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Published in: Journal of Assisted Reproduction and Genetics 8/2015

01-08-2015 | Fertility Preservation

Utilization rates and results of long-term embryo cryopreservation before gonadotoxic treatment

Authors: M. M. Dolmans, S. Hollanders de Ouderaen, D. Demylle, C. Pirard

Published in: Journal of Assisted Reproduction and Genetics | Issue 8/2015

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Abstract

Purpose

The aim of this study was to evaluate long-term embryo cryopreservation, utilization, and success rate in patients subjected to gonadotoxic treatments in the context of cancer.

Methods

This is a retrospective study on patients (n = 54) undergoing ovarian stimulation and IVF for fertility preservation between January 1997 and June 2014. Embryos were slow-frozen and stored until the women were cured and able to undergo embryo transfer.

Results

Fifty-four women underwent 66 oocyte pick-up procedures in total, and embryos were obtained from 52 of the 54 patients. Four patients died before their frozen embryos could be thawed. Of the remaining 48, 9 women returned to use their embryos, resulting in 6 pregnancies (66 % cumulative pregnancy rate), two of which ended in miscarriage. The live birth rate per patient was thus 44 % (4/9). The true come-back rate, calculated after applicable exclusions, was found to be 23 %.

Conclusion

IVF followed by embryo freezing is a widely established technique for fertility preservation, but little has been published on the outcomes in cancer patients. While we found the number of good-quality embryos to be lower than in a normal population, the cumulative live birth rate was similar to that achieved with fresh embryos in non-cancer patients. The utilization rate of this fertility preservation method can be considered high.
Literature
1.
go back to reference Tschudin S, Bitzer J. Psychological aspects of fertility preservation in men and women affected by cancer and other life-threatening diseases. Hum Reprod Update. 2009;15(5):587–97.CrossRefPubMed Tschudin S, Bitzer J. Psychological aspects of fertility preservation in men and women affected by cancer and other life-threatening diseases. Hum Reprod Update. 2009;15(5):587–97.CrossRefPubMed
2.
go back to reference Practice Committees of American Society for Reproductive Medicine, Society for Assisted Reproductive. Mature oocyte cryopreservation: a guideline. Fertil Steril. 2013;99:37–43.CrossRef Practice Committees of American Society for Reproductive Medicine, Society for Assisted Reproductive. Mature oocyte cryopreservation: a guideline. Fertil Steril. 2013;99:37–43.CrossRef
4.
go back to reference Roque M, Lattes K, Serra S, Solà I, Geber S, Carreras R, et al. Fresh embryo transfer versus frozen embryo transfer in in vitro fertilization cycles: a systematic review and meta-analysis. Fertil Steril. 2013;99(1):156–62.CrossRefPubMed Roque M, Lattes K, Serra S, Solà I, Geber S, Carreras R, et al. Fresh embryo transfer versus frozen embryo transfer in in vitro fertilization cycles: a systematic review and meta-analysis. Fertil Steril. 2013;99(1):156–62.CrossRefPubMed
5.
go back to reference Domingo J, Guillen V, Ayllon Y, Martinez M, Munoz E, Pellicer A, et al. Ovarian response to controlled ovarian hyperstimulation in cancer patients is diminished even before oncological treatment. Fertil Steril. 2012;97:930–4.CrossRefPubMed Domingo J, Guillen V, Ayllon Y, Martinez M, Munoz E, Pellicer A, et al. Ovarian response to controlled ovarian hyperstimulation in cancer patients is diminished even before oncological treatment. Fertil Steril. 2012;97:930–4.CrossRefPubMed
6.
go back to reference Lawrenz B, Fehm T, von Wolff M, Soekler M, Huebner S, Henes J, et al. Reduced pretreatment ovarian reserve in premenopausal female patients with Hodgkin lymphoma or non-Hodgkin-lymphoma—evaluation by using antimüllerian hormone and retrieved oocytes. Fertil Steril. 2012;98:141–4.CrossRefPubMed Lawrenz B, Fehm T, von Wolff M, Soekler M, Huebner S, Henes J, et al. Reduced pretreatment ovarian reserve in premenopausal female patients with Hodgkin lymphoma or non-Hodgkin-lymphoma—evaluation by using antimüllerian hormone and retrieved oocytes. Fertil Steril. 2012;98:141–4.CrossRefPubMed
7.
go back to reference Friedler S, Koc O, Gidoni Y, Raziel A, Ron-El R. Ovarian response to stimulation for fertility preservation in women with malignant disease: a systematic review and meta-analysis. Fertil Steril. 2012;97:125–33.CrossRefPubMed Friedler S, Koc O, Gidoni Y, Raziel A, Ron-El R. Ovarian response to stimulation for fertility preservation in women with malignant disease: a systematic review and meta-analysis. Fertil Steril. 2012;97:125–33.CrossRefPubMed
8.
go back to reference Tulandi T, Holzer H. Effects of malignancies on the gonadal function. Fertil Steril. 2012;98(4):813–5.CrossRefPubMed Tulandi T, Holzer H. Effects of malignancies on the gonadal function. Fertil Steril. 2012;98(4):813–5.CrossRefPubMed
9.
go back to reference Robertson AD, Missmer SA, Ginsburg ES. Embryo yield after in vitro fertilization in women undergoing embryo banking for fertility preservation before chemotherapy. Fertil Steril. 2011;95(2):588–91.CrossRefPubMed Robertson AD, Missmer SA, Ginsburg ES. Embryo yield after in vitro fertilization in women undergoing embryo banking for fertility preservation before chemotherapy. Fertil Steril. 2011;95(2):588–91.CrossRefPubMed
10.
go back to reference Sabatini ME, Wolkovich AM, Macklin EA, Wright DL, Souter I, Toth TL. Pronuclear embryo cryopreservation experience: outcomes for reducing the risk of ovarian hyperstimulation syndrome and for fertility preservation in cancer patients. J Assist Reprod Genet. 2011;28(3):279–84.PubMedCentralCrossRefPubMed Sabatini ME, Wolkovich AM, Macklin EA, Wright DL, Souter I, Toth TL. Pronuclear embryo cryopreservation experience: outcomes for reducing the risk of ovarian hyperstimulation syndrome and for fertility preservation in cancer patients. J Assist Reprod Genet. 2011;28(3):279–84.PubMedCentralCrossRefPubMed
11.
go back to reference Cardozo ER, Thomson AP, Karmon AE, Dickinson KA, Wright DL, Sabatini ME. Ovarian stimulation and in-vitro fertilization outcomes of cancer patients undergoing fertility preservation compared to age matched controls: a 17-year experience. J Assist Reprod Genet. 2015;32(4):587–96.CrossRefPubMed Cardozo ER, Thomson AP, Karmon AE, Dickinson KA, Wright DL, Sabatini ME. Ovarian stimulation and in-vitro fertilization outcomes of cancer patients undergoing fertility preservation compared to age matched controls: a 17-year experience. J Assist Reprod Genet. 2015;32(4):587–96.CrossRefPubMed
12.
go back to reference Van Langendonckt A, Demylle D, Wyns C, Nisolle M, Donnez J. Comparison of G1.2/G2.2 and Sydney IVF cleavage/blastocyst sequential media for the culture of human embryos: a prospective, randomized, comparative study. Fertil Steril. 2001;76(5):1023–31.CrossRefPubMed Van Langendonckt A, Demylle D, Wyns C, Nisolle M, Donnez J. Comparison of G1.2/G2.2 and Sydney IVF cleavage/blastocyst sequential media for the culture of human embryos: a prospective, randomized, comparative study. Fertil Steril. 2001;76(5):1023–31.CrossRefPubMed
13.
go back to reference Ethics Committee of American Society for Reproductive Medicine. Fertility preservation and reproduction in patients facing gonadotoxic therapies: a committee opinion. Fertil Steril. 2013;100(5):1224–31.CrossRef Ethics Committee of American Society for Reproductive Medicine. Fertility preservation and reproduction in patients facing gonadotoxic therapies: a committee opinion. Fertil Steril. 2013;100(5):1224–31.CrossRef
14.
go back to reference Practice Committees of American Society for Reproductive Medicine; Society for Assisted Reproductive Technology. Mature oocyte cryopreservation: a guideline. Fertil Steril. 2013;99(1):37–43.CrossRef Practice Committees of American Society for Reproductive Medicine; Society for Assisted Reproductive Technology. Mature oocyte cryopreservation: a guideline. Fertil Steril. 2013;99(1):37–43.CrossRef
15.
go back to reference Pacey AA, Merrick H, Arden-Close E, Morris K, Barton LC, Crook AJ, et al. Monitoring fertility (semen analysis) by cancer survivors who banked sperm prior to cancer treatment. Hum Reprod. 2012;27(11):3132–9.CrossRefPubMed Pacey AA, Merrick H, Arden-Close E, Morris K, Barton LC, Crook AJ, et al. Monitoring fertility (semen analysis) by cancer survivors who banked sperm prior to cancer treatment. Hum Reprod. 2012;27(11):3132–9.CrossRefPubMed
16.
go back to reference Dolmans MM, Jadoul P, Gilliaux S, Amorim CA, Luyckx V, Squifflet J, et al. A review of 15 years of ovarian tissue bank activities. J Assist Reprod Genet. 2013;30(3):305–14.PubMedCentralCrossRefPubMed Dolmans MM, Jadoul P, Gilliaux S, Amorim CA, Luyckx V, Squifflet J, et al. A review of 15 years of ovarian tissue bank activities. J Assist Reprod Genet. 2013;30(3):305–14.PubMedCentralCrossRefPubMed
17.
go back to reference Dolmans MM, Marotta ML, Pirard C, Donnez J, Donnez O. Ovarian tissue cryopreservation followed by controlled ovarian stimulation and pick-up of mature oocytes does not impair the number or quality of retrieved oocytes. J Ovarian Res. 2014;7:80.PubMedCentralCrossRefPubMed Dolmans MM, Marotta ML, Pirard C, Donnez J, Donnez O. Ovarian tissue cryopreservation followed by controlled ovarian stimulation and pick-up of mature oocytes does not impair the number or quality of retrieved oocytes. J Ovarian Res. 2014;7:80.PubMedCentralCrossRefPubMed
18.
go back to reference Devesa M, Martínez F, Coroleu B, Rodríguez I, González C, Barri PN. Ovarian response to controlled ovarian hyperstimulation in women with cancer is as expected according to an age-specific nomogram. J Assist Reprod Genet. 2014;31(5):583–8.PubMedCentralCrossRefPubMed Devesa M, Martínez F, Coroleu B, Rodríguez I, González C, Barri PN. Ovarian response to controlled ovarian hyperstimulation in women with cancer is as expected according to an age-specific nomogram. J Assist Reprod Genet. 2014;31(5):583–8.PubMedCentralCrossRefPubMed
19.
go back to reference Klock SC, Zhang JX, Kazer RR. Fertility preservation for female cancer patients: early clinical experience. Fertil Steril. 2010;94:149–55.CrossRefPubMed Klock SC, Zhang JX, Kazer RR. Fertility preservation for female cancer patients: early clinical experience. Fertil Steril. 2010;94:149–55.CrossRefPubMed
20.
go back to reference Pavone ME, Hirshfeld-Cytron J, Lawson AK, Smith K, Kazer R, Klock S. Fertility preservation outcomes may differ by cancer diagnosis. J Hum Reprod Sci. 2014;7:111–8.PubMedCentralCrossRefPubMed Pavone ME, Hirshfeld-Cytron J, Lawson AK, Smith K, Kazer R, Klock S. Fertility preservation outcomes may differ by cancer diagnosis. J Hum Reprod Sci. 2014;7:111–8.PubMedCentralCrossRefPubMed
21.
go back to reference Michaan N, Ben-David G, Ben-Yosef D, Almog B, Many A, Pauzner D, et al. Ovarian stimulation and emergency in vitro fertilization for fertility preservation in cancer patients. Eur J Obstet Gynecol Reprod Biol. 2010;149:175–7.CrossRefPubMed Michaan N, Ben-David G, Ben-Yosef D, Almog B, Many A, Pauzner D, et al. Ovarian stimulation and emergency in vitro fertilization for fertility preservation in cancer patients. Eur J Obstet Gynecol Reprod Biol. 2010;149:175–7.CrossRefPubMed
22.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
23.
go back to reference Rienzi L, Cobo A, Paffoni A, Scarduelli C, Capalbo A, Vajta G, et al. Consistent and predictable delivery rates after oocyte vitrification: an observational longitudinal cohort multicentric study. Hum Reprod. 2012;27(6):1606–12.CrossRefPubMed Rienzi L, Cobo A, Paffoni A, Scarduelli C, Capalbo A, Vajta G, et al. Consistent and predictable delivery rates after oocyte vitrification: an observational longitudinal cohort multicentric study. Hum Reprod. 2012;27(6):1606–12.CrossRefPubMed
24.
go back to reference Cobo A, Garcia-Velasco JA, Domingo J, Remohi J, Pellicer A. Is vitrification of oocytes useful for fertility preservation for age-related fertility decline and in cancer patients? Fertil Steril. 2013;99(6):1485–95.CrossRefPubMed Cobo A, Garcia-Velasco JA, Domingo J, Remohi J, Pellicer A. Is vitrification of oocytes useful for fertility preservation for age-related fertility decline and in cancer patients? Fertil Steril. 2013;99(6):1485–95.CrossRefPubMed
25.
26.
Metadata
Title
Utilization rates and results of long-term embryo cryopreservation before gonadotoxic treatment
Authors
M. M. Dolmans
S. Hollanders de Ouderaen
D. Demylle
C. Pirard
Publication date
01-08-2015
Publisher
Springer US
Published in
Journal of Assisted Reproduction and Genetics / Issue 8/2015
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-015-0533-z

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