Fertility preservation and in vitro fertilization (IVF) success rates after cancer.

Abstract

Background: Evidence of the success of in vitro fertilization (IVF) procedures is critical for informed decision making before and after cancer treatment. We compared IVF outcomes between women with and without cancer.

Methods: Using data from a national IVF database-the Society for Assisted Reproductive Clinic Outcomes Reporting System, linked to statewide cancer registries and birth certificates in 9 states-we identified women who initiated IVF after a cancer diagnosis. Fertility preservation was defined as oocyte retrieval ≤90 days after cancer diagnosis, and IVF after cancer treatment as retrieval >90 days postdiagnosis. Number of oocytes retrieved and conception and livebirth rates were compared between these groups and a comparison group of women without cancer in couples with male factor infertility only.

Results: Compared with retrievals for male factor infertility only (n = 81 370), the number of oocytes retrieved was not significantly different for women who underwent retrieval for fertility preservation (n = 2941) but was significantly lower for women who underwent retrievals after cancer treatment (n = 2479) (mean difference = -2.99, 95% confidence interval [CI] = -3.40 to 2.59). Rate of conception as a function of transfer attempts and likelihood of livebirth after conception also did not significantly differ for fertility preservation (n = 291) compared with male factor infertility only (n = 34 410). Women with IVF after cancer treatment (n = 672) had a lower rate of conception (hazard ratio = 0.70, 95% CI = 0.61 to 0.79) but a similar overall likelihood of a livebirth after conception, relative to the group with male factor infertility only.

Conclusion: IVF outcomes may be maximized when ovarian retrieval is initiated before cancer treatment.