Skip to main content

Advertisement

SpringerLink
Log in

Oncologic oocyte cryopreservation: national comparison of fertility preservation between women with and without cancer

  • Fertility Preservation
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

The majority of data regarding oocyte cryopreservation (OC) outcomes focuses on healthy women. We compare trends, cycle characteristics, and outcomes between women freezing oocytes for fertility preservation due to cancer versus elective and other medical or fertility-related diagnoses.

Methods

Retrospective cohort using national surveillance data includes all autologous OC cycles between 2012 and 2016. Cycles were divided into 4 distinct groups: cancer, elective, infertility, and medically indicated. We calculated trends and compared cycle and outcome characteristics between the 4 groups. We used multivariable log-binomial models to estimate associations between indication and gonadotropin dose, hyperstimulation, and cancelation and used Poisson regression models to estimate associations between indication and oocyte yield and maturity.

Results

The study included 29,631 autologous OC cycles. Annual total (2925 to 8828) and cancer-related (177 to 504) cycles increased over the study period; the proportions remained constant. Compared to elective, cancer-related cycles were more likely to be performed among women < 35 years old, with higher BMI, living in the South, using an antagonist protocol. Compared to elective OC cycles, gonadotropin dose (aRR 0.89, 95%CI 0.80–0.99), cancelation (aRR 0.90, 95%CI 0.70–1.14), and hyperstimulation (aRR 1.46, 95%CI 0.77–2.29) were not different for cancer-related cycles. Oocyte yield and percent maturity were comparable in both groups.

Conclusion

The number of OC cycles among women with cancer has increased; however, the percentage OC cycles for cancer have remained stable. While patient demographic characteristics were different among those undergoing OC for cancer indication, cycle outcomes were comparable to elective OC. The outcomes of the subsequent oocyte thaw, fertilization, and embryo transfer cycles remain unknown.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ethics Committee of the American Society for Reproductive Medicine, Electronic address Aao. Fertility preservation and reproduction in patients facing gonadotoxic therapies: an ethics committee opinion. Fertil Steril. 2018;110(3):380–6. https://doi.org/10.1016/j.fertnstert.2018.05.034.

    Article  Google Scholar 

  2. Oktay K, Harvey BE, Partridge AH, Quinn GP, Reinecke J, Taylor HS, et al. Fertility preservation in patients with cancer: ASCO clinical practice guideline update. J Clin Oncol. 2018;36(19):1994–2001. https://doi.org/10.1200/JCO.2018.78.1914.

    Article  PubMed  Google Scholar 

  3. Hipp HS, Shandley LM, Schirmer A, McKenzie L, Kawwass JF. Oocyte cryopreservation in adolescent women. J Pediatr Adolesc Gynecol. 2019;32(4):377–82. https://doi.org/10.1016/j.jpag.2019.03.001.

  4. Practice Committees of American Society for Reproductive M, Society for Assisted Reproductive T. Mature oocyte cryopreservation: a guideline. Fertil Steril. 2013;99(1):37–43. https://doi.org/10.1016/j.fertnstert.2012.09.028.

    Article  Google Scholar 

  5. Garcia-Velasco JA, Domingo J, Cobo A, Martinez M, Carmona L, Pellicer A. Five years' experience using oocyte vitrification to preserve fertility for medical and nonmedical indications. Fertil Steril. 2013;99(7):1994–9. https://doi.org/10.1016/j.fertnstert.2013.02.004.

    Article  PubMed  Google Scholar 

  6. Turan V, Quinn MM, Dayioglu N, Rosen MP, Oktay K. The impact of malignancy on response to ovarian stimulation for fertility preservation: a meta-analysis. Fertil Steril. 2018;110(7):1347–55. https://doi.org/10.1016/j.fertnstert.2018.08.013.

    Article  PubMed  Google Scholar 

  7. Quinn MM, Cakmak H, Letourneau JM, Cedars MI, Rosen MP. Response to ovarian stimulation is not impacted by a breast cancer diagnosis. Hum Reprod. 2017;32(3):568–74. https://doi.org/10.1093/humrep/dew355.

    Article  CAS  PubMed  Google Scholar 

  8. Dolinko AV, Farland LV, Missmer SA, Srouji SS, Racowsky C, Ginsburg ES. Responses to fertility treatment among patients with cancer: a retrospective cohort study. Fertility Research and Practice. 2018;4:3. https://doi.org/10.1186/s40738-018-0048-2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Pereira N, Hancock K, Cordeiro CN, Lekovich JP, Schattman GL, Rosenwaks Z. Comparison of ovarian stimulation response in patients with breast cancer undergoing ovarian stimulation with letrozole and gonadotropins to patients undergoing ovarian stimulation with gonadotropins alone for elective cryopreservation of oocytesdagger. Gynecol Endocrinol. 2016;32(10):823–6. https://doi.org/10.1080/09513590.2016.1177013.

    Article  CAS  PubMed  Google Scholar 

  10. Technology SfAR. In: history of IVF. 2019. https://www.sart.org/patients/history-of-ivf/. Accessed July 10 2019.

  11. Public Law 102–493 - Fertility Clinic Success Rate and Certification Act of 1992. 1992.

  12. Sterne JA, White IR, Carlin JB, Spratt M, Royston P, Kenward MG, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ. 2009;338:b2393. https://doi.org/10.1136/bmj.b2393.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Pedersen AB, Mikkelsen EM, Cronin-Fenton D, Kristensen NR, Pham TM, Pedersen L, et al. Missing data and multiple imputation in clinical epidemiological research. Clin Epidemiol. 2017;9:157–66. https://doi.org/10.2147/CLEP.S129785.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Gunnala V, Fields J, Irani M, D'Angelo D, Xu K, Schattman G, et al. BRCA carriers have similar reproductive potential at baseline to noncarriers: comparisons in cancer and cancer-free cohorts undergoing fertility preservation. Fertil Steril. 2019;111(2):363–71. https://doi.org/10.1016/j.fertnstert.2018.10.014.

    Article  CAS  PubMed  Google Scholar 

  15. Lekovich J, Lobel ALS, Stewart JD, Pereira N, Kligman I, Rosenwaks Z. Female patients with lymphoma demonstrate diminished ovarian reserve even before initiation of chemotherapy when compared with healthy controls and patients with other malignancies. J Assist Reprod Genet. 2016;33(5):657–62. https://doi.org/10.1007/s10815-016-0689-1.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Ethics Committee of the American Society for Reproductive M. Disparities in access to effective treatment for infertility in the United States: an ethics committee opinion. Fertil Steril. 2015;104(5):1104–10. https://doi.org/10.1016/j.fertnstert.2015.07.1139.

    Article  Google Scholar 

  17. Commerce UDo. US census. 2018. https://www.census.gov/quickfacts/fact/table/US/PST045218. Accessed July 11 2019.

Download references

Acknowledgements

SART wishes to thank all of its members for providing clinical information to the SART CORS database for use by patients and researchers. Without the efforts of our members, this research would not have been possible.

Author information

Authors and Affiliations

  1. Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory Reproductive Center, 550 Peachtree Street. Suite 1800, Atlanta, GA, 30308, USA

    Jennifer F. Kawwass, Lisa M. Shandley, Sheree L. Boulet & Heather S. Hipp

Authors
  1. Jennifer F. Kawwass
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lisa M. Shandley
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sheree L. Boulet
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Heather S. Hipp
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jennifer F. Kawwass.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(DOCX 21.4 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kawwass, J.F., Shandley, L.M., Boulet, S.L. et al. Oncologic oocyte cryopreservation: national comparison of fertility preservation between women with and without cancer. J Assist Reprod Genet 37, 883–890 (2020). https://doi.org/10.1007/s10815-020-01715-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-020-01715-8

Keywords

Search

Navigation