Abstract
Simple SummaryThe study goal is to demonstrate that oocyte cryopreservation is a feasible and efficient option for fertility preservation in cancer patients through the comparison of in vitro fertilization treatments in nononcological patients.The preservation of fertility in cancer patients is a crucial aspect of modern reproductive medicine. Amenorrhea and infertility often occur after cancer therapy, worsening the quality of life. Cryopreservation of oocytes in young cancer patients is a therapeutic option for preserving fertility. A prospective study was conducted on 508 cancer patients who underwent oocyte cryopreservation to preserve fertility between 1996 and 2021 including the COVID-19 pandemic period. Patients underwent ovarian stimulation, followed by egg retrieval, and oocytes were cryopreserved by slow freezing or vitrification. Sixty-four thawing/warming cycles were performed. Survival, fertilization, pregnancy, and birth rate over the thawing/warming cycles were obtained. The data were compared with those from a group of 1042 nononcological patients who cryopreserved supernumerary oocytes. An average of 8.8 ± 6.9 oocytes were retrieved per cycle, and 6.1 ± 4.2 oocytes were cryopreserved. With their own stored oocytes, 44 patients returned to attempt pregnancy. From a total of 194 thawed/warmed oocytes, 157 survived (80%). In total, 100 embryos were transferred in 57 transfer/cycles, and 18 pregnancies were achieved. The pregnancy rate per transfer and pregnancy rate per patient were 31% and 41%, respectively. No statistically significant differences were observed between oncological patients and nononcological patients. A total of 15 babies were born from oncological patients. Children born showed normal growth and development. One minor malformation was detected.
Highlights
The preservation of fertility in cancer patients has become mandatory in modern reproductive medicine and oncology
The present study reports the large number of cancer patients who underwent oocyte cryopreservation to preserve fertility and the follow-up of the 15 children born so far
After diagnosis and before chemotherapy, the patients were directed to the fertility preservation program
Summary
The preservation of fertility in cancer patients has become mandatory in modern reproductive medicine and oncology. Amenorrhea and infertility often occur after cancer therapy, worsening the quality of life. It is well established that chemotherapy, especially alkylating agents, are gonadotoxic and may induce premature ovarian insufficiency (POI) [1,2]; the American Society of Clinical Oncology (ASCO) and the American Society for Reproductive Medicine (ASRM) recommend fertility preservation [3,4]. Oocyte cryopreservation is no longer experimental [5]; egg storage is likely one of the best choices to preserve fertility in cancer patients [6–11]. Oocyte cryopreservation can be used alone or in association with GnRH analogue administration to improve patients’ opportunities [12]. Oocyte cryopreservation has a number of safety reports, and more than 3000 live births have been achieved with no evidence of an increase in child anomalies [13–15]
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