ''Die blauen Ratgeber.'' 49, brochure of the
German Cancer Aid The German Cancer Aid () is a not-for-profit organization to fight cancer in all its forms. The institution was founded on September 25, 1974, by Mildred Scheel during the term of her husband, Walter Scheel, as federal president of Germany. It ...
(Deutsche Krebshilfe), p. 37, ISSN 0946-4816
online
(PDF; 1,44 MB) (in German language)


References


Further reading

* Michael von Wolff, Frank Nawroth (editors): ''Fertility Preservation in Oncological and Non-Oncological Diseases. A Practical Guide.'' Springer 2020, , * Michael von Wolff, Darius Dian: ''Fertility preservation in women with malignant tumors and gonadotoxic treatments.'' Dtsch Ärztebl Int. 109 (2012), pp. 220–6, * Dominik Denschlag: ''Fertilitätsprophylaxe.'' In: Christoph Keck: ''Kinderwunschbehandlung in der gynäkologischen Praxis: Sinnvolle Diagnostik- und Therapiestrategien für Frauenärzte.'' Georg Thieme Verlag, 2013, , pp. 286–292 (in German language) * Michael von Wolff, Petra Stute: ''Netzwerk FertiPROTEKT.'' in: Michael von Wolff, Petra Stute: ''Gynäkologische Endokrinologie und Reproduktionsmedizin: Das Praxisbuch.'' chapter 36.5, pp. 399–400, Schattauer Verlag,
Stuttgart Stuttgart (; ; Swabian German, Swabian: ; Alemannic German, Alemannic: ; Italian language, Italian: ; ) is the capital city, capital and List of cities in Baden-Württemberg by population, largest city of the States of Germany, German state of ...
2013, (in German language) * ''Kinderwunsch und Krebs.'' In: ''Die blauen Ratgeber.'' 49, brochure of the
German Cancer Aid The German Cancer Aid () is a not-for-profit organization to fight cancer in all its forms. The institution was founded on September 25, 1974, by Mildred Scheel during the term of her husband, Walter Scheel, as federal president of Germany. It ...

online
{{Webarchive, url=https://web.archive.org/web/20130516212002/http://www.krebshilfe.de/fileadmin/Inhalte/Downloads/PDFs/Blaue_Ratgeber/049_kinderwunsch.pdf , date=2013-05-16 (PDF-file; 1,44 MB) (in German language)


External links


FertiPROTEKT website


information of the European Leukemia Information Center (ELIC) of European LeukemiaNet (in German language) Oncology Fertility medicine Medical and health organisations based in Germany