Obstetric outcome after oocyte vitrification and warming for fertility preservation in women with cancer

Abstract

Obstetric outcome of first pregnancies achieved after vitrification and warming oocytes from women being treated for cancer was evaluated. Of a total of 493 women who consulted for fertility preservation, 357 had their oocytes cryopreserved after being diagnosed with cancer, and 11 returned after being cured for assisted reproduction treatments (eight had breast cancer, one Hodgkin lymphoma, one endometrial adenocarcinoma, and one thyroid cancer). The oocyte survival rate was 92.3%, the fertilization rate was 76.6%, and the mean number of embryos transferred was 1.8 ± 0.7. Beta-human chorionic gonadotropin was detected in seven out of the 11 embryo transfers carried out. Four ongoing pregnancies were achieved and delivered at term with normal fetal weight and no major or minor malformations. Women diagnosed with cancer who have their eggs cryopreserved before anti-cancer treatment have good assisted reproductive technology performance and good perinatal outcomes. Cryopreservation of oocytes seems to be a good alternative for fertility preservation in these women.

Successful Oocyte Cryopreservation in Reproductive-Aged Cancer Survivors

“…Commensurate with their higher estradiol response, those with hematologic malignancies had more oocytes retrieved (22, interquartile range 13-30), oocytes cryopreserved (19, interquartile range 10-30), and metaphase II oocytes cryopreserved Because the gynecologic cancer group represented a heterogeneous blend of patients, and because this group is the oncologic patient population for which gynecologists provide care, we subdivided the oocyte yield outcomes of these patients to assess differences. These data are also shown in Table 2 [8][9][10][11][12][13][14][15][16][17][18][19][20]. Compared with the expected value for age, patients with ovarian, uterine, and cervical malignancies had a median of 27 (interquartile range 214 to 1), +12 (interquartile range 23 to 13), and +4 (interquartile range 28 to 8) oocytes retrieved, respectively.…”

“…[9][10][11] However, few live births from oocyte cryopreservation have been described in cancer survivors. [12][13][14] We performed this study to demonstrate that oocyte cryopreservation is a feasible reproductive option for women of childbearing age who require gonadotoxic therapies.…”

IVF for fertility preservation in breast cancer patients—efficacy and safety issues

“…A large meta-analysis, however, has outlined lower ongoing pregnancy rates (>20 weeks of gestation) when warmed oocytes were in use [26], and this finding was proposed to stem from studies heterogeneity. As opposed to donors and infertile subjects, for oncologic patients, data is currently limited to several case reports and small series [27][28][29][30][31][32]. In the meantime, while information on outcomes for this population is awaited, experience drawn from infertile patients/oocyte recipients can be used when consulting cancer patients seeking fertility preservation.…”

Pharmacological options for the protection of ovarian function in patients undergoing chemotherapy

“…Oocyte cryopreservation before oncotherapy may offer hope, although the success of this technique is often limited by the number of available oocytes after stimulation, and the availability of time for ovarian stimulation. 3 Embryo freezing may be another option in women with a male partner at the time.…”