Responses to fertility treatment among patients with cancer: a retrospective cohort study

Abstract

BackgroundCancer treatments have significant negative impacts on female fertility, but the impact of cancer itself on fertility remains to be clarified. While some studies have shown that compared with healthy women, those with cancer require higher doses of gonadotropins resulting in decreased oocyte yields, others have shown comparable oocyte yields between the two groups. The purpose of this study is to evaluate whether there is an association between any cancer and/or type of cancer, and response to ovarian stimulation for egg and embryo banking.MethodsIn this retrospective cohort study, ovarian stimulation cycles performed from June 2007 through October 2014 at a single academic medical center were reviewed to identify those undertaken for women with cancer undergoing fertility preservation (n = 147) or women with no cancer undergoing their first cycle due to male factor infertility (n = 664). Of the 147 women undergoing fertility preservation, 105 had local cancer (Stage I-III solid malignancies) and 42 had systemic cancer (hematologic or Stage IV solid malignancies). Response to ovarian stimulation was compared among these two groups and women with no cancer.ResultsAdjusting for age and BMI, women with systemic cancer had lower baseline antral follicle counts (AFC) than women with no cancer or local cancer. Women with systemic cancer required higher doses of FSH than women with no cancer or local cancer, and they had higher oocyte to AFC ratios than women with no cancer or local cancer, but greater odds of cycle cancellation as compared to women with no cancer or local cancer. No significant differences were observed among the three groups for duration of stimulation, number of oocytes and mature oocytes retrieved, or number of embryos created.ConclusionsWomen with cancer achieve similar oocyte and embryo yields as women with no cancer, although those with systemic cancer require higher FSH doses and are at greater risk of cycle cancellation.

Oocyte Cryopreservation: Retrospective Analysis Of 5 Years Experience

“…In our study, the rate of patients who underwent oocyte cryopreservation due to cancer in all cycles was 31.7%. Similar to previous studies, the low ovarian reserve was not detected in this group of patients (20,21). The number of oocytes collected from patients in the Onco-FP group and thus the number of frozen oocytes was significantly higher than in the EFP group.…”

Fertility, sexuality and cancer in young adult women

“…Efficacy of oocyte/embryo cryopreservation in cancer patients has been addressed by several recent retrospective or prospective studies. Similar outcomes were found for the success of this strategy in cancer patients compared with nononcological women treated for social egg freezing [23][24][25][26][27]. In the retrospective study by Garcia-Velasco et al [23], the efficacy of oocyte cryopreservation was compared between 560 nononcological women, mainly treated for social egg freezing, and 355 cancer patients.…”

Fertility preservation before hematopoetic stem cell transplantation: a case series of women with GATA binding protein 2 deficiency, dedicator of cytokinesis 8 deficiency, and sickle cell disease

“…Additionally, in the setting of lifethreatening medical conditions, some may find oocyte disposition less emotionally and ethically challenging than embryo disposition. Oocyte to live-born child efficiency estimates provide reassurance that the use of vitrified oocytes should afford our patients similar probabilities of live birth when compared with in vitro fertilization with fresh oocytes (30)(31)(32)(33)(34). Doyle et al (30) published a retrospective evaluation of 128 autologous in vitro fertilization cycles using vitrified/ warmed oocytes cryopreserved for medical and elective indications.…”