39,894 research outputs found
For Pianist: the piano music of Christian Wolff
No full textMulti-concert portrait of the solo piano music of Christian Wolff, including UK premieres of recent works, and the world premieres of
Stephen Chase Piano Dances, Tim Parkinson piano piece 2006 and Michael Parsons Oblique Pieces 8 and 9.
Concerts held in 'Persistence Works', Sheffield, and The Warehouse, Londo
Removal of Ovarian Tissue
No full textHalf an ovary or a whole ovary can be removed laparoscopically for tissue cryopreservation. As a rule, removal of half an ovary is enough. The removal of a whole ovary is only recommended for children, in case of pelvic radiotherapy or stem cell transplantation. It is advisable to exclude metastases in a small piece of tissue to determine the follicle density and to measure the serum AMH concentration before removal. Cryopreservation of ovarian tissue is particularly suitable if less than 2 weeks are available for a fertility preservation method to be carried out, if the patient is younger than 35 years of age or if chemotherapy has already been started. The ovarian tissue can be transferred to a specialized cryobank at 4 °C overnight for cryopreservation
How to Use the Book
No full textThe chapter describes how to use the book. The book provides systematically all information required to indicate and to perform fertility-preservation techniques and to treat patients afterwards
Indications for and Against Fertility Preservation
No full textCounselling on fertility-preservation therapy should be provided for all women and men who are highly likely to survive the disease, in whom pregnancy or paternity is compatible with the disease, who are at risk of a relevant reduction in fertility and for whom fertility-preservation therapy with a low risk to health is feasible. This means that a balance must be struck between advising as many patients with an indication for fertility-preservation therapy as possible, but also only treating those who will have a sufficiently high probability of benefiting from such therapy, thus avoiding overtreatment
Pregnancy After Chemotherapy and Pelvic Radiotherapy
No full textThe effect of chemotherapy on a later pregnancy seems to be rather small. However, alkylating agents in childhood might have a negative effect on uterine function. The effect of radiotherapy depends strongly on the radiation intensity and the age at radiation exposure. Radiation during childhood seems to have a greater negative effect on the uterus than in adulthood. Radiotherapy to the adult uterus with whole-body radiation (12 Gy) is associated with an increased risk of abortion, premature birth and a low birth weight. If the uterus is irradiated with >25 Gy in childhood, pregnancy should not be recommended. If the uterus is irradiated with >45 Gy in adults, pregnancy should not be advised
Networks for Fertility Preservation
No full textFertility preservation requires close coordination between reproductive medicine specialists, reproductive biologists and oncologists in various disciplines. Therefore, it is inevitable that fertility-preservation activities should organize themselves into a network structure both as a medical-logistic network and as a professional medical society. The necessary network structures can differ significantly at regional, national and international levels, as the size of the regions to be integrated and the local cultural and geographical conditions, as well as the political conditions, are very different. To address these issues, this chapter aims to point out the basic importance and the chances, but also the difficulties of fertility-protection networks
Fertility Treatment After Fertility Preservation Therapies
No full textAs soon as it is medically justifiable, cryopreserved gametes or the cryopreserved gonadal tissue can be thawed. Sperm are used either for intrauterine insemination or IVF/ICSI therapy. The birth rate per patient is approximately 50%. If oocytes had been cryopreserved, the birth rates are about 35% if all frozen oocytes are transferred after fertilization. Ovarian tissue is transplanted orthotopically, which leads to birth rates of approximately 25% according to current data. If IVF/ICSI therapy is carried out treatment require modifications due to the frequently very low ovarian reserve after gonadotoxic therapy
Transplantation of Ovarian Tissue
No full textCryopreserved ovarian tissue can be transplanted after a thawing process. An orthotopic transplantation, that is in or on the ovary or in the ovarian fossa seems to be ideal. It is still unclear which of these locations is best. At least 70% of grafts are endocrine active and form follicles after transplantation. According to current data, every fourth transplanted woman gives birth to a child. Two-third of the pregnancies occurred spontaneously after transplantation and one-third of the cases after ART. The life expectancy of the transplant is usually several years. Tissue can also be transplanted to avoid hormone replacement therapy in patients with premature ovarian insufficiency, but this is not advisable from an endocrinological point of view
Other Malignancies
No full textIn chapters “Breast Cancer, Hodgkin’s Lymphoma, Acute Leukaemia, Ovarian Tumours and Ovarian Cancer, Cervical Cancer, Endometrial Hyperplasia and Endometrial Carcinoma, Paediatric Oncological Cancer” and “Non-Malignant Diseases Requiring Stem Cell Transplantation; Severe Autoimmune Diseases; Endometriosis; Turner Syndrome; Transgender”, this book covers in detail approximately two-third of all diseases for which fertility preservation therapy is indicated. Other, but considerably less frequent diseases are presented in tabular form in this chapter in terms of their frequency, 5-year survival rate, gonadotoxicity of oncological treatment and the potential risk of gonadal metastases occurring. Recommendations for fertility preservation are derived from this. Overall, around 80% of the diseases requiring fertility preservation are described in this book
- …
