New York University on March 9, XML Template K:/LUP/LUP d Fertility preservation methods in young women with SLE prior to cytotoxic therapy M Henes . Despite all the improvements in the treatment concept of S the disease can pose a therapeutic challenge Sunitinib to rheumatologists. Especially during acute exacerbations with severean manifestati cytotoxic treatment with cyclophosphamide can be necessary. The risk for premature ovarian failure deed as premature depletion of ovarian follicles before the age of 0 after CYC treatment is dependent especially on the age of the patient at the time of the CYC therapy and on the cumulative dose of CYC. Boumpas found a rate of 7 in patients aged under 5 years with ! 5 cycles and in patients over 0 years of age. Ioannidis and Park described similar results.
Current work has shown thatpared to a healthy control gro SLE patients without CYC pretreatment have a reduced ovarian reserve as measured Oridonin inhibitor by the antiMuellerian hormone Ecdysone 3604873 . According to animal mode other immunosuppressives most probably do not exert negative eects on ovarian reserve. 1 The Ferti PROTEKT network was established in and includes 9 centres in Germa Switzerland and Austria. University centr hospitals and private fertility clinics that meet the strict quality standards can join the network. All fertility preservation techniques must be discussed with the patient and oered to h either at the same centre or at a cooperating hospital. Every consulted patient has to be documented on a standardized form and reported to the network.
The aim buy Emodin of the network is the pooling of expertise from oncologis rheumatologists and reproductive medicine specialis and the implementation of aprehensive national care structure and development of obligatory treatment rmendations and standardized counselling structures.pulsory documentation has been made of all patients and treatments since . The choice of fertility preservation treatment options include the administration of gonadotropinreleasing hormone analogu which prevents the recruitment of the primordial follicle by suppressing follicle stimulating hormone release and should therefore reduce damage to the ovaries caused by cytotoxic treatment. There is also the possibility of cryoconservation of the ovarian tissue. Approximately to aplete ovary is removed laparoscopically and cryoconserved.
In the case of POF after cytotoxic thera part of the ovary can be retransplanted laparoscopically. A further embryo option for fertility preservation is controlled ovarian stimulation therapy for the cryoconservation of oocytes. Similar to infertility treatme follicle ripening is induced by administering highdose gonadotrop the follicle is aspirated and the oocytes are then cryoconserved unfertilized or fertilized using either in vitro fertilization or intracytoplasmic sperm injection . A detailed description of the various fertility preservation metho the implementati e cacy and risks has already been published elsewhere as open access. 2 Because of the ovarian toxici the reduced ovarian reserve and the mostly young age of the SLE patien fertility preservation should be taken int.nsideration before starting CYC treatment. Unlike malignant disea there are no recommendations for ovarian protection in SLE.