Fertility preservation in female sarcoma patients

Abstract

ObjectiveTo assess ovarian reserve, after radio-chemotherapy treatments in sarcoma patients that underwent fertility preservation procedures.DesignA retrospective chart review of all eligible patients was done.Materials and MethodsThe research group included 12 sarcoma patients who underwent fertility preservation procedure (“ovarian protection” with GnRh agonist, ovarian tissue cryopreservation, oocytes cryopreservation, and embryos cryopreservation). In most women a combination of several fertility preservation techniques was used.ResultsMean age of patients was 26 years and 67% had no children. 58% had bone sarcoma and 42% had soft tissue sarcoma. Mean LH, FSH and day 3 E2 levels were above the normal range. The number of antral follicles was under the threshold indicating low ovarian reserve and mean Anti-Mullerian Hormone levels were near that threshold. Sub-division of the research group, according to the basic disease, revealed preserved or almost preserved ovarian reserve among soft tissue sarcoma patients and low ovarian reserve among woman with bone sarcoma.ConclusionSoft tissue sarcoma patients demonstrate an ovarian reserve that allows response to fertility treatments after chemotherapy. In this sub-group a surgical procedure like ovarian tissue cryopreservation may not be justified and GnRH analog protective treatment could be sufficient; while bone sarcoma patients demonstrate low post treatment ovarian reserve, a finding that may justify fertility preservation procedure, like IVF and embryos cryopreservation with or without oocyte cryopreservation, before radio-chemotherapy. Every patient should be consulted regarding the potential risks of chemotherapy and choose for herself whether to perform fertility preservation procedure. A multi-centered, prospective study is needed to establish the best fertility preservation aproach. ObjectiveTo assess ovarian reserve, after radio-chemotherapy treatments in sarcoma patients that underwent fertility preservation procedures. To assess ovarian reserve, after radio-chemotherapy treatments in sarcoma patients that underwent fertility preservation procedures. DesignA retrospective chart review of all eligible patients was done. A retrospective chart review of all eligible patients was done. Materials and MethodsThe research group included 12 sarcoma patients who underwent fertility preservation procedure (“ovarian protection” with GnRh agonist, ovarian tissue cryopreservation, oocytes cryopreservation, and embryos cryopreservation). In most women a combination of several fertility preservation techniques was used. The research group included 12 sarcoma patients who underwent fertility preservation procedure (“ovarian protection” with GnRh agonist, ovarian tissue cryopreservation, oocytes cryopreservation, and embryos cryopreservation). In most women a combination of several fertility preservation techniques was used. ResultsMean age of patients was 26 years and 67% had no children. 58% had bone sarcoma and 42% had soft tissue sarcoma. Mean LH, FSH and day 3 E2 levels were above the normal range. The number of antral follicles was under the threshold indicating low ovarian reserve and mean Anti-Mullerian Hormone levels were near that threshold. Sub-division of the research group, according to the basic disease, revealed preserved or almost preserved ovarian reserve among soft tissue sarcoma patients and low ovarian reserve among woman with bone sarcoma. Mean age of patients was 26 years and 67% had no children. 58% had bone sarcoma and 42% had soft tissue sarcoma. Mean LH, FSH and day 3 E2 levels were above the normal range. The number of antral follicles was under the threshold indicating low ovarian reserve and mean Anti-Mullerian Hormone levels were near that threshold. Sub-division of the research group, according to the basic disease, revealed preserved or almost preserved ovarian reserve among soft tissue sarcoma patients and low ovarian reserve among woman with bone sarcoma. ConclusionSoft tissue sarcoma patients demonstrate an ovarian reserve that allows response to fertility treatments after chemotherapy. In this sub-group a surgical procedure like ovarian tissue cryopreservation may not be justified and GnRH analog protective treatment could be sufficient; while bone sarcoma patients demonstrate low post treatment ovarian reserve, a finding that may justify fertility preservation procedure, like IVF and embryos cryopreservation with or without oocyte cryopreservation, before radio-chemotherapy. Every patient should be consulted regarding the potential risks of chemotherapy and choose for herself whether to perform fertility preservation procedure. A multi-centered, prospective study is needed to establish the best fertility preservation aproach. Soft tissue sarcoma patients demonstrate an ovarian reserve that allows response to fertility treatments after chemotherapy. In this sub-group a surgical procedure like ovarian tissue cryopreservation may not be justified and GnRH analog protective treatment could be sufficient; while bone sarcoma patients demonstrate low post treatment ovarian reserve, a finding that may justify fertility preservation procedure, like IVF and embryos cryopreservation with or without oocyte cryopreservation, before radio-chemotherapy. Every patient should be consulted regarding the potential risks of chemotherapy and choose for herself whether to perform fertility preservation procedure. A multi-centered, prospective study is needed to establish the best fertility preservation aproach.