A Japanese nationwide survey on the cryopreservation of embryos, oocytes and ovarian tissue for cancer patients

Abstract

Aim The survival rates of cancer patients have greatly improved owing to the advances in oncology. The preservation of fertility in cancer patients is an important task. To determine the reality of cryopreservation of embryos, oocytes and ovarian tissue in cancer patients, large‐scale survey analysis was performed in Japan. Methods We sent 613 Japan Society of Obstetrics and Gynecology‐certified assisted reproductive technology institutions a questionnaire about their experience of performing cryopreservation for cancer patients between January 2011 and December 2015. Subsequently, the institutions that conducted cryopreservation for cancer patients were sent a second questionnaire. Results We received replies from 481 (78.5%) institutions. Among them, 126 (26.2%) conducted cryopreservation for cancer patients. These 126 institutions were sent a second questionnaire. Of these, 108 (85.7%) institutions responded. At the 108 institutions, 1085 embryo or oocyte cryopreservation procedures and 122 ovarian tissue cryopreservation procedures were conducted for cancer patients. Cryopreservation was mainly performed for breast cancer patients (~70%), followed by patients with hematological malignancy. A total of 361 and 19 embryo transfer cycles were performed for patients whose embryos and oocytes were cryopreserved, respectively, and 42 and seven institutions reported pregnancy outcomes after embryo transfer in patients that underwent embryo and oocyte cryopreservation, respectively. However, pregnancy was not observed in the seven cases that underwent ovarian tissue transfer. Conclusion Indications, age limits and ovarian stimulation protocols for cryopreservation widely varied between the institutions. A national registration system for oncofertility must be established to evaluate the safety and efficacy of the current system.

Oncofertility Care in Young Women and the Outcomes of Pregnancy Over the Last 5 Years

“…The purpose of this study is to investigate the rates at which cancer survivors actually receive the available forms of oncofertility care and the outcomes of this care, and to determine what causes infertility in female cancer survivors who wish to become pregnant. Although our number of patients was small, our patient characteristics and outcomes were not much different from those in previous reports such as that by Sanada et al [1]. In this study, we uncovered three findings worth noting.…”

“…Cancer treatments such as alkylating agents and pelvic irradiation expose patients to an increased risk of posttreatment infertility [1], which diminishes patients' quality of life [2]. The future ability to have children has been cited as one of the top five unmet needs of adolescent cancer patients, along with health, work/school, romantic relationships and close friendships [3].…”

Survey of professionals on breast cancer, fertility preservation and pregnancy in Argentina

“…More than half of those surveyed did not consider OS safe or were unaware of it, especially in those with ER positive BC, similar to the 43.2% published by Lambertini et al [13]. Regarding OS protocols in BC patients, 51.3% stated that they should include letrozole or tamoxifen, similar to that described by Sanada et al [21], who used aromatase inhibitors in up to 68.3% of patients with BC. The results of the prospective STIM trial (NTR4108) confirming the safety of these protocols are awaited [22].…”

Recent advances: fertility preservation and fertility restoration options for males and females

“…Gonadal tissue cryopreservation is an investigational option to preserve the reproductive potential of patients who cannot produce eggs or sperm. Gonadal tissue freezing has been performed for thousands of patients worldwide, demonstrating that the methods to obtain tissues are safe and feasible 29 , 30 , 183 , 184 . However, access to gonadal tissue freezing is limited primarily to academic centers and is performed under institutionally approved experimental protocols.…”