Implications of systemic malignancies on human fertility.

Cancer patients have now longer life expectancy due to improved treatment modalities. As the mortality rate decreased and the survival rate increased, the consequences of cancer treatment in terms of impaired fertility became more frequently encountered. The objective of this review is to highlight fertility issues associated with systemic malignancies. Systemic malignancies lead to deterioration of human fertility directly or indirectly as a result of cytotoxic treatment regimens. A variety of measures may be used to decrease the incidence of fertility decline that occurs. Gamete cryopreservation represents a widely accepted method for fertility preservation in cancer patients. In addition, other procedures such as germ cell transplantation and ovarian cryopreservation, which are currently being developed, are expected to make significant contribution in these cases. However, there are some ethical issues that should be considered before offering patients any of these options.