Does the use of oocyte cryopreservation and assisted reproduction result in pregnancy and live birth for women with a history of cancer?
Cryopreservation of mature oocytes is now acknowledged as a successful form of fertility preservation for post pubertal girls and women at risk of premature ovarian insufficiency. Given the delay between collection and eventual use of the oocytes in patients with cancer, there are few reports detailing success rates. A large body of evidence regarding pregnancy and live birth rates for women who have cryopreserved oocytes for a variety of reasons (including cancer), demonstrates comparable pregnancy and live birth rates to infertile patients who have standard IVF treatment.
Ten to fourteen days is required for the stimulation phase and retrieval, and back-to-back and luteal start cycles are possible to ensure maximal opportunity without undue delay of commencement of cancer treatment. Early referral of cancer patients facilitates the opportunity for a stimulation cycle and should be a high priority. One or two cycles of ovarian stimulation will yield a finite number of oocytes. Even with a large cohort of oocytes retrieved, this will provide only a small number of embryos to conceive with in the future, given the expected attrition rate for any IVF treatment from cryopreserved oocyte to usable embryo.
Pregnancy rates from oocyte cryopreservation are similar to those from embryo cryopreservation and fresh embryo transfer, hence consideration must be given to the degree of relationship security.
|Mature oocyte cryopreservation provides a realistic opportunity for future pregnancy for cancer patients. The age of the patient and the number of oocytes retrieved will influence the number of opportunities for pregnancy. Pregnancy rates after oocyte cryopreservation are similar to those after embryo cryopreservation.||II, III-3, IV||, , |
|The opportunity to freeze oocytes should be offered to post-pubertal girls and women at risk of gonadotoxicity from cancer treatment.||C|
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