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

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 following a cancer diagnosis. Fertility preservation was defined as oocyte retrieval ≤90 days after cancer diagnosis, and IVF after cancer treatment as retrieval >90 days post-diagnosis. 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 to 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 = 2,941) but was significantly lower for women who underwent retrievals after cancer treatment (N = 2,479) (mean difference=-2.99; 95% CI: -3.40-2.59). 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 to 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: 0.61-0.79), 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.