Central Nervous System Depressants

All Drugs and Chemicals

Anesthetics

ovarian tissue biopsy during general anesthesia

ovarian tissue biopsy

Fabienne Gumy-Pause, Dr

Maja Beck Popovic, Prof

Background:

Due to the remarkable improvement in treatments these last decades, long term survival can be expected in more than 80% of childhood cancer patients. Unfortunately, cancer treatments can be harmful to the gonads and can affect reproductive and endocrine functions. While loss of fertility is a major concern for most patients, only the experimental option of ovarian tissue cryopreservation can be proposed to prepubertal girls with a high risk of infertility. For pubertal patient, cryopreservation of mature oocytes after ovarian stimulation can be offered if oncological treatment debut can be delayed. As it is often not possible, ovarian tissue cryopreservation can also be offered.

Primary aims

- To cryopreserve ovarian tissue of pre or peripubertal patient who will be receiving highly gonadotoxic oncological treatment.

Secondary aims

* To create a database in order to record clinical and biological follow-up data
* To pool resources with Fertisave Registry
* To create a research biobank for future research projects

Multicentric study: HUG, CHUV

Female Fertility Preservation Using Ovarian Tissue Cryopreservation Before Highly Gonadotoxic Cancer Treatment

The safety will be assessed by recording the number of complications of the procedure (e.g. bleeding, infection)

Comparison of biochemical markers (e.g., FSH; LH, AMH, progesterone, oestradiol) between patients who undergo ovarian biopsy and controls

Gumy-Pause Fabienne

Principal Investigator

Patients meeting eligibility criteria are offered experimental procedure of testicular biopsy for clinical storage and use in laboratory research. The intervention does not involve a drug or device.

Testicular biopsy for clinical storage and laboratory research.

Testicular Biopsy

Rod T Mitchell, MBChB

Mark Brougham, MBChB

Prepubertal boys treated for cancer are at risk of infertility as a result of their treatment. At present there are no options to preserve fertility in these boys. With informed consent, the investigators aim to cryopreserve (freeze) testis tissue biopsies taken from boys undergoing cancer therapy with a high risk of infertility. A portion of cryopreserved tissue will be securely stored, which in the future may be used to restore fertility in the patients. A second portion of the tissue will be used for laboratory work aimed at understanding the conditions required for development of the germ cells.

Patients will be recruited from the Oncology Department at the Royal Hospital for Children and Young People (RHCYP) in Edinburgh. Tissue will be obtained from prepubertal patients with cancer who are about to undergo treatment with a high risk (\>80%) of infertility. Informed consent will be obtained from the patients legal guardian (and patient if applicable) for the procedure and subsequent use of tissue. A testis biopsy from one testis will be performed and if possible will coincide with a planned routine procedure requiring general anaesthetic in order to avoid the need for additional anaesthesia.

The procedure will take place at RHCYP during the initial assessment and prior to the commencement of cancer treatment and will not result in delay of treatment. Tissue will be assessed for the presence of sperm for storage using existing methods. In addition, tissue will be cryopreserved by Tissue and Cells Directorate, SNBTS in Edinburgh. The tissue will be stored for up to 55 years in accordance with current legislation (HFEA Act as amended 2005). Research will be carried out at the MRC Centre for Reproductive Health in accordance with Human Tissue (Scotland) Act 2006.

Objectives

1. Primary Objective

   a) Cryopreservation of testicular tissue from pre- and peri-pubertal patients undergoing potentially sterilising therapy for future therapeutic use to preserve fertility.

   i. Development/refinement of inclusion and exclusion criteria ii. Exploration of patients and parents attitudes to this approach to fertility preservation iii. Development of the required multidisciplinary group to provide this
2. Secondary Objectives

   1. Follow-up patients after testis tissue cryopreservation
   2. Laboratory research - testicular germ cell development for fertility preservation i. Development of optimal freezing methods for testicular tissue ii. In-vitro culture methods for germ cell maturation iii. Development of xenografting approaches for maturation of germ cells

Design Prospective cohort study of pre- and peri-pubertal boys

Study Population Pre- and peri-pubertal boys due to undergo therapy with high risk of subsequent infertility

Main Study Endpoint Successful long-term cryostorage of testicular tissue for potential future use in fertility preservation, and follow-up of patients for effects of testicular biopsy on subsequent endocrine function

Establishment of laboratory techniques for the development of methods to support long term storage of tissue and methods for in vivo/in vitro spermatogenesis

Methods

Patient Recruitment Patients will be recruited from the Oncology Department at the RHCYP in Edinburgh. Testicular cryopreservation will be offered to eligible patients providing they meet the inclusion criteria. Age appropriate patient information sheets will be provided to the patients.

Patient Consent Consent will be for testis tissue cryopreservation and storage. Patients will also have the option of allowing tissue to be used for research purposes, however declining this aspect will not prevent them from consenting to cryopreservation of tissue. Due to the young age and immaturity of the study patients, written informed consent for a testicular biopsy under general anaesthetic will be obtained from the parents/guardian of the patient, unless the patients are considered able to give fully informed consent themselves. Patient assent will be sought from those boys not considered competent to provide written informed consent due to their young age.

Surgical Procedure The testicular biopsy will take place in operating theatres at the RHCYP before cancer gonadotoxic treatment begins. This will, whenever possible, coincide with a planned routine procedure requiring general anaesthetic in order to avoid the need for additional anaesthesia, hence this will not result in delay to commencing treatment. A blood sample will be taken for viral screening which is a requirement for tissue storage. The blood sample will be stored to allow further testing for infectious diseases as required over time by Tissues Services and the HTA.

Testicular volume will be assessed by visual inspection and manual palpation at surgery. The amount of tissue removed will typically be approximately 0.6-0.8mls from one testis, and never in excess of 50% of the total volume of a single testis. The procedure will involve a unilateral open testicular biopsy through a scrotal incision.

Since treatment with cytotoxic therapy will not have started prior to the biopsy, the risk of infection is minimal. In patients with solid tumours bleeding is unlikely to be a major problem since platelet numbers and function are generally normal in these patients. In patients with leukaemia thrombocytopenia is likely to be present at diagnosis, but haemostasis is routinely secured by platelet transfusion for operative procedures in these patients.

The biopsy will be taken for testis tissue cryopreservation, with a portion of the sample going for laboratory research (if consent has been obtained for this purpose). In pubertal patients, the tissue for cryopreservation will be immediately analysed by an experienced embryologist for the presence of sperm using standard methods. If sperm are present then a portion of the sample will be used for Testicular Sperm Extraction (TESE) and storage, whilst remaining tissue will be cryopreserved using methods described below.

Cryopreservation of testicular tissue Testis tissue will be stored under the licence terms of the HTA. Samples are collected into sterile Hank's balanced saline solution (HBSS; 14175-129; Life Technologies, Merelbeke, Belgium), and transported to Tissue Services for cryopreservation and storage.

1. Cryopreservation of Immature Testicular Tissue Cryopreservation of ITT is performed by placing two tissue pieces in each cryovial containing 0.7 M DMSO (D2650; Sigma-Aldrich, Bornem, Belgium), with 0.1 M sucrose (+S; 10274-5c; VWR, Leuven, Belgium) and 10 mg/ ml HSA as previously described (Keros, Hultenby et al. 2007) (Wyns, Curaba et al. 2007). Equilibration is performed at +4°C for 30 min. Using a programmable freezer, the vials are cooled at 1°C/min with holding at 0°C for 5 min, followed by cooling at 0.5°C/min until 20°C. At this temperature, the program is put on hold for 10 min to allow manual seeding. The program continues at a rate of 0.5°C/min until 240°C, held for 10 min, and continued to 270°C at 7°C/min, with subsequent plunging into liquid nitrogen.
2. Cryopreservation of Mature Testicular Tissue Each biopsy is minced carefully with two fine needles in a Petri dish with 2 mL HBSS or Human Tubule Fluid, supplemented with 2.5% HSA (adapted from Verheyen, De Croo et al. 1995). After centrifugation of the tissue/cell suspension at 500g for 10 min and removal of the supernatant, the pellet is resuspended in 200 µL HBSS or Human Tubule Fluid, supplemented with 2.5% HSA. SpermFreeze (Vitrolife) (is added slowly at a ratio of 1:1 (v/v) to the suspension. After 20 min of equilibration at 37°C, the sperm suspension is aspirated into a 500-µL cryostraw (IMV, l'Aigle Cedex, France). Cooling and freezing are carried out under computer control using a standard programme for ejaculated spermatozoa (Verheyen, Pletincx et al. 1993). The straws are placed into the chamber of a programmable biological freezer and cooled according to the following programme: (i) cooling rate of -1°C/min from room temperature to 4°C (ii) hold for 1 min (iii) freezing rate of -5°C/min from 4°C to -80°C (iv) plunge into liquid nitrogen (-196 °C).

Laboratory research The primary aim of this application is to store testis tissue from patients that may be used in the future for fertility preservation if required. However, consent will also be sought for use of an extra portion of tissue for laboratory research. In addition to obtaining tissue as described above, the investigators will also use tissues obtained from an alternative source of tissue obtained from a collaborating centre (John Radcliffe Hospital, Oxford, UK). This second source of human prepubertal testis material will be stored under a HTA licence (reference: 11106) in which consent has previously been obtained for the use of the tissue in approved research, including animal research.

This testis tissue will be used for three main aspects of laboratory research

1. Optimal freezing methods for pre-pubertal testis tissue and cells

   Freezing conditions need to be optimized and improved with xeno-free clinical grade components before clinical application can be considered. The investigators will assess the use of various cryoprotectants on survival and developmental potential of germ cells within the portion of pre-pubertal tissue taken for research. Post-thaw viability and functionality will be assessed by immunohistochemistry, flow cytometry and RT-PCR. To evaluate the functional properties of the tissue after freezing, the tissue will be xenografted or used for in-vitro culture.
2. In-vitro culture of pre-pubertal testis tissue

   Testis tissue organ culture using a soft agar system has resulted in full spermatogenesis using neonatal mouse testis (Sato, Katagiri et al. 2011). This method will be adapted for use with human pre-pubertal testis tissue by investigating the effects of different culture media, serum and the addition of gonadotrophins/other growth factors to stimulate germ cell differentiation. This will be evaluated by histological analysis and expression of markers for spermatogonia (e.g. MAGE-A4, Thy-1), spermatocytes (e.g. SCP-3, Prohibitin) and spermatids (e.g. Protamine-2, SP-10) which will be studied with different methodologies, including qPCR, flow cytometry and protein expression. Modifications of the culture conditions by adding the following substances will be considered: (1) Knock-out Serum Replacement (KO-SR) as it induced complete spermatogenesis in neonatal mouse testicular tissue culture (Sato, Katagiri et al. 2011); (2) Retinoic acid as it has a known role in meiosis and spermatogenic differentiation; (3) Testosterone as high concentrations of testosterone are essential for spermatogenesis in vivo.
3. Xenografting

Testis xenografting represents a model system to investigate the factors required to establish the spermatogonial stem cell (SSC) niche (Mitchell, Saunders et al. 2010). Testis tissue will be xenografted in mice, ectopically (dorsal skin, scrotal, kidney capsule) or directly into the testis in order to establish the SSC pool. The investigators will examine which factors are responsible for the maintenance of the SSC niche using established advanced immunohistochemical co-localisation studies. The investigators will determine protein expression in the SSCs and the surrounding niche, including somatic cells, basal lamina and vasculature. This will include proteins that have been shown to be important in SSC self-renewal/differentiation in rodents, such as c-kit/KITL and GDNF/Gfrα1. Grafts will also be maintained for longer periods in order to investigate subsequent differentiation of the germ cells beyond the spermatogonial stage by investigating morphology and expression of meiotic markers such as described for in-vitro work. The effects on the establishment of spermatogenesis by exposure of xenografts to exogenous gonadotrophins (LH/hCG +/- FSH) will also be determined. Moreover, the xenografting approach will be used to obtain SSCs which can then be propagated and/or transplanted into seminiferous tubules to achieve colonization.

Follow up of Patients Patients will be followed up in the Oncology clinic as normal until they are no longer required to have regular surveillance imaging when they will be transferred to the joint Oncology/Endocrinology 'Late Effects' clinic at the RHCYP in Edinburgh. Patients will be reviewed every 3 months through childhood and puberty to monitor growth and pubertal status. Subsequent follow up will be between 3 monthly and annually. Puberty will be assessed by clinical examination using Tanner Staging and also by measuring blood levels of gonadotrophins, testosterone and Inhibin B. Testicular volumes will be measured using a Prader orchidometer and an annual ultrasound of the testes will be performed to assess testicular growth and monitor for scarring or damage as a result of the biopsy. A key outcome is the prevalence of gonadal failure (divided into spermatogenic and endocrine) in boys who have had testicular biopsies in comparison with those with similar and other diagnoses who have not. This will ensure that in the unlikely event that there are adverse effects of the biopsy this will be detected and it will also allow modification of the selection criteria for biopsy and testis tissue cryopreservation.

The same protocol applies to all subjects.

Project is on male fertility and therefore by definition is only applicable to males. Similar programmes are already established for females.

Cryopreservation of Prepubertal Testicular Tissue for Preservation of Fertility in Young Boys With Cancer

Cryopreservation of Prepubertal Testicular Tissue for Preservation

Measurement of reproductive hormones in blood

Most advanced germ cell stage identified in tissue after culture or xenotransplant.

University of Oxford

University of Edinburgh

Neoplasms

All Conditions

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Skin and Connective Tissue Diseases

Leiomyoma

Infertility

Myofibroma

Myoma

Neoplasms, Connective and Soft Tissue

Neoplasms by Histologic Type

Genital Diseases

Urogenital Diseases

Neoplasms, Connective Tissue

Connective Tissue Diseases

Data collection from the medical file of the patients

Retrospective data collection

Call for collecting fertility data and obstetrical issues of the patients

Phone interview

Natacha Nohilé

Henri Azaïs, MD, PhD

Meriem Koual, MD, PhD

Uterine leiomyomas (or fibroids) are a common disease (30% of women over 35 years of age) in women of childbearing age and can cause various symptoms such as menometrorrhagia, dysmenorrhoea, pelvic pain and heaviness, and infertility.

Uterine artery embolisation, first used in France in 1990, is a safe, effective and less invasive therapeutic technique than surgical treatment (myomectomy or hysterectomy), particularly in the case of numerous and large fibroids. This technique is validated by the French National College of Gynaecologists-Obstetricians (CNGOF) as an alternative treatment for women who do not wish to become pregnant (grade A recommendation), but at present there is little reliable data concerning fertility, the occurrence of pregnancy and the obstetrical prognosis after uterine artery embolisation for fibroids. A recent systematic review of the literature with meta-analysis published very recently showed that 40.5% of patients with a desire for pregnancy were able to become pregnant after embolisation (CI: 33.3%-48.2%) but that the rates of miscarriage, obstetric complications and low birth weight were not negligible (respectively 33.5% (95% CI: 26.3-41%), 25.4% (95% CI = 13-40.2%) and 10% (95% CI = 6.2-14.6%) (Ghanaati et al. 2020).

In France, uterine artery embolisation is performed in more than thirty centres in women who have completed their parental project. On the other hand, in the absence of consistent literature, it is performed in patients of childbearing age, when it represents the only acceptable alternative or in the event of contraindication or refusal of surgery by the patient. To our knowledge, there is no large-scale French study to date on the impact of embolisation on fertility and pregnancy outcomes.

The aim of this study is to compile a retrospective database of all cases of uterine artery embolisation for uterine pathology performed at the Georges-Pompidou European Hospital (HEGP) since 2007 and to assess the impact of embolisation on fertility in patients of childbearing age.

Fertility After Uterine Artery Embolization

Uterine Artery Embolization For Uterine Pathology: What Impact On Fertility?

Individual participant data (IPD) that underlies results in publication could be shared. IPD detailed in the protocol of a planned metaanalysis could be shared

Rate of live births after embolisation (percentage)

* Pregnancy rate (percentage) ;
* Miscarriage rate (percentage) ;
* Assisted reproduction rate;
* Obstetric complication rates (haemorrhage, caesarean section, prematurity, pre-eclampsia, placental disorders)

* Complication rate of embolisation (percentage)
* Post-embolisation myomectomy and hysterectomy rates (percentage)

Gedeon Richter France

Collège National des Gynécologues et Obstétriciens Français

Assistance Publique - Hôpitaux de Paris

Behaviors and Mental Disorders

Quality of Life

Participants recruited from a tertiary care hospital, and women diagnosed with gynecological malignancies (e.g. cervical, ovarian, endometrial cancer) who underwent fertility-sparing surgery between 2010 and 2022.

Sparing the uterus and/or ovaries of the patients suffering from gynecologic malignancies to keep the patients' fertility

Fertility sparing surgery

NAZLI ALBAYRAK, MD

FSS which aims to preserve a woman's fertility while still effectively treating the cancer, has become an increasingly popular option for young women diagnosed with these types of cancers. It is important to assess how FSS affects a woman's reproductive health, sexual function, psychological well-being, and overall quality of life. This research aims to provide valuable insights into the long-term effects of FSS on a woman's life, and can help healthcare providers make informed decisions about the best treatment options for their patients.

This is a prospective cohort study that aims to evaluate the infertility and pregnancy outcomes, as well as the quality of life of women who underwent fertility-sparing surgery for gynecological malignancies. The study included a comprehensive evaluation of the participants' medical history, surgical procedures, oncological treatment, and fertility preservation methods. Participants recruited from a tertiary care hospital, and women diagnosed with gynecological malignancies (e.g. cervical, ovarian, endometrial cancer) who underwent fertility-sparing surgery between 2010 and 2022. Women who have undergone total hysterectomy, bilateral salpingo-oophorectomy, or adjuvant oncological treatment were excluded from the study. Participants were contacted by phone and asked to complete questionnaires to assess their quality of life using the WHOQoL-BREF and FertiQoL scales.

The study included a comprehensive evaluation of the participants' medical history, surgical procedures, oncological treatment, and fertility preservation methods.

Infertility and Pregnancy Outcomes of Fertility Spared Gynecological Oncology Patients

The Evaluation of Infertility and Pregnancy Outcomes, as Well as the Assessment of Quality of Life Using WHOQoL and FertiQoL, in Cases of Gynecological Malignancies That Have Undergone Fertility-sparing Surgery(FSS)

Incidence and rate of patients getting pregnant after FSS

Rate of patients referring to IVF clinic after FSS

% of patients' satisfaction via Quality of life after the surgery, and decision-regret analysis regarding to fertility sparing by the validated questionnaires

Acibadem University

PGY-4 Ob/Gyn resident, MD

testicular tissue biopsy during general anesthesia

testicular tissue biopsy

Tamara Diesch-Furlanetto, Dr

Maja Beck Popovic, Dr

Fabienne Gumy-Pause

Background:

Due to the remarkable improvement in treatments these last decades, long term survival can be expected in more than 80% of childhood cancer patients. Unfortunately, cancer treatments can be harmful to the gonads and can affect reproductive and endocrine functions. While loss of fertility is a major concern for most patients, sperm cryopreservation should be offered to all pubertal male patients. For prepubertal boys, only the experimental option of testicular biopsy in order to cryopreserve testicular stem cells can be proposed.

Primary aims

- To cryopreserve testicular tissue of prepubertal patient receiving highly gonadotoxic oncological treatment.

Secondary aims

* To cryopreserve testicular tissue after failure of sperm cryopreservation in pubertal patient with high risk of infertility
* To create a database in order to record clinical and biological follow-up data
* To create a research biobank for future research projects

Multicentric study: HUG, CHUV, UKBB

Male Fertility Preservation Using Cryopreservation of Testicular Tissue Before Highly Gonadotoxic Cancer Treatment

The safety will be assessed by recording the number of complications of the procedure (e.g. bleeding, infection, testicular atrophy)

Comparison of biochemical markers (e.g., FSH; LH, AMH; Inhibin B, SHBG and testosterone) between patients who undergo testicular biopsy and controls

Symptoms and General Pathology

Tissue Adhesions

Cicatrix

Fibrosis

Pharmaceutical Solutions

Patient randomized in this arm have been treated with Prevadh film applied on the uterine surgical sites, at the end of the myomectomy surgery to prevent post-surgey adhesion formation.

Patients randomized in the Ringer solution group have been treated with Ringer lactate solution directly applied to the uterine surgical sites at the end of the myomectomy surgery.

Ringer lactate solution was applied directly onto the uterine surgical sites at the end of the myomectomy surgery, to prevent post-surgical adhesion formation.

Ringer lactate solution

Prevadh film was applied directly onto the uterine surgical sites at the end of the myomectomy surgery to prevent post-surgical adhesion formation.

Prevadh film

BECKER Patrice

CANIS Michel, Pr

The purpose of this study was to evaluate clinically the efficacy of the PREVADH® Film in the prevention of adhesions in gynaecologic surgery, and to assess post-operative complications related to adhesions and pregnancy rate after myomectomy by open surgery.

This study was addressed to patients having an immediate or differed pregnancy desire and presenting a symptomatic or asymptomatic fibroma being able to interfere with fertility.

* The primary end point was the assessment of adhesion rate to the uterine surgical sites during a laparoscopic second look performed 10 to 20 weeks post-surgery.
* The secondary end points were the assessment, throughout a 3 years follow-up period, of:

  * pregnancy rate,
  * adverse events related to adhesions,
  * adnexal adhesions according to American Fertility Society score,
  * abdomino-pelvic adhesions according to the modified American Fertility Society score.

Efficacity Assessment of PREVADH® in Adhesion Prevention in Gynaecologic Surgery

Efficacy and Safety of Prevadh™ in the Prevention of Adhesions in Gynaecological Surgery: a Multicenter, Randomized, French Study

The primary endpoint was the assessment of adhesions to uterine scars and comprised the incidence (expressed per patient and per uterine scar), extent, and severity of adhesions observed during the second-look laparoscopy performed 10 to 20 weeks after the myomectomy.

This assessment was made by the surgeon (investigator) on the one hand and by two independent surgeons who reviewed the video recordings on the other hand.

Fertility was assessed by pregnancy and deliveries rates at 3 years.

Adnexal Adhesions were assessed by AFS score. AFS (= American Fertility Society) score was developed in 1980's by the American Fertility Society in an effort to address needs for a classification scheme for adnexal adhesions suspected to be associated with infertility. 4 anatomic sites evaluated: R-tube; R-ovary; L-tube; L-ovary. Final AFS score for a patient is the score of the side with lower summed score. The higher score, representing the side with the higher adhesion burden, is dropped; Score AFS is from 0 (best possible outcome) to 32 (worse possible outcome).

mAFS abdominopelvic adhesion score in 23 sites (at the anterior caudal peritoneum; parietocolic gutter right; right and left colon; right and left anterior cranial peritoneum; rectosigmoid; omentum; small intestine; anterior and posterior uterus; posterior cul-de-sac; right and left ovaries \[internal and lateral sides\], pelvic side walls, ovarian fossae, tubes, and bulbs). It ranges from 0 (best possible outcome) to 16 (worse possible outcome).

Registrat-Mapi

Medtronic - MITG

Patients randomized in the Prevadh group have been treated with Prevadh Film directly applied to the uterine surgical sites at the end of the myomectomy surgery.

Prevadh™ (P) Group With Adverse Event

Patients randomized in the Ringer solution group have been treated with Ringer lactate solution directly applied to the uterine surgical sites at the end of the myomectomy surgery.

.

Ringer Lactate™ (R) Group With Adverse Event

Prevadh film was applied directly onto the uterine surgical sites at the end of the myomectomy surgery to prevent post-surgical adhesion formati.

Prevadh™ (P) Group

Ringer Lactate™ (R) Group

Total

Age, Categorical

Gender

the surgeons were not blinded to the patients' allocation group at second-look laparoscopy.Recruitment was stopped early. 2 data analyses have been performed over the study period for primary endpoint, without any error type I adjustment.

Patrice BECKER, Global Director, Clinical Affairs

Two patients in group Prevadh group were withdrawn from the study, at 1 and 6 days post-myomectomy. One patient was re-operated for compress removal in Prevadh group and was excluded. Two patients in group Lactate Ringer group were withdrawn from the study, at 1 and 6 days post-myomectomy.

Number of Patients With Adhesions to Uterine Scars

Pregnancy rates at 3 years

Delivery rates at 3 years

Patients randomized in the Prevadh group have been treated with Prevadh film directly applied to the uterine surgical sites at the end of the myomectomy surgery.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Female Fertility Preservation Using Ovarian Tissue Cryopreservation Before Highly Gonadotoxic Cancer Treatment	NCT03180827	Childhood Cance... Fertility Disor...	ovarian tissue ...	2 Months - 18 Years	University Hospital, Geneva
Cryopreservation of Prepubertal Testicular Tissue for Preservation of Fertility in Young Boys With Cancer	NCT06063551	Fertility Disor... Childhood Cance...	Testicular Biop...	1 Day - 18 Years	University of Edinburgh
Fertility After Uterine Artery Embolization	NCT05271981	Fertility Disor... Fertility Issue... Myoma;Uterus Uterine Artery ...	Retrospective d... Phone interview	18 Years - 45 Years	Assistance Publique - Hôpitaux de Paris
Infertility and Pregnancy Outcomes of Fertility Spared Gynecological Oncology Patients	NCT05823194	Fertility Disor... Gynecologic Can...	Fertility spari...	20 Years - 49 Years	Acibadem University
Fertility After Uterine Artery Embolization	NCT05271981	Fertility Disor... Fertility Issue... Myoma;Uterus Uterine Artery ...	Retrospective d... Phone interview	18 Years - 45 Years	Assistance Publique - Hôpitaux de Paris
Fertility After Uterine Artery Embolization	NCT05271981	Fertility Disor... Fertility Issue... Myoma;Uterus Uterine Artery ...	Retrospective d... Phone interview	18 Years - 45 Years	Assistance Publique - Hôpitaux de Paris
Male Fertility Preservation Using Cryopreservation of Testicular Tissue Before Highly Gonadotoxic Cancer Treatment	NCT03180918	Childhood Cance... Fertility Disor...	testicular tiss...	3 Months - 18 Years	University Hospital, Geneva
Efficacity Assessment of PREVADH® in Adhesion Prevention in Gynaecologic Surgery	NCT01388907	Uterine Fibroid... Fertility Disor...	Ringer lactate ... Prevadh film	20 Years - 42 Years	Medtronic - MITG

Spots Global Cancer Trial Database for fertility disorders