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Protecting fertilityFor many, parent is one of the happiest days in life. Unfortunately, 1 in 6 couples who want to conceive, fail to do so. This infertility has many different causes and we focus on reduced ovarian reserve and late effects of childhood cancer treatment. becoming a Helen Torrance and Frank Broekmans work at the Center for Reproductive Medicine which is an international and national expert center and global leader in the field of reproduction. Both care and research are aimed at optimizing the chances of a healthy conception and thereby the chances of a healthy child. 14 UMC Utrecht - Child research
ANTE- AND PERINATAL DAMAGE Helen Torrance MD, PhD specializes in reproductive medicine. She combines clinical and scientific research related to fertility. Her current interests include future fertility for children with chronic disease and optimizing successful implantation. htorranc@umcutrecht.nl Changing IVF protocols Ovarian ageing and reduced ovarian reserve have been a main topic of research at the Center for Reproductive Medicine for more than 20 years, and we’ve answered many diagnostic, prognostic, etiologic and therapeutic questions. One of our most recent multicenter randomized controlled trials studied the efficacy of individual hormonal treatment for IVF. We demonstrated that high doses of hormones in women with a reduced ovarian reserve actually do not increase her chances of having a baby. Our findings have helped change long-standing IVF practice in which high-dose hormones were prescribed for infertility. This is especially important as there are concerns that IVF impacts the long-term health of the children conceived through this technique. Although still unclear, high hormone doses may be a causal factor. Caring for the entire reproductive life cycle Ovarian ageing can have a clear cause, be idiopathically or be iatrogenically caused by, for example, cancer treatment. We collaborate with the Princess Maxima Center to provide both care and research for children with cancer, focusing on early fertility counselling and fertility preservation. can be devastating. We’re Infertility improving care for these patients so more people can enjoy the exceptional path of parenthood. - Helen Torrance This type of lifecycle medicine and care is also important for children with other childhood diseases that used to be lethal but are now considered chronic diseases. These children need follow-up care directly related to their condition and sadly, disease progression and exposure to medication during childhood and adolescence may affect their reproductive system. More research into current and future fertility of these patients is needed. Mapping out infertility If patients have concerns about future fertility, then fertility counselling and fertility preservation should be offered to all individuals at risk as becoming a parent may significantly contribute to a long-term improved quality of life. From 2019 onwards, we expect to complement existing long-term child health follow-up databases with fertility parameters so that early determinants can be connected to late fertility outcome. Our team will start by including girls with chronic hematologic conditions (for example, Diamond Blackfan anemia, sickle cell anemia or thalassemia; in collaboration with the department of haematology (Bartels) and will then extend this concept to other childhood diseases. Frank Broekmans MD, PhD is devoted to the mysteries behind ageing ovaries. He focuses on assessing fertility in childhood disease survivors with the goal of preventing early life onset genetic disease. His group conducts Preimplantation Genetic Diagnostic testing of embryos created by Assisted Reproductive Technology. fbroekma@umcutrecht.nl time to be proactive - to provide preventative It’s care for infertility and to avoid reproductive consequences of childhood disease. - Frank Broekmans UMC Utrecht - Child research 15
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