Fertility preservation through oocyte or embryo vitrification prior to oncological treatment: a 12-year experience.

IF 2.7 3区医学 Q2 GENETICS & HEREDITY

Journal of Assisted Reproduction and Genetics Pub Date : 2025-05-01 Epub Date: 2025-05-30 DOI:10.1007/s10815-025-03522-5

Appoline Zimmermann, Jeanne Perrin, Carole Deveze, Jacqueline Saias-Magnan, Catherine Guillemain, Blandine Courbiere

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引用次数: 0

Abstract

Purpose: Fertility preservation in women with cancer represents a major medical challenge at the intersection of oncological and reproductive concerns. With therapeutic advancements, the survival rates of cancer patients have significantly improved, offering the possibility of motherhood. Currently, there is a lack of data on the return of cryopreserved oocytes/embryos and pregnancy outcomes following cancer treatment.

Methods: We conducted a retrospective, single-center, descriptive cohort study, including women who underwent fertility preservation through oocyte or embryo cryopreservation before a medium risk of gonadotoxicity chemotherapy for cancer at our Department of Reproductive Medicine and Oncofertility between January 2012 and May 2024.

Results: A total of 327 women were included, with 318 cases of oocyte cryopreservation and nine embryo cryopreservation. The average follow-up duration was 5.1 ± 2.7 years. Among the 49 women who expressed a desire for pregnancy post-cancer treatment, 65.3% of them (n = 32/49) reported at least one live birth. Of the 35 live births recorded, 80% (n = 28/35) resulted from spontaneous pregnancies, five were achieved after thawing vitrified oocytes (11.4%), and three after oocyte donation (8.6%). The return rate of cryopreserved oocytes was 6.92% (22/318), with a live birth rate per woman of 22.7% (5/22) following oocyte warming.

Conclusion: Although fertility preservation (FP) must be proposed systematically in age-reproductive women facing cancer with a medium risk of gonadotoxicity chemotherapy, physicians must be aware of the low rate of oocyte return and the potential for spontaneous pregnancies despite a post-cancer diminished ovarian reserve. Fertility consultations should also be better integrated into oncologic post-treatment care.

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肿瘤治疗前通过卵母细胞或胚胎玻璃化保存生育能力：12年的经验。

目的：癌症妇女的生育能力保存是肿瘤学和生殖学交叉关注的一个重大医学挑战。随着治疗方法的进步，癌症患者的存活率大大提高，为生育提供了可能。目前，缺乏关于冷冻保存的卵母细胞/胚胎和癌症治疗后妊娠结局的数据。方法：我们进行了一项回顾性、单中心、描述性队列研究，纳入了2012年1月至2024年5月在生殖医学和肿瘤生育科接受中等风险的促性腺毒性化疗前通过卵母细胞或胚胎冷冻保存保存生育能力的妇女。结果：共纳入327例女性，其中卵母细胞冷冻保存318例，胚胎冷冻保存9例。平均随访时间为5.1±2.7年。在49名癌症治疗后表示希望怀孕的妇女中，65.3% （n = 32/49）报告至少有一个活产。在记录的35例活产中，80% （n = 28/35）为自然妊娠，5例（11.4%）为解冻玻璃化卵母细胞后妊娠，3例（8.6%）为捐赠卵母细胞后妊娠。冷冻卵母细胞的恢复率为6.92%(22/318)，卵母细胞升温后每名妇女的活产率为22.7%（5/22）。结论：尽管对于面临癌症且接受促性腺毒性化疗的中等风险的育龄妇女，必须系统地提出保留生育能力（FP），但医生必须意识到，尽管癌症后卵巢储备功能减弱，但卵母细胞返回率较低，并且有可能自然怀孕。生育咨询也应更好地纳入肿瘤治疗后护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Assisted Reproduction and Genetics 医学-妇产科学

CiteScore

5.70

自引率

9.70%

发文量

286

审稿时长

1 months

期刊介绍： The Journal of Assisted Reproduction and Genetics publishes cellular, molecular, genetic, and epigenetic discoveries advancing our understanding of the biology and underlying mechanisms from gametogenesis to offspring health. Special emphasis is placed on the practice and evolution of assisted reproduction technologies (ARTs) with reference to the diagnosis and management of diseases affecting fertility. Our goal is to educate our readership in the translation of basic and clinical discoveries made from human or relevant animal models to the safe and efficacious practice of human ARTs. The scientific rigor and ethical standards embraced by the JARG editorial team ensures a broad international base of expertise guiding the marriage of contemporary clinical research paradigms with basic science discovery. JARG publishes original papers, minireviews, case reports, and opinion pieces often combined into special topic issues that will educate clinicians and scientists with interests in the mechanisms of human development that bear on the treatment of infertility and emerging innovations in human ARTs. The guiding principles of male and female reproductive health impacting pre- and post-conceptional viability and developmental potential are emphasized within the purview of human reproductive health in current and future generations of our species. The journal is published in cooperation with the American Society for Reproductive Medicine, an organization of more than 8,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.