#29 : A Retrospective Review of Patients Undergoing Fertility Preservation in a Tertiary Institution in Singapore Over 10 Years

Abstract

Background and Aims: Early detection and advancement in cancer treatments have drastically improved survivorship. Hence, there is a shift towards long-term quality of life goals such as protecting the oncologic patient’s fertility potential. The study aims to determine the uptake and use of fertility preservation options in women presenting at a tertiary institution in Singapore. This is the first review to outline the uptake rates, methods and fertility outcomes among women undergoing fertility preservation in Singapore. Method: The study is a retrospective review of premenopausal female patients presenting to a single tertiary institution between 2010 and 2019 for fertility preservation. Our primary outcome measures are the uptake rate, type of fertility preservation undertaken and live birth rate. Our secondary outcome are reasons for decline of fertility preservation. Results: Forty-one patients were referred between 2010 and 2019. There were 2 referrals received in 2010 compared to 10 referrals in 2019. Twenty-nine patients underwent fertility preservation procedures, with 27 (93.1%) successful fertility preservation procedures performed. Most of the patients opted for embryo cryopreservation (44.4%) or oocyte cryopreservation (33.3%). Three patients (11.1%) underwent ovarian tissue cryopreservation. Two patients (7.4%) opted for a combination of oocyte and embryo cryopreservation and 1 patient (3.7%) had a combination of ovarian tissue and oocyte cryopreservation. There were 3 successful live births. One patient achieved a live birth from stored embryos achieved from in-vitro maturation subsequent fertilisation. The other two patients achieved live births from stored embryos and oocytes respectively. The most commonly cited reason for declining fertility preservation was financial limitations (41.7%). Conclusion: While the referral rates have been increasing over the years, the rates remain low. Further studies can be done to assess the barriers to fertility preservation referrals. Funding for fertility preservation procedures may increase uptake in this group of women.