INTRODUCTION: The standard procedure in cervical cancer is radical hysterectomy and pelvic lymphadenectomy (PLND). Because of the increasing age of women bearing children, fertility has become a major challenge. We present pregnancy results after less radical fertility-sparing surgery in women with IA1, LVSI positive, IA2 and IB1 (<2 cm, infiltration less than half of the cervical stroma). MATERIALS AND METHOD: All women (n = 91) underwent laparoscopic sentinel lymph node mapping with frozen section followed by PLND and "selective parametrectomy" (removal of afferent lymphatic channels from the paracervix) if sentinel nodes (SLN) are negative. If lymph nodes were verified negative by definitive histopathology, patients were treated by simple trachelectomy (IB1) or large cone (IA1/IA2) biopsy 1 week after primary surgery. RESULTS: From 1999 to 2018, 91 women were enrolled in the study (median age 29.1 years, range 21-40). Fertility was spared in 76 (83.5%) women; 13 (17.1%) women did not plan future pregnancy and 63 (82.9%) had pregnancy desires. Fifty-four of 63 women conceived (pregnancy rate 85.7%) and 48 of 63 delivered 58 babies (delivery rate 76.2%). Thirty-nine women delivered in term (67.2%): 13 women between 32 and 36 + 6 weeks of pregnancy, 3 between 28 and 31 + 6 weeks and 3 between 24 and 27 + 6 weeks. Only one woman still plans pregnancy. One woman is currently pregnant. CONCLUSION: The goal of fertility-sparing surgery is to produce good oncological results and promising pregnancy outcomes. Pregnancy results after less radical fertility-sparing procedures show promise (pregnancy rate 82.9% and delivery rate 76.2%).

• Klíčová slova
• Cervical cancer, Less radical fertility-sparing surgery, Pregnancy outcomes, Sentinel lymph node mapping,
• MeSH
• biopsie sentinelové lymfatické uzliny MeSH
• cerkláž cervikální MeSH
• cervix uteri * patologie   chirurgie   MeSH
• dospělí MeSH
• fertilita * fyziologie   MeSH
• laparoskopie MeSH
• lidé MeSH
• mladý dospělý MeSH
• nádory děložního čípku * diagnóza   patologie   chirurgie   MeSH
• peritoneum chirurgie   MeSH
• předčasný porod epidemiologie   MeSH
• těhotenství MeSH
• trachelektomie MeSH
• výsledek těhotenství * MeSH
• zachování plodnosti * metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

BACKGROUND: Fertility-sparing treatment in patients with cervical cancer should, in principle, follow identical algorithms to that in patients without future reproductive plans. In recent years, a trend toward nonradical procedures, such as conization or simple trachelectomy, has become apparent in medical literature, because of their associations with better pregnancy outcomes. However, the published reports included small numbers of patients and heterogenous treatment strategies to ascertain the safety of such approaches. OBJECTIVE: This study aimed to collect multi-institutional data regarding the oncological outcomes after fertility-sparing treatment in patients with cervical cancer and to identify prognostic risk factors, including the influence of the radicality of individual cervical procedures. STUDY DESIGN: Patients aged 18 to 40 years with International Federation of Gynecology and Obstetrics 2018 stage IA1 with positive lymphovascular space invasion or ≥IA2 cervical cancer who underwent any type of fertility-sparing procedure were eligible for this retrospective observational study, regardless of their histotype, tumor grade, and history of neoadjuvant chemotherapy. Associations between disease- and treatment-related characteristics with the risk of recurrence were analyzed. RESULTS: A total of 733 patients from 44 institutions across 13 countries were included in this study. Almost half of the patients had stage IB1 cervical cancer (49%), and two-thirds of patients were nulliparous (66%). After a median follow-up of 72 months, 51 patients (7%) experienced recurrence, of whom 19 (2.6%) died because of the disease. The most common sites of recurrence were the cervix (53%) and pelvic nodes (22%). The risk of recurrence was 3 times higher in patients with tumors >2 cm in size than in patients with smaller tumors, irrespective of the treatment radicality (19.4% vs 5.7%; hazard ratio, 2.982; 95% confidence interval, 1.383-6.431; P=.005). The recurrence risk in patients with tumors ≤2 cm in size did not differ between patients who underwent radical trachelectomy and patients who underwent nonradical (conization and simple trachelectomy) cervical procedures (P=.957), regardless of tumor size subcategory (<1 or 1-2 cm) or lymphovascular space invasion. CONCLUSION: Nonradical fertility-sparing cervical procedures were not associated with an increased risk of recurrence compared with radical procedures in patients with tumors ≤2 cm in size in this large, multicenter retrospective study. The risk of recurrence after any type of fertility-sparing procedure was significantly greater in patients with tumors >2 cm in size.

• Klíčová slova
• cervical cancer, conization, fertility-sparing treatment, recurrence, trachelectomy,
• MeSH
• cervix uteri chirurgie   patologie   MeSH
• lidé MeSH
• nádory děložního čípku * chirurgie   patologie   MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• staging nádorů MeSH
• těhotenství MeSH
• výsledek těhotenství MeSH
• zachování plodnosti * metody   MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH

UNLABELLED: : Objective: Endometriosis is a chronic disease with a relatively high prevalence in the female population. Both the disease itself and its surgical treatment can adversely affect the fertility of patients. For this reason, endometriosis is offered as a possible indication for fertility preservation by cryopreservation methods. The aim of this paper is to present the current knowledge on the options of fertility preservation in this subpopulation. METHODS: Search of relevant literature in PubMed/Medline, Web of Science and Scopus databases. RESULTS: Fertility preservation by cryopreservation methods has so far been used mainly in the care of women with cancer. With increasing experience, the effectiveness and availability of these methods have increased significantly and the indication spectrum has been extended to selected benign diseases such as endometriosis. Three techniques are currently established in practice: embryo cryopreservation, oocyte cryopreservation and ovarian tissue cryopreservation. Oocyte cryopreservation is the most commonly used technique, since it is the most advantageous for the patient and, according to the available data, is an effective way to increase the chances of future pregnancy for patients with endometriosis The purpose is to realize the protection of reproduction before the planned operation. CONCLUSION: The diagnosis of endometriosis negatively affects the fertility of women. For some patients, the solution is fertility preservation by cryopreservation methods. Further clinical studies are needed to define exact, practically applicable indication criteria, potential risks of procedures and their benefits and cost-effectiveness.

• Klíčová slova
• Endometriosis, embryo cryopreservation, fertility preservation, oocyte cryopreservation, ovarian tissue cryopreservation,
• MeSH
• endometrióza * komplikace   MeSH
• kryoprezervace metody   MeSH
• lidé MeSH
• nádory * MeSH
• oocyty MeSH
• těhotenství MeSH
• zachování plodnosti * metody   MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Cervical cancer directly affects the reproductive function of women of childbearing age. Up to one-third of the disease is dia-gnosed in women younger than 45 years of age, who may still have open reproductive plans. Therefore, in recent years, there has been increasing interest in performing fertility-sparing treatment (FST), which aims to preserve fertility while achieving the same oncologic safety as radical surgical treatment. OBJECTIVE: To summarize the current knowledge on FST in women with early stages of cervical cancer. METHODS: Review of published literature on the topic using medical databases. RESULTS: FST is reserved for patients with HPV-associated cervical cancer up to stage IB with negative nodes. Conservative procedures (conization and simple vaginal trachelectomy) and radical trachelectomy are available. Conservative procedures for tumors 2cm have comparable oncological outcomes as radical treatment with a significantly lower rate of perinatological complications. On average, 55% of patients become pregnant after treatment and of these, on average 70% give birth to a live newborn. Approximately 38% of deliveries are preterm, most often after radical trachelectomy. The most common postoperative complication with direct impact on fertility is cervical stenosis. CONCLUSION: In a selected group of patients with tumors up to 2cm, FST is a safe procedure with good perinatological outcomes. However, it remains unclear whether it is safe to offer this treatment to patients with larger tumors. The use of neoadjuvant chemotherapy followed by conservative surgery is a promising approach but requires further validation in clinical trials.

• Klíčová slova
• cervical cancer, cervical uterine cancer, conization, fertility-sparing treatment, trachelectomy,
• MeSH
• fertilita MeSH
• lidé MeSH
• nádory děložního čípku * chirurgie   patologie   MeSH
• neoadjuvantní terapie MeSH
• novorozenec MeSH
• staging nádorů MeSH
• těhotenství MeSH
• trachelektomie * metody   MeSH
• zachování plodnosti * metody   MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Fertility preservation in cancer patients or oncofertility is a relatively new trend in modern medicine. In patients with unfulfilled reproductive plans, the possibility of starting a family is one of the key parameters of quality of life after overcoming a cancer. Guidelines have existed since 2013 and in 2020 the European Society of Human Reproduction and Embryology has also published a guideline, but the main problem of their application in clinical practice is the lack of information for both patients and, unfortunately, professionals, as well as the high cost of treatment. From 2022, health insurance companies in the Czech Republic partially cover the expenses for fertility preservation treatment for cancer patients. The possibilities of oncofertility are based, on the one hand, on improving the results of oncological treatment, on the other hand, on the development of reproductive technologies. Thanks to progress in treatment, up to 80% of pediatric oncology patients survive into adulthood, but chemotherapy, especially highly effective alkylating agents, is associated with a high risk of impaired fertility. This article overviewed9 modern global trends of fertility preservation in women undergoing cancer treatment based on an analysis of the English-language literature over the past 5 years.

• Klíčová slova
• embryo cryopreservation, fertility preservation, gonadotropin-releasing hormone agonists, oncofertility, oocyte cryopreservation, oocyte in vitro maturation, ovarian tissue cryopreservation,
• MeSH
• dítě MeSH
• dospělí MeSH
• fertilita MeSH
• kryoprezervace metody   MeSH
• kvalita života MeSH
• lidé MeSH
• nádory * komplikace   terapie   MeSH
• oocyty MeSH
• zachování plodnosti * metody   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The incidence of endometrial cancer in young women is increasing, especially in developed countries. Although it is predominantly a disease of peri- and postmenopausal women, there is an absolute increase in younger women of childbearing age who, with today's lifestyle and pushing back maternal needs, do not have fulfilled reproductive plans. About 67% of cancers are diagnosed in the early stages. For these women, fertility-preserving procedures can be considered until reproductive plans are fulfilled. Subsequently, however, definitive management is appropriate even in the absence of carcinoma. This article discusses the most common gynecologic pelvic cancer, endometrial adenocarcinoma, and the possibility of fertility-preserving procedures.

• Klíčová slova
• endometrial (endometrioid) carcinoma, endometrial cancer, fertility sparing, young woman,
• MeSH
• fertilita MeSH
• lidé MeSH
• nádory endometria * patologie   terapie   MeSH
• nádory ženských pohlavních orgánů * MeSH
• zachování plodnosti * metody   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

AIMS: Curative sphincter sparing radiotherapy is a treatment option for early rectal cancer. There are many methods developed for fertility preservation in young patients treated with pelvic radiotherapy. Pregnancy rates after radiotherapy are dependent on the radiation dose to ovaries and uterus. Data on outcomes of total body irradiation suggest a pregnancy is possible following 12-14 Gy TBI, despite elevated rates of preterm deliveries and other complications. METHODS: We report a case of full-term delivery of twins after curative chemoradiotherapy for anorectal adenocarcinoma T2 N0 M0 with the total dose 58.6 Gy. The patient underwent laparoscopic laterocranial ovarian transposition before radiotherapy. RESULTS: Long term complete remission was achieved after treatment. Although a spontaneous conception was not successful, the patient underwent an in vitro fertilisation procedure with donor eggs and conceived twins 10 years after the radiotherapy treatment. The mean dose to the uterus was 16 Gy and to the uterine cervix 35 Gy. She reached a full-term pregnancy and delivered two healthy babies by caesarean section at a gestational age of 38 weeks, weighing 2420 g and 2220 g. CONCLUSION: This is the first case report of the successful pregnancy following sphincter sparing curative pelvic radiotherapy for rectal cancer. Furthermore it allows us to propose an increased limit dose to the uterus enabling fertility sparing beyond the limits achieved from total body irradiation series with 12-14 Gy and accept 16 Gy as uterine body (35 Gy for uterine cervix) limit for IMRT treatment planning in young patients asking for maintaining fertility potential.

• Klíčová slova
• dose constraints, fertility sparing, radiotherapy, rectal adenocarcinoma, uterus dose,
• MeSH
• adenokarcinom terapie   MeSH
• celková dávka radioterapie MeSH
• chemoradioterapie * MeSH
• dospělí MeSH
• fertilizace in vitro MeSH
• léčba šetřící orgány metody   MeSH
• lidé MeSH
• nádory rekta terapie   MeSH
• těhotenství MeSH
• uterus MeSH
• výsledek těhotenství MeSH
• zachování plodnosti metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Cervical cancer is increasingly diagnosed in women who have not yet completed their reproductive plans. For women with early-stage disease (FIGO stage IA1-IB1), fertility-sparing procedures, such as conization, trachelectomy or radical trachelectomy, represent the treatments of choice. However, women who undergo repeated conization or trachelectomy represent a challenge for obstetricians because they are at increased risk of infertility, mid-trimester miscarriage, preterm premature rupture of membranes and preterm delivery. So far, the evidence-based guidance on the management of these pregnancies is limited. This article reviews the literature discussing pregnancy management in women after fertility-sparing surgery for early cervical cancer. Although the evidence is limited, certain measures are desirable, including screening and treatment of asymptomatic bacteriuria, screening for cervical incompetence and progressive cervical shortening by transvaginal ultrasonography, and fetal fibronectin testing. Vaginal progesterone supplementation should be primary prevention for all women after trachelectomy. Women with a history of preterm delivery or late miscarriage may benefit from cervical cerclage. Elective delivery by cesarean section in the early-term period is desirable.

• Klíčová slova
• cerclage, fertility-sparing surgery, fetal fibronectin, preterm labor, preterm premature rupture of membranes, trachelectomy,
• MeSH
• dospělí MeSH
• gynekologické chirurgické výkony metody   MeSH
• lidé MeSH
• nádory děložního čípku chirurgie   MeSH
• těhotenství MeSH
• úhrn těhotenství na počet žen v reprodukčním věku MeSH
• výsledek těhotenství * MeSH
• zachování plodnosti metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

INTRODUCTION/OBJECTIVES: Fertility preservation is a major concern for adolescent cancer patients; yet, educational gaps remain. Our intervention study examined whether specially designed educational materials regarding fertility preservation increase knowledge and empowerment of patients and parents. METHODS: Eleven paediatric-oncological centres in four European countries agreed to enrol all eligible patients and parents in a questionnaire survey at 3 and 6 months after diagnosis. Treating physicians were surveyed on their medical consultation regarding fertility. RESULTS: Educational intervention increased knowledge in both patients (n = 113 and n = 101 in the control and intervention groups, respectively) and parents (n = 111 and n = 99 in the control and intervention groups, respectively), but the difference did not achieve statistical significance (knowledge difference patients: 5.6% (t0)/13.1% (t1); parents: 6.4% (t0)/3.8% (t1)). Parents of older patients (OR = 1.3, 95%CI = 1.1-1.7) and higher educational groups (OR = 6.2, 95%CI = 2.1-18.3) in the intervention group (OR = 1.9, 95%CI = 1.03-3.7) achieved higher knowledge levels. Empowerment was significantly improved in both patients (p = 0.046, d = 0.27) and parents (p = 0.046, d = 0.48) in the intervention group. DISCUSSION/CONCLUSIONS: In our study, the use of specifically prepared flyers and brochures successfully raised the level of fertility preservation knowledge in parents of older patients as well as parents with higher educational levels. Overall, the intervention improved patient and parent empowerment. Subsequent projects will include simpler information and digital material to particularly reach out to younger and less educated individuals.

• Klíčová slova
• childhood cancer, fertility impairment, fertility preservation, informational material, knowledge, paediatric oncology, patient education, patient empowerment,
• MeSH
• empowerment * MeSH
• lékařská onkologie organizace a řízení   MeSH
• lidé MeSH
• mladiství MeSH
• nádory terapie   MeSH
• vzdělávání pacientů jako téma metody   MeSH
• zachování plodnosti metody   psychologie   MeSH
• zdraví - znalosti, postoje, praxe * MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

Successful derivation and cultivation of primordial germ cells (PGCs) opened the way to efficient transgenesis and genome editing in the chicken. Furthermore, implantation of male PGCs from non-chicken galliform species into the chicken embryos resulted in cross-species germline chimeras and viable offspring. We have recently improved the PGC technology by demonstrating that chicken male PGCs transplanted into the testes of adult cockerel recipients mature into functional sperms. However, the availability of this orthotopic transplantation for cross-species transfer remains to be explored. Here we tested the capacity of genetically distant male PGCs to mature in the microenvironment of adult testes. We derived PGCs from the Chinese black-bone Silkie and transplanted them into infertile White Leghorn cockerels. Within 15-18 weeks after transplantation, we observed restoration of spermatogenesis in recipient cockerels and production of healthy progeny derived from the transplanted PGCs. Our findings also indicate the possibility of cross-species orthotopic transplantation of PGCs. Thus, our results might contribute to the preservation of endangered avian species and maintaining the genetic variability of the domestic chicken.

• Klíčová slova
• implantation, primordial germ cells, spermatogenesis, testis,
• MeSH
• chiméra genetika   MeSH
• chov metody   MeSH
• křížení genetické MeSH
• kultivované buňky MeSH
• kur domácí * klasifikace   genetika   MeSH
• kuřecí embryo MeSH
• ohrožené druhy MeSH
• spermatogeneze fyziologie   MeSH
• spermie cytologie   transplantace   MeSH
• testis cytologie   MeSH
• transplantace heterologní veterinární   MeSH
• zachování plodnosti metody   veterinární   MeSH
• zachování přírodních zdrojů * metody   MeSH
• zárodečné buňky transplantace   MeSH
• zvířata MeSH
• Check Tag
• kuřecí embryo MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH