Long-term outcomes in cancer patients who did or did not pursue fertility preservation

Fertility preservation is both safe and efficacious for eligible cancer patients, regardless of stimulation protocol used.

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Volume 109, Issue 2, Pages 349–355

Authors:

Molly B. Moravek, M.D., M.P.H., Rafael Confino, B.S., Kristin N. Smith, B.S., Ralph R. Kazer, M.D., Susan C. Klock, Ph.D., Angela K. Lawson, Ph.D., William J. Gradishar, M.D., Mary Ellen Pavone, M.D., M.S.C.I.

Abstract:

Objective

To compare long-term outcomes of cancer patients who pursued fertility preservation (FP) with those who did not and compare random-start (RS) and menstrual cycle–specific (CS) protocols for FP.

Design

Retrospective cohort.

Setting

Single urban academic institution.

Patient(s)

Oncology patients who contacted the FP patient navigator, 2005–2015.

Intervention(s)

None.

Main Outcome Measure(s)

Time to cancer treatment, disease-free survival, and reproductive outcomes in FP versus no-FP patients and cycle outcomes for RS versus CS protocols. Data were analyzed by χ2 and logistic regression.

Result(s)

Of 497 patients who met the inclusion criteria, 41% elected FP. The median number of days to cancer treatment was 33 and 19 days in the FP and no-FP groups, respectively. There was no difference in cancer recurrence or mortality. There were no differences in stimulation parameters, outcomes, or days to next cancer treatment in RS versus CS protocols. Twenty-one patients returned to use cryopreserved specimens, resulting in 16 live births. Eight of 21 returning patients used a gestational carrier. Thirteen FP (6.4%) and 16 no-FP (5.5%) patients experienced a spontaneous pregnancy.

Conclusion(s)

FP is both safe and efficacious for eligible cancer patients. Only 10% of patients returned to use cryopreserved specimens, and almost half used a gestational carrier, suggesting the need for further research into reproductive decision-making in cancer survivors.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

1 Comments

Go to the profile of Mary Samplaski
Mary Samplaski over 2 years ago

Did the authors contact these patients and ask: for those who did FP, were they happy with their decision?; and for the non-FP, did they regret not pursuing FP? What were the reasons for the non-FP patients not pursuing FP?