Experiences in fertility preservation: lessons learned to ensure that fertility and reproductive autonomy remain options for cancer survivors
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Assess fertility preservation (FP) measures chosen by patients newly diagnosed with malignancy and their outcomes.
Reproductive-age patients referred for FP underwent counseling and elected cryopreservation vs. no treatment. Outcome measures included ovarian stimulation, FP choice, oocytes/zygotes retrieved/cryopreserved and pregnancy outcome.
From 2005 to 2012, 136 patients were counseled with 124 electing treatment: 83 oocyte-only, 21 oocyte + zygote and 20 zygote-only cryopreservation. Age, partnership and financial status factored into FP choice. Treatment was completed in 12 ± 2 days with 14 ± 11 metaphase-II oocytes harvested and cryopreserved/cycle. Eight patients returned to attempt pregnancy; three succeeded.
Our data demonstrate that oocyte and/or zygote banking are feasible FP options for women with malignancy; given the choice, the majority elected oocyte cryopreservation, highlighting desire for reproductive autonomy. Continued growth and research, combined with interdisciplinary communication, will ensure that appropriate candidates are offered FP and the potential for future parenthood, an important quality-of-life marker for survivors.
KeywordsCancer survivor Fertility preservation Oocyte cryopreservation Embryo cryopreservation Quality-of-life
Dr. Noyes would like to acknowledge Dr. Eleonora Porcu of Bologna, Italy for introducing her to oocyte cryopreservation technology and its application as a fertility preservation measure for cancer patients. She also wishes to thank all the oncologists who entrusted her with the FP care of their patients as well as the entire IVF team at the NYULFC, especially Dr. James Grifo and Patti Labella for their efforts in making the oocyte cryopreservation program a success.
Conflicts of interest
None of the authors has a conflict of interest.
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