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Journal of Assisted Reproduction and Genetics

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01-10-2013 | Fertility Preservation

Experiences in fertility preservation: lessons learned to ensure that fertility and reproductive autonomy remain options for cancer survivors

Authors: Nicole Noyes, Katherine Melzer, Sarah Druckenmiller, M. Elizabeth Fino, Meghan Smith, Jaime M. Knopman

Published in: Journal of Assisted Reproduction and Genetics | Issue 10/2013

Abstract

Purpose

Assess fertility preservation (FP) measures chosen by patients newly diagnosed with malignancy and their outcomes.

Methods

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.

Results

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.

Conclusions

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.

Azim AA, Costantini-Ferrando M, Oktay M. Safety of fertility preservation by ovarian stimulation with letrozole and gonadotropins in patients with breast cancer: a prospective controlled study. J Clin Oncol. 2008;26:2630–5.PubMedCrossRef

Baynosa J, Westphal L, Madrigrano A, Wapnir I. Timing of breast cancer treatments with oocyte retrieval and embryo cryopreservation. J Am Coll Surg. 2009;209:603–7.PubMedCrossRef

Byrne J, Rasmussen SA, Steinhorn SC, Connelly RR, Myers MH, Lynch CF, et al. Genetic disease in offspring of long-term survivors of childhood and adolescent cancer. Am J Hum Genet. 1998;62:45–52.PubMedCrossRef

Chiva L, Lapuente F, Gonzalez-Cortijo L, Carballo N, Garcia JF, Rojo A, et al. Sparing fertility in young patients with endometrial cancer. Gynecol Oncol. 2008;111:S101–4.PubMedCrossRef

Cobo A, Meseguer M, Remohi J, Pellicer A. Use of cryo-banked oocytes in an ovum donation programme: a prospective, randomized, controlled, clinical trial. Hum Reprod. 2010;25:2239–46.PubMedCrossRef

Das M, Shehata F, Son WY, Tulandi T, Holzer H. Ovarian reserve and response to IVF and in vitro maturation treatment following chemotherapy. Hum Reprod. 2012;27:2509–14.PubMedCrossRef

Diaz J, Sonoda Y, Leitao M, Zivanovic O, Vrown C, Chi D, et al. Oncologic outcome of fertility-sparing radical trachelectomy vs. radical hysterectomy for stage 1B1 cervical carcinoma. Gynecol Oncol. 2008;111:255–60.PubMedCrossRef

Dolmans MM, Demylle D, Martinez-Madrid B, Donnez J. Efficacy of in vitro fertilization after chemotherapy. Fertil Steril. 2005;83:897–901.PubMedCrossRef

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.PubMedCrossRef

10.

Ginsburg ES, Yanushpolsky EH, Jackson KV. In vitro fertilization for cancer patients and survivors. Fertil Steril. 2001;75:705–10.PubMedCrossRef

11.

Goodwin PJ, Ennis M, Pritchard KI, Trudeau M, Hood N. Risk of menopause during the first year after breast cancer diagnosis. J Clin Oncol. 1999;17:2365–70.PubMed

12.

Grifo JA, Noyes N. Delivery rate using cryopreserved oocytes is comparable to conventional in vitro fertilization using fresh oocytes: potential fertility preservation for female cancer patients. Fertil Steril. 2010;93:609–15.PubMedCrossRef

13.

Han AR, Kwon YS, Kim DY, Kim JH, Kim YM, Kim YT, et al. Pregnancy outcomes using assisted reproductive technology after fertility-preserving therapy in patients with endometrial adenocarcinoma or atypical complex hyperplasia. Int J Gynecol Cancer. 2009;19:147–51.PubMedCrossRef

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.

15.

Ichinose M, Fujimoto A, Osuga Y, Minaguchi T, Kawana K, Yano T, et al. The influence of infertility treatment on the prognosis of endometrial cancer and atypical complex endometrial hyperplasia. Int J Gynecol Cancer. 2013;23:288–93.PubMedCrossRef

16.

Knopman JM, Papadopoulos E, Grifo J, Fino ME, Noyes N. Surviving childhood and reproductive age malignancy: effects of treatment on fertility, gametes and future parenthood. Lancet Oncol. 2010;11:490–8.PubMedCrossRef

17.

Li FP, Fine W, Jaffe N, Holmes GE, Holmes FF. Offspring of patients treated for cancer in childhood. J Natl Cancer Inst. 1979;62:1193–7.PubMed

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.

19.

Noyes N, Abu-Rustum N, Ramirez P, Plante M. Options in the management of fertility-related issues after radical trachelectomy in patients with early cervical cancer. Gynecol Oncol. 2009;114:117–20.PubMedCrossRef

20.

Noyes N, Porcu E, Borini A. With more than 900 babies born, live birth outcomes following oocyte cryopreservation do not appear different from those occurring after conventional IVF. Reprod Biomed Online. 2009;18:769–76.PubMedCrossRef

21.

Noyes N, Knopman J, Labella P, McCaffrey C, Clark-Williams M, Grifo J. Oocyte cryopreservation outcomes including pre-cryo and post-thaw meiotic spindle evaluation following slow cooling and vitrification of human oocytes. Fertil Steril. 2010;94:2078–82.PubMedCrossRef

22.

Noyes N, Knopman J, Long K, Coletta J, Abu-Rustum N. Fertility considerations in the management of gynecologic malignancies. Gynecol Oncol. 2011;120:326–33.PubMedCrossRef

23.

Noyes N, Knopman J, Melzer K, Fino ME, Friedman B, Westphal L. Oocyte cryopreservation as a fertility preservation measure for cancer patients. Reprod Biomed Online. 2011;23:323–33.PubMedCrossRef

24.

Oktay K, Hourvitz A, Sahin G, Oktem O, Safro B, Cil A, et al. Letrozole reduces estrogen and gonadotropin exposure in women with breast cancer undergoing ovarian stimulation before chemotherapy. J Clin Endocrinol Metab. 2006;91:3885–90.PubMedCrossRef

25.

Park JY, Seong SJ, Kim TJ, Kim JW, Kim SM, Bae DS, et al. Pregnancy outcomes after fertility-sparing management in young women with early endometrial cancer. Obstet Gynecol. 2013;121:136–42.PubMed

26.

Parmegiani L, Cognigni GE, Bernardi S, Cuomo S, Ciampaglia W, Infante FE, et al. Efficiency of aseptic open vitrification and hermetical cryostorage of human oocytes. Reprod Biomed Online. 2011;23:505–12.PubMedCrossRef

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.PubMedCrossRef

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.

29.

Practice Committees of the American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology. Mature oocyte cryopreservation: a guideline. Fertil Steril. 2013;99:37–43.CrossRef

30.

Reddy J, Oktay K. Ovarian stimulation and fertility preservation with the use of aromatase inhibitors in women with breast cancer. Fertil Steril. 2012;98:1363–9.PubMedCrossRef

31.

Reh A, Lu L, Weinerman R, Grifo J, Krey L, Noyes N. Treatment outcomes and quality-of-life assessment in a university-based fertility preservation program: results of a registry of female cancer patients at 2 years. J Assist Reprod Genet. 2011;28:635–41.PubMedCrossRef

32.

Rienzi L, Romano S, Albricci L, Maggiulli R, Capalbo A, Baroni E, et al. Embryo development of fresh 'versus' vitrified metaphase II oocytes after ICSI: a prospective randomized sibling-oocyte study. Hum Reprod. 2010;25:66–73.PubMedCrossRef

33.

Ruddy KJ, Partridge AH. The unique reproductive concerns of young women with breast cancer. Adv Exp Med Biol. 2012;732:77–787.PubMedCrossRef

34.

Rudick B, Opper N, Paulson R, Bendikson K, Chung K. The state of oocyte cryopreservation in the United States. Fertil Steril. 2010;94:2642–6.PubMedCrossRef

35.

Schover LR, Rybicki LA, Martin BA, Bringelsen KA. Having children after cancer. A pilot survey of survivors’ attitudes and experiences. Cancer. 1999;86:530–5.CrossRef

36.

Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62:10–29.PubMedCrossRef

37.

Socie G, Salooja N, Cohen A, Rovelli A, Carreras E, Locasciulli A, et al. Nonmalignant late affects after allogeneic stem cell transplantation. Blood. 2003;101:3373–85.PubMedCrossRef

38.

Wang CB, Wang CJ, Huang HJ, et al. Fertility-preserving treatment in young patients with endometrial adenocarcinoma. Cancer. 2002;94:2192–8.PubMedCrossRef

39.

Waring AB, Wallace WH. Subfertility following treatment for childhood cancer. Hosp Med. 2000;61:550–7.PubMed

40.

Werner M, Reh A, Labella P, Noyes N. Laboratory evaluation in oocyte cryopreservation suggests retrieved oocytes are comparable whether frozen for medical indications, deferred reproduction or oocyte donation. J Assist Reprod Genet. 2010;27:613–7.PubMedCrossRef

41.

www.sart.org (accessed website 6/26/2012).

Title: Experiences in fertility preservation: lessons learned to ensure that fertility and reproductive autonomy remain options for cancer survivors
Authors: Nicole Noyes
Katherine Melzer
Sarah Druckenmiller
M. Elizabeth Fino
Meghan Smith
Jaime M. Knopman
Publication date: 01-10-2013
Publisher: Springer US
Published in: Journal of Assisted Reproduction and Genetics / Issue 10/2013
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI: https://doi.org/10.1007/s10815-013-0066-2

ACC 2024 Congress

Springer Medicine

Experiences in fertility preservation: lessons learned to ensure that fertility and reproductive autonomy remain options for cancer survivors

Abstract

Purpose

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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