LAUSR

T wenty years of data on how young patients with cancer use their stored eggs and embryos after cancer treatment indicates that fertility preservation can be successful, particularly among breast cancer survivors, according to a study presented in July at the virtual annual meeting of the European Society of Human Reproduction and Embryology. Researchers note that approximately 1 in 6 women who stored their gametes (reproductive cells) had a good outcome. They analyzed 879 young female patients who had been treated for a variety of cancers between 2000 and 2019 and had sought counseling on fertility preservation. Both chemotherapy and radiotherapy can have adverse effects on ovarian function and cause infertility. The results were presented by Dalia Khalifé, MD, who completed the research as a clinical fellow at Guy’s and St. Thomas’ Hospital in London. Dr. Khalifé is presently an obstetrics and gynecology specialist at Jumeirah American Clinic in Dubai. The patients’ mean age was 33 years, and 63% of them had a breast cancer diagnosis. After they were counseled, 373 women (42%) opted for fertility preservation by 1 of several methods: egg freezing (53%), embryo freezing (41%), both methods combined (5%), and ovarian tissue cryopreservation (1%). Thus far in the analysis, 61 women (16%) have returned to use their frozen eggs and embryos, and 44 of them have experienced a high birth rate of 71% (and a twin birth rate of 9%) with in vitro fertilization. Approximately two-thirds of the patients returned for fertility treatment within 2 years of their diagnoses. Women who previously had breast cancer were the most likely to return and also had the highest birth rates: 70% versus 30% for female survivors of lymphoma. According to Dr. Khalifé, almost all patients in the study showed some deterioration in their ovarian reserve levels, the result of the mild to severe toxicity of their treatment. She adds that there were even a number of naturally conceived pregnancies after cancer treatment. The most common fertility treatment offered to young women is oocyte freezing, which scientists have perfected through the years. Although ovarian tissue cryopreservation is not widely available, it is used in certain urgent cases and provides an option for the prepubertal female, Dr. Khalifé says. Patient follow-up rates will continue to increase in the future because young women in their teens and 20s are unlikely to return for many years, she adds, noting that the study’s data should be reassuring to many.