Reproductive choices and outcomes after freezing oocytes for medical reasons: a follow-up study

Dahhan, Taghride; Dancet, Eline; Miedema, David; Veen, Fulco van der; Goddijn, Mariëtte

doi:10.1093/humrep/deu137

Cited by 25 publications

(14 citation statements)

References 28 publications

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“…If assisted reproductive treatments involving IVF are needed thereafter, the ovaries are often difficult to access for ovum pickup. Ovarian stimulation in connection with subsequent cryopreservation of oocytes or embryos before cancer treatment is thus indicated in such cases [ 6 , 30 – 34 ]. However, even if ovarian function is preserved, or oocytes or embryos have been cryopreserved, irradiation of the uterus may cause irreversible damage.…”

Section: Introductionmentioning

confidence: 99%

Fertility preservation in women with cervical, endometrial or ovarian cancers

Feichtinger

Rodriguez‐Wallberg

2016

gynaecol oncol res pract

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BackgroundAlthough cancer in general affects an aged population, a significant number of women develop cancer at childbearing age. Long-term survival rates after gynecological cancer, especially in young patients are increasing and all quality-of-life aspects, including preservation of fertility have become of major relevance.OutcomesSurgical techniques aimed at sparing reproductive organs and preserving fertility have been developed for women presenting with gynecological cancer found at early stages. Indications for fertility-sparing surgery are in general restricted to women presenting with a well-differentiated low-grade tumor in its early stages or with low malignant potential. Up to now, use of fertility-sparing techniques in well-selected patients has not been shown to affect overall survival negatively and fertility outcomes reported have been favorable. Still larger amounts of data and longer follow-up periods are needed. Several current fertility-sparing cancer treatments may result in sub-fertility and in those cases assisted reproductive techniques are indicated. Overall quality of life has been satisfactory in cancer patients after fertility-sparing surgery.ConclusionsFertility-sparing surgery is a viable tool to enable gynecological cancer patients of young age to fulfill their family building without impairment of oncological outcome. Cancer patients of reproductive age should undergo fertility counseling to analyze this sensitive subject. Further studies are needed to investigate the role of fertility-sparing treatment and combined adjuvant therapy in higher-grade cancers.

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Section: Introductionmentioning

confidence: 99%

Fertility preservation in women with cervical, endometrial or ovarian cancers

Feichtinger

Rodriguez‐Wallberg

2016

gynaecol oncol res pract

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“…Nevertheless, the provision of accurate information on which to base realistic expectations, particularly for fertility preservation in women, is limited because the practice is still in its infancy and long-term outcome data are scarce [9, 52]. The limited existing evidence suggests that the rate of utilization of stored material among women who freeze oocytes or embryos before cancer treatment is low and that most post-treatment pregnancies occur spontaneously or as a result of ART with fresh oocytes [53, 54]. A recent review of 30 studies reporting reproductive outcomes for men who had stored sperm before undergoing cancer treatment found that only 8% had returned to use their stored sperm.…”

Section: Discussionmentioning

confidence: 99%

Cryopreservation of reproductive material before cancer treatment: a qualitative study of health care professionals’ views about ways to enhance clinical care

Hammarberg

Kirkman

Stern

et al. 2017

BMC Health Serv Res

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BackgroundCancer treatment can diminish fertility in women and men. The need for fertility preservation is growing as increasing numbers of people survive cancer. Cryostorage of reproductive material to preserve potential for conception for cancer survivors has moved from being experimental to being a part of clinical management of women and men who are diagnosed with cancer in their reproductive years. There is little existing evidence about how fertility preservation services can be enhanced to meet the complex needs of patients who are diagnosed with cancer in their reproductive years. The aim of this research was to inform clinical practice development by drawing on the collective experience and knowledge of staff at well-established clinics that offer fertility preservation before cancer treatment.MethodsA qualitative research model was adopted using semi-structured interviews with professionals involved in the care of people who freeze reproductive material before cancer treatment. In the state of Victoria, Australia, two large assisted reproductive technology (ART) centres have been providing fertility preservation services for more than two decades. An invitation to participate in a semi-structured interview about clinical care in the context of fertility preservation was emailed to past and current staff members. To capture diverse perspectives, informants were sought from all relevant professions: fertility specialists, andrologists, nurses, embryologists/scientists, counsellors, and administrative staff. Transcripts were analysed thematically.ResultsThirteen key informants were interviewed from August 2013 to February 2014. The identified themes relating to enhancing clinical care in a fertility preservation service were communication between oncology and ART specialists; managing urgency; managing patients’ expectations; establishing and implementing protocols, systems, and data bases; and maintaining contact with patients.ConclusionThe collective knowledge of this study’s informants, who represent multidisciplinary teams with more than two decades’ experience in fertility preservation, yields important insights into strategies that fertility preservation services can employ to promote the integration of oncology and fertility care, the psychosocial care of patients, data recording and monitoring, and reporting of outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2292-2) contains supplementary material, which is available to authorized users.

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“…A follow-up study in 2014 included a cohort of 85 women who cryopreserved their oocytes between 2009 and 2012 [11]. A total of 68 women, followed up for an average 25.3 months, returned the questionnaire (response rate: 80 %).…”

Section: Discussionmentioning

confidence: 99%

“…Three out of the eight pregnancies had resulted in live births, two resulted in miscarriages and three were ongoing. Most women (71 %) intended to conceive with their cryopreserved oocytes as a last resource option [11]. After a mean follow-up of 2 years, none of the women with a medical reason to cryopreserved oocytes had used her oocytes.…”

Section: Discussionmentioning

confidence: 99%

Social Egg Freezing: Developing Countries Are Not Exempt

Allahbadia

2015

J Obstet Gynecol India

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Non-medical egg freezing has only been available for about the last 5 years, as new vitrification techniques have made the success rates for actual conception more reliable than the earlier method of slow freezing. The improved outcomes of new technologies of vitrification and intra-cytoplasmic sperm injection (ICSI) have led to the marketing of egg freezing for non-medical reasons, whereby women are offered the possibility of preserving their eggs until such time as they wish to have a child. For many women today, it is not cancer but the simple passage of time that robs them of their chance of motherhood. Social, educational, emotional and financial pressures often lead them to delay trying to start a family until their late thirties, by which time the chance of success is very low. Women at age 40 face a 40 % chance of miscarriage if they can get pregnant at all, and by the age of 45, the risk of miscarriage is 75 %. Donor eggs are not an option for many because of supply constraints and ethical and cultural concerns. Freezing a woman's eggs at age 30 literally ''freezes in time'' her fertility potential and 123gives her the chance of a healthy pregnancy at a time of her choosing. Despite the initial reactions of disapproval, more and more fertility clinics are now offering oocyte cryopreservation to healthy women in order to extend their reproductive options. This procedure is now becoming popular even in developing economies, and egg freezing in major Indian Metros is now routine.

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Reproductive choices and outcomes after freezing oocytes for medical reasons: a follow-up study

Abstract: This study was not externally funded. There are no conflicts of interest to declare.

Cited by 25 publications

References 28 publications

Fertility preservation in women with cervical, endometrial or ovarian cancers

Fertility preservation in women with cervical, endometrial or ovarian cancers

Cryopreservation of reproductive material before cancer treatment: a qualitative study of health care professionals’ views about ways to enhance clinical care

Social Egg Freezing: Developing Countries Are Not Exempt

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