Reproductive Tissue Cryopreservation for Cancer Survivors: Barriers and Challenges in Low-Resource Settings
Fertility preservation for cancer survivor
DOI:
https://doi.org/10.3329/bmrcb.v51i02.85718Keywords:
Cancer Survivors, Chemoradiation, Fertility Preservation, Low-Resource SettingsAbstract
Reproductive tissue cryopreservation is done for fertility preservation (FP), which is a critical aspect of cancer survivorship, especially for children, adolescents, and young adults undergoing gonadotoxic treatments such as chemotherapy and radiotherapy. Preserving reproductive potential has become more crucial as cancer survival rates have increased. However, obstacles to FP make it challenging to use and implement, especially in environments with limited resources. This review aims to examine the effects of cancer treatments on reproduction, the FP procedures that are available for both male and female patients, the difficulties in making FP decisions, and the obstacles to putting FP strategies into practice in settings with limited resources. Fertility is greatly impacted by chemotherapy and radiation, with pelvic radiation and alkylating drugs presenting the most significant hazards. Male tissue freezing include sperm cryopreservation from ejaculated semen and testicular sperm or tissue in case of azoospermia. Techniques for females include cryopreservation of oocytes, embryos, and ovarian tissue. A multidisciplinary approach involving oncologists, reproductive specialists, and psychosocial support teams are necessary to enhance fertility preservation (FP) accessibility. However, implementing FP opportunities in low-resource settings is challenging due to several barriers. Due to cultural preconceptions, exorbitant prices, a lack of medical knowledge, and limited awareness, the acceptance of FP remains low despite advancements. In low-resource settings, financial constraints, inadequate infrastructure, and insufficient training of healthcare professionals further exacerbate FP access issues. Barriers to FP at the patient, provider, health system, and societal levels were identified, along with potential remedies. Establishing oncofertility patient navigation systems, integrating FP discussions into oncology care, and creating financial support programs can facilitate informed FP decisions and improve implementation in low-resource settings.
Bangladesh Medical Res Counc Bull 2025;51(2): 91-102
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Copyright (c) 2025 Mosammat Rashida Begum, Nazia Ehsan, Maryia Ehsan, Fahmida Rashid
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