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Aim The aim of this official guideline published by the German Society of Gynecology and Obstetrics (DGGG) and coordinated with the German Society of Urology (DGU) and the German Society of Reproductive Medicine (DGRM) is to provide consensus-based recommendations, obtained by evaluating the relevant literature, on counseling and fertility preservation for prepubertal girls and boys as well as patients of reproductive age. Statements and recommendations for girls and women are presented below. Statements or recommendations for boys and men are not the focus of this guideline. Methods This S2k guideline was developed at the suggestion of the guideline commission of the DGGG, DGU and DGRM and represents the structured consensus of representative members from various professional associations (n = 40). Recommendations The guideline provides recommendations on counseling and fertility preservation for women and girls which take account of the patient's personal circumstances, the planned oncologic therapy and the individual risk profile as well as the preferred approach for selected tumor entities. Ziel Das Ziel dieser offiziellen Leitlinie, die von der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) publiziert und zusammen mit der Deutschen Gesellschaft für Urologie (DGU) sowie Deutschen Gesellschaft für Reproduktionsmedizin (DGRM) koordiniert wurde, ist es, durch die Evaluation der relevanten Literatur konsensbasierte Handlungsempfehlungen für die Beratung und den Einsatz von fertilitätserhaltenden Maßnahmen bei präpubertären Mädchen und Jungen sowie für Patienten/-innen im reproduktiven Alter zu geben. Im Folgendem werden die Statements und Empfehlungen für Mädchen und Frauen dargestellt. Die Statements und Empfehlungen für Jungen und Männer sind nicht Inhalt dieser Publikation. Methoden Diese S2k-Leitlinie wurde durch einen strukturierten Konsens von repräsentativen Mitgliedern verschiedener Fachgesellschaften (n = 40) im Auftrag der Leitlinienkommission der DGGG, DGU und DGRM entwickelt. Empfehlungen Es werden Empfehlungen zur Beratung und dem Einsatz von fertilitätserhaltenden Maßnahmen bei Patientinnen unter Berücksichtigung der Lebensumstände, der geplanten onkologischen Therapie und des individuellen Risikoprofils dargestellt sowie über das Vorgehen bei ausgewählten Tumorentitäten.

Objective: The publication of the results of the Women's Health Initiative randomized controlled trial in 2002 resulted in a critical discussion on the risks and benefits of hormone therapy (HT), including estrogen plus progestogen therapy and estrogen therapy. The aim of the present study was to evaluate German gynecologists' self-prescription habits regarding HT compared with their habits of prescribing HT to their patients, as an expression of their attitude toward HT. Methods: A self-administered, anonymous questionnaire was sent to all 9,589 German gynecologists in private practice in November 2010. Results: The response rate was 3,227 (33.7%). This article reports the results for 2,549 eligible questionnaires. A total of 2,459 (97.0%) respondents favored HT for themselves or their female partner. Conclusions: This report describes the first study in Germany showing an underuse of HT among patients in comparison with the self-administration behavior of gynecologists. For various indications, most German gynecologists favored HT for themselves or their female partner (female gynecologists, n = 1,538, 96%; male gynecologists, n = 917, 98.5%, respectively). This study demonstrates that although the great majority of German gynecologists have a favorable attitude regarding personal use of HT, various discrepancies between physician and patient care exist, especially for the indications of cognitive disorders, achievement of overall well-being, and antiaging. This finding calls for a more unified treatment of perimenopausal and postmenopausal disorders.

Aim: The aim of this study was to compare self-reported questionnaire-based information on fertility impairment with results from hormone analyses in women who underwent chemoradiotherapy during childhood and adolescence. Material and Methods: In a cross-sectional study, questionnaires and hormone analyses (anti-Mullerian hormone [AMH], follicle-stimulating hormone, luteinizing hormone, estradiol, progesterone) were evaluated in 86 female former pediatric oncology patients in Berlin in 2009. Results: Eighty-six women (median age 23 years, range 19–41) participated in the study with a median follow up of 14 years (range 2–30) after diagnosis. Among women with information on permanent and transient amenorrhea, 9% (5/55) of the women stated that they were permanently amenorrheic. Among women not taking oral contraceptives and giving information on the regularity of their menstrual cycle, 18% (4/22) had an irregular menstrual cycle and 82% (18/22) had a regular menstrual cycle. The median AMH values for women who were categorized as infertile by questionnaire-based information were significantly lower than the AMH values of women who were categorized as fertile by questionnaire (0.05 vs 2.2 ng/mL, P = 0.004). Questionnaire-based categories on the regularity of the menstrual cycle and categories based on AMH values showed a satisfying percentage agreement (66.7%) and were moderately correlated (r = 0.42, P = 0.002). Conclusion: Self-reported questionnaire data used to detect fertility impairment has limited correspondence with objectively measured AMH values.

Young patients with cervical cancer who undergo chemoradiation might be interested in fertility preservation, not only dependent upon the use of a gestational carrier as maybe achieved by the use of ovarian transposition and cryo-conservation of oocytes or ovarian tissue, but may prefer to carry pregnancy to term after cancer treatment. The latter approach is a non- established concept needing both modern radiation therapy approaches as well as modifications -if at all possible- in current recommendations for target volume delineation to spare dose to the unaffected uterus. Future strategies to serve selected patients in this respect should only be conducted in prospective clinical evaluations and are critically discussed in this article.

The aim of this study was to compare self-reported questionnaire-based information on fertility impairment with results from hormone analyses in women who underwent chemoradiotherapy during childhood and adolescence.In a cross-sectional study, questionnaires and hormone analyses (anti-Müllerian hormone [AMH], follicle-stimulating hormone, luteinizing hormone, estradiol, progesterone) were evaluated in 86 female former pediatric oncology patients in Berlin in 2009.Eighty-six women (median age 23 years, range 19-41) participated in the study with a median follow up of 14 years (range 2-30) after diagnosis. Among women with information on permanent and transient amenorrhea, 9% (5/55) of the women stated that they were permanently amenorrheic. Among women not taking oral contraceptives and giving information on the regularity of their menstrual cycle, 18% (4/22) had an irregular menstrual cycle and 82% (18/22) had a regular menstrual cycle. The median AMH values for women who were categorized as infertile by questionnaire-based information were significantly lower than the AMH values of women who were categorized as fertile by questionnaire (0.05 vs 2.2 ng/mL, P = 0.004). Questionnaire-based categories on the regularity of the menstrual cycle and categories based on AMH values showed a satisfying percentage agreement (66.7%) and were moderately correlated (r = 0.42, P = 0.002).Self-reported questionnaire data used to detect fertility impairment has limited correspondence with objectively measured AMH values.