Utilization rates and results of long-term embryo cryopreservation before gonadotoxic treatment

Abstract

Purpose The aim of this study was to evaluate long-term embryo cryopreservation, utilization, and success rate in patients subjected to gonadotoxic treatments in the context of cancer. Methods This is a retrospective study on patients (n=54) undergoing ovarian stimulation and IVF for fertility preservation between January 1997 and June 2014. Embryos were slowfrozen and stored until the women were cured and able to undergo embryo transfer. Results Fifty-four women underwent 66 oocyte pick-up procedures in total, and embryos were obtained from 52 of the 54 patients. Four patients died before their frozen embryos could be thawed. Of the remaining 48, 9 women returned to use their embryos, resulting in 6 pregnancies (66 % cumulative pregnancy rate), two of which ended in miscarriage. The live birth rate per patient was thus 44 % (4/9). The true come-back rate, calculated after applicable exclusions, was found to be 23 %. Conclusion IVF followed by embryo freezing is a widely established technique for fertility preservation, but little has been published on the outcomes in cancer patients. While we found the number of good-quality embryos to be lower than in a normal population, the cumulative live birth rate was similar to that achieved with fresh embryos in non-cancer patients. The utilization rate of this fertility preservation method can be considered high.

Recent advances in fertility preservation

“…regarding pregnancy and LBR in women affected by cancer seeking to preserve their fertility, embryos were obtained from 52 of 54 patients undergoing COS for embryo cryopreservation. The cumulative pregnancy rate achieved was 66% and the LBR per patient was 44%, similar to rates obtained with fresh embryos in noncancer patients. However, fewer good‐quality embryos were found in cancer survivors than in the normal infertile population …”

“…The cumulative pregnancy rate achieved was 66% and the LBR per patient was 44%, similar to rates obtained with fresh embryos in noncancer patients. However, fewer good‐quality embryos were found in cancer survivors than in the normal infertile population …”

“…In a study by Dolmans et al . regarding pregnancy and LBR in women affected by cancer seeking to preserve their fertility, embryos were obtained from 52 of 54 patients undergoing COS for embryo cryopreservation.…”

Advances in the Treatment and Prevention of Chemotherapy-Induced Ovarian Toxicity

“…One retrospective study demonstrated that pregnancy rate per transfer for cancer patients was similar to patients who underwent IVF due to tubal factor infertility (37% versus 43%, p = 0.49) and live birth rate per transfer was also was not significantly different (30% versus 32%, p = 0.85) [ 70 ]. In addition, studies that compared IVF and embryo cryopreservation in cancer patients to those without cancer did not show significant differences in the number of harvested oocytes, fertilization rate, and live birth rate, although there were few good quality embryos in patients with cancer [ 71 , 72 ].…”

SEOM Clinical Guideline of fertility preservation and reproduction in cancer patients (2016)

“…Different methods to preserve fertility could be proposed depending on patients’ age, current success rate, required delay in cancer treatment, required ovarian stimulation, sperm requirement and risk of reintroducing malignant cells (Table 5) [20–22]:…”