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.
- 9.Engmann L, DiLuigi A, Schmidt D, Nulsen J, Maier D, Benadiva C. The use of gonadotropin-releasing hormone (GnRH) agonist to induce oocyte maturation after cotreatment with GnRH antagonist in high-risk patients undergoing in vitro fertilization prevents the risk of ovarian hyperstimulation syndrome: a prospective randomized controlled study. Fertil Steril. 2008;89:84–91.PubMedCrossRefGoogle Scholar
- 14.Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Altekruse SF, Kosary CL, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations), National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER web site, 2012. Website accessed: 1/31/12.
- 18.Meirow D. Ovarian injury and modern options to preserve fertility in female cancer patients treated with high dose radio-chemotherapy for hemato-oncological neoplasias and other cancers. Leuk Lymphoma. 1999;33:66–76.Google Scholar
- 27.Partridge A, Gelber S, Gelber RD, Castiglione-Gertsch M, Goldhirsch A, Winer E. Age of menopause among women who remain premenopausal following treatment for early breast cancer: long-term results from International Breast Cancer Study Group Trials V and VI. Eur J Cancer. 2007;43:1646–53.PubMedCrossRefGoogle Scholar
- 28.Practice Committee of the Society for Assisted Reproductive Technology. Practice Committee of the American Society for Reproductive Medicine: Essential elements of informed consent for elective oocyte cryopreservation: a practice committee opinion. Fertil Steril. 2008;90:S134–5.Google Scholar
- 41.www.sart.org (accessed website 6/26/2012).