Book Review: Fertility Preservation: Principles and Practice 2nd Edition, edited by Jacques Donnez and S. Samuel Kim
Reviewed by: Allison A. Eubanks, M.D.1
1S. Naval Hospital Okinawa, Japan
This 2nd edition textbook is an updated version of the 2011 original publication. In the last 10 years, since the original publication, significant advances in fertility preservation have improved outcomes for patients seeking to preserve their fertility in the face of gonadotoxic cancer therapy or simply as a choice. This update brings in multiple new experts, with diverse backgrounds, who discuss fertility preservation across various clinical settings, including preservation prior to surgical or medical gonadotoxic therapy and preservation in support of delayed childbearing for social or lifestyle preferences. The text discusses new technologies in an ever-changing practice of reproductive medicine while also providing applicability to everyday clinical practices in the treatment of both men and women.
Notably, since the original publication, the American Society of Reproductive Medicine (ASRM), removed the experimental label from oocyte cryopreservation in 2012.1 More and more studies have revealed the safety and efficacy of this method for fertility preservation, and in 2014, ASRM released a publication supporting the use of oocyte cryopreservation as an elective procedure for women choosing to delay fertility. Expanding fertility preservation to those without an oncologic diagnosis, enhances the relevance and applicability of this text to clinical practice.1
The text begins with a history of artificial reproductive technology (ART) and it describes mechanisms by which radiation and chemotherapy impact the reproductive system. Following this, the authors review the basics of cryopreservation and its application in the pediatric population as well as in patients pursuing cryopreservation for delayed childbearing and patients facing gonadotoxic treatments for breast, gynecological, gastrointestinal and hematologic malignancies. Medical and surgical practices of preservation techniques in both male and female patients are separately and thoroughly reviewed. This update also addresses the evolution of ART technologies beyond those described in the original publication. Updates include research aimed at investigating the use of artificial ovaries as well as current practices of uterine transplantation, whole ovary and ovarian tissue allo- and auto-transplantation, and the role and applicability of advanced genetic technologies. Finally, the text concludes with a review of the possible ethical, legal, and religious considerations in this ever-expanding field. Each chapter is an independent comprehensive review of the topic with clinical applications and clear illustrations.
For example, a new chapter dedicated to addressing “Uterine Transplantation” describes appropriate transplantation candidacy while also providing an in depth review of relevant animal studies and recent cases of human uterine transplantation from both living and deceased donors. It concludes with a proposal of future research in uterine transplantation techniques, including minimally invasive approaches.
The topic of onco-fertility is particularly highlighted in the text due to increasingly complicated and necessary expeditious timelines, risks of hormonal exposures required for gamete recruitment and development, and risk of malignant transmissions following subsequent auto-transplantation. Thus, the text purports that onco-fertility-focused ART requires continued extensive research in order to overcome multiple scientific hurdles for this patient population. While addressing specific onco-fertility techniques, the text asserts that these techniques are also applicable to patients facing non-cancerous health conditions that may lead to adverse reproductive potential as well as to patients choosing to delay childbearing for social or lifestyle preferences.
Useful for the general Obstetrician and Gynecologist, this newer edition dedicates a chapter to specifically address ovarian preservation in patients with endometriosis. Here, the authors explicitly outline optimal surgical techniques to preserve maximal normal ovarian tissue, from simple excision of an endometrioma to the advanced surgical approaches of ovarian tissue transplantation in the most severe of cases.
Fertility Preservation: Principles and Practice 2nd Edition merges oncology and fertility with a fascinating, multi-disciplinary approach inclusive of ART’s unique history as well as the most modern preservation technologies, techniques, and on-going research. Fertility preservation, while generally thought of as very specific to Reproductive Endocrinologists, should be a multidisciplinary therapy and this text is clearly written for a merging of multiple specialties like oncology, maternal fetal medicine, and pediatrics. For a reader looking for updates from the scientific community or for research on a particular preservation method, the division of chapters allows for a quick, specific read. With a topic that will only continue to become more important as cancer survivorship increases and more families elect to delay and preserve fertility, this updated text allows readers a comprehensive review of fertility preservation to enhance care of both male and female patients inclusive of ethical considerations in this rapidly evolving field.
- Ethics Committee of the American Society for Reproductive Medicine. "Planned oocyte cryopreservation for women seeking to preserve future reproductive potential: an Ethics Committee opinion." Fertility and sterility6 (2018): 1022-1028.