Oocyte Cryostorage to Preserve Fertility in Oncological Patients (original) (raw)
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Journal of Assisted Reproduction and Genetics, 2010
Purpose To compare oocyte cryopreservation cycles performed in cancer patients to those of infertile women. Methods Cancer patients referred for fertility preservation underwent counseling in compliance with the ASRM; those electing oocyte cryopreservation were included. Ovarian stimulation was achieved with injectable gonadotropins and freezing was performed using slow-cooling and vitrification methods. Results Fifty cancer patients (mean age 31 y) underwent oocyte cryopreservation; adequate ovarian stimulation was achieved in 10±0.3 days. The outcome from these cycles included a mean peak estradiol of 2,376 pg/ml and an average of 19 oocytes retrieved (15 mature oocytes were cryopreserved/cycle). All patients tolerated ovarian hyperstimulation. There were no significant differences noted between cryopreservation cycles performed in cancer patients and in women without malignancy.
Oocyte cryopreservation as a fertility preservation measure for cancer patients
Reproductive BioMedicine Online, 2011
Dr Noyes has worked full-time in infertility since 1990. She received her medical degree from the University of Vermont, then completed residency in obstetrics/gynaecology and fellowship in reproductive endocrinology at the New York Hospital-Cornell Medical Center. She is board-certified in both obstetrics/gynaecology and reproductive endocrinology. Dr Noyes has been involved in the treatment of over 17,000 infertility patients using assisted reproductive technologies. In addition, since 2004, she and Dr Westphal have been actively involved in fertility preservation, including oocyte freezing. Their continued academic collaboration has culminated in this important and informative clinical review.
JBRA Assisted Reproduction, 2019
Objective: This study aimed to assess whether a diagnosis of cancer interferes with ovarian function prior to the treatment of the disease. Methods: This observational retrospective study used data from medical records of ovarian stimulation cycles performed for purposes of oocyte cryopreservation. Results: The included patients had a mean age of 35.13±3.72 years and 51.6% of them were aged between 36 and 40 years. More than half of the patients (57.6%) were single and 82.1% had a normal body mass index (BMI). Most women had not become pregnant (85.5%) or had babies (95.1%) or miscarriages (89.6%) prior to cryopreservation. The mean number of oocytes obtained from non-cancer patients was 11.4±8, while for cancer patients the number was 13.8±9. The mean number of frozen mature oocytes was 9.7±7 for the non-cancer group and 11.2±7.2 for the cancer group. The majority (63.1%) of the patients had up to 10 oocytes frozen per cycle. Breast cancer had the highest incidence among the included patients. There was no significant difference in ovarian response between patients with different types of cancer. Conclusion: The number of harvested and frozen oocytes from cancer and non-cancer patients indicated that in the two groups response to ovarian stimulation was similar.
Cryopreservation and fertility: current and prospective possibilities for female cancer patients
ISRN obstetrics and gynecology, 2011
With the evolution of the treatment of malignant neoplasms, the survival rates of patients undergoing chemo- or radiotherapy are increasing. The continuous development of techniques of assisted human reproduction has led to important strategies in an attempt to maintain reproductive function in patients subjected to treatment of neoplastic diseases, among them cryopreservation of embryos, gametes, and ovarian cortical tissue. The freezing of ovarian tissue is currently being proposed with the primary purpose of preserving ovarian function in these patients. Currently, the major challenge of groups working with preservation of fertility is the use of cryopreserved ovarian tissue after disease remission. The main alternatives presented today are the implantation of hetero- or orthotopic tissue and isolation of immature follicles from ovarian tissue followed by in vitro maturation and assisted reproduction procedures.
Oocyte cryopreservation in oncological patients
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2004
The use of chemotherapy and radiotherapy in oncological patients may reduce their reproductive potential. Sperm cryopreservation has been already used in men affected by neoplastic disease. Oocyte cryopreservation might be an important solution for these patients at risk of losing ovarian function. A program of oocyte cryopreservation for oncological patients is also present in our center. From June 1996 to January 2000, 18 patients awaiting chemotherapy and radiotherapy for neoplastic disease were included in our oocyte cryopreservation program. Our experience documents that oocyte storage may be a concrete and pragmatic alternative for oncological patients. The duration of oocyte storage does not seem to interfere with oocyte survival as pregnancies occurred even after several years of gamete cryopreservation in liquid nitrogen. #
Human oocyte cryopreservation in infertility and oncology
Current Opinion in Endocrinology, Diabetes & Obesity, 2008
Purpose of review To evaluate the present state of research and clinical application of human oocyte cryopreservation in infertility and oncology. Recent findings Recent literature documents have an increasing interest in cryopreserving human eggs. A number of studies report on different freezing protocols and various types of clinical application. Increasing attention is paid to vitrification as an alternative to slow cooling for oocyte cryopreservation. Several studies cover the modification of meiotic spindle during cryopreservation in order to assess the less damaging cryopreservation system. The first births with cryopreserved oocytes in cancer patients are reported. Summary Egg freezing may circumvent the ethical and legal concerns regarding embryo cryopreservation, increase assisted reproduction flexibility and be a concrete option to save fertility in women with cancer. Recently, egg survival and pregnancy rates improved, with the birth of more than 500 children. The birth rate per thawed oocyte is around 5-6%. As regards safety, data on birth defects seems to be reassuring so far but must be monitored by an international registry. Comparative studies between slow freezing and vitrification in the same patient population are needed to elucidate pros and cons of each technique.
Acta morphologica et anthropologica
Cancer is the second most common cause of death after the diseases of the cardio-vascular system. Due to the modern complex treatment methods, there are increasing survival rates of oncological patients. That puts forward the question for the quality of life of the recovered and respectively, their ability to have children. In large number of cases, the chemo-/radiotherapy leads to damage to oogenesis and spermatogenesis. For that reason, the patients are offered fertility preservation solutions before the start of the anti-tumour therapy. The basic approaches to fertility preservation in patients with pending chemo-or radiotherapy are presented in the current review.
Fertility and Sterility, 2009
Objective: To analyze if oocytes can be obtained in all patients before cancer treatment within 2 weeks by initiating ovarian stimulation during the follicular or luteal phase. Design: Prospective controlled multicenter trial. Setting: Four university-based centers. Patient(s): Forty cancer patients before chemotherapy. Intervention(s): Twenty-eight patients were stimulated with gonadotropins in the follicular phase (group I). In 12 patients (group II), ovarian stimulation was initiated in the luteal phase, and these received GnRH antagonists and recombinant FSH. In 14 patients, 143 oocytes were further processed for fertilization by intracytoplasmic sperm injection (ICSI). Main Outcome Measure(s): Number of oocytes aspirated after ovarian stimulation, cumulative FSH/hMG dosage, viability and maturity of oocytes, and fertilization rate by ICSI. Result(s): Patients in group I (age 27.6 AE 4.9 yrs) were stimulated on average for 10.6 days, and patients in group II (age 31.2 AE 5.7 yrs) for 11.4 days. Total amount of FSH was on average 2,255 IU (I) and 2,720 IU (II) per patient. Average and median numbers of aspirated oocytes were, respectively, 13.1 and 11.5 (I) versus 10.0 and 8.5 (II); 83.7% (I) and 80.4% (II) of the oocytes were mature and viable and could be treated by ICSI. Fertilization rate was 61.0% (I) versus 75.6% (II). Conclusion(s): This pilot study suggests that oocytes can be obtained before cancer treatment efficiently irrespective of the phase of the menstrual cycle.