Fertility Preservation Through Oocyte Vitrification: Clinical and Laboratory Perspectives

10.3791/61963 ◽  
2021 ◽  
Author(s):  
Roberta Maggiulli ◽  
Alberto Vaiarelli ◽  
Danilo Cimadomo ◽  
Adriano Giancani ◽  
Luisa Tacconi ◽  
...  
Keyword(s):  
Fertility Preservation ◽  
Oocyte Vitrification

O-180 Oocyte vitrification for fertility preservation does not delay the initiation of neoadjuvant chemotherapy for breast cancer

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
I Sellami ◽  
M Grynberg ◽  
A Benoit ◽  
C Sifer ◽  
A Mayeur ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Fertility Preservation ◽  
Cancer Diagnosis ◽  
Ovarian Tissue ◽  
Young Patients ◽  
Oocyte Retrieval ◽  
Breast Cancer Patients ◽  
Oocyte Vitrification

Abstract Study question Does oocyte vitrification for fertility preservation (FP) delay the initiation of neoadjuvant chemotherapy for breast cancer? Summary answer The indication of neoadjuvant chemotherapy for breast cancer should not be considered as an impediment to urgent oocyte vitrification for FP. What is known already FP is considered as one of the most important issues to address for young breast cancer patients. Cryopreservation of oocytes or embryos may be considered after controlled ovarian hyperstimulation (COH) or in vitro maturation (IVM). Pregnancies have been reported after reutilization of oocytes frozen following both procedures. Although oocyte competence is better after COH, this strategy requires on average 13 days to be achieved. In addition, the safety of ovarian stimulation before tumor removal is currently not formally established. In case of neoadjuvant chemotherapy, the risk-benefit balance of COH is not well known. Study design, size, duration Retrospective cohort study including all breast cancer patients eligible for oocyte vitrification following COH or IVM before initiation of neoadjuvant chemotherapy between January 2016 and December 2020. Participants/materials, setting, methods Inclusion criteria were: female patients with confirmed non metastatic breast cancer, 18 to 40 years of age, with indication of neoadjuvant chemotherapy, who have had oocyte retrieval for FP after COH or IVM +/- cryopreservation of ovarian tissue. Various time-points related to cancer diagnosis, FP or chemotherapy were obtained from medical record review. Main results and the role of chance A total of 198 patients with confirmed breast cancer who had oocyte retrieval following COH (n = 57) or IVM +/- cryopreservation of ovarian tissue (n = 141) for FP prior to neoadjuvant chemotherapy were included. Although women in IVM group were significantly younger as compared to patients who underwent COH (31.7 ± 4.2 vs. 33.3 ± 4.0 years, p = 0.019), ovarian reserve parameters, BMI and cancer stage did not differ between the two groups. Overall, the average time from cancer diagnosis to chemotherapy start was similar between patients having undergone COH or IVM before oocyte vitrification (37.3 ± 13.8 vs. 36.9 ±13.5 days in COH and IVM groups respectively, p=0.857). Limitations, reasons for caution The time from referral to FP consultation may have influenced the type of FP. In addition, the retrospective nature of the present analysis may constitute a limitation. Moreover, the efficiency and security of the different FP strategies used has not been analysed. Wider implications of the findings Oocyte vitrification following COH or IVM was not associated with delayed breast cancer treatment in the neoadjuvant setting, so long as there was a prompt FP referral. Young patients undergoing neoadjuvant chemotherapy should be informed of these findings to avoid unnecessary anxiety due to concern for delays. Trial registration number Not applicable

scholarly journals Oocyte vitrification as an efficient option for elective fertility preservation

2016 ◽  
Vol 105 (3) ◽  
pp. 755-764.e8 ◽  
Author(s):  
Ana Cobo ◽  
Juan A. García-Velasco ◽  
Aila Coello ◽  
Javier Domingo ◽  
Antonio Pellicer ◽  
...  
Keyword(s):  
Fertility Preservation ◽  
Oocyte Vitrification ◽  
Efficient Option

P–463 Patients undergoing elective and onco-fertility preservation respond similarly to controlled ovarian stimulation for fertility preservation

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Kira ◽  
M Hentschke ◽  
N Fontour. d. Vasconcelos ◽  
V Deven. Trindade ◽  
T Colombo ◽  
...  
Keyword(s):  
Fertility Preservation ◽  
Ovarian Stimulation ◽  
Negative Impact ◽  
Controlled Ovarian Stimulation ◽  
Historical Study ◽  
Similar Response ◽  
Breast Cancer Patients ◽  
Oocyte Vitrification ◽  
Patients With Cancer ◽  
Significant Difference

Abstract Study question Is the oocyte vitrification response different in patients undergoing elective and onco-fertility preservation? Summary answer Patients undergoing elective and onco-fertility preservation seem to respond similarly to controlled ovarian stimulation for fertility preservation. What is known already Age persists as the factor with the most significant impact on the prognosis of female fertility. The ovarian reserve can also be threatened by surgical, radiotherapy or chemotherapy procedures. Thus, maternity delay and the increased incidence of malignant diseases are the most jeopardizing conditions for reproductive potential in women. Studies are still conflicting about oocyte freezing results in patients with and without cancer. Some studies suggest worse outcomes in patients with cancer regarding the number of mature vitrified oocytes when compared to healthy patients whether others show similar response to the ovarian stimulation for fertility preservation in both groups. Study design, size, duration Observational, cross-sectional, and historical study using data from 367 who underwent oocyte vitrification from a Reproductive Medicine Center, between 2009 and 2018. Participants/materials, setting, methods Patients were divided into an elective group (EG; n = 327) and an onco-fertility group (OFG; n = 40). Data were presented as mean ± standard deviation or median and interquartile range (IQR) and absolute and relative frequencies. Chi-square test, Student’s t-test, or Mann-Whitney test were applied. Generalized linear models were used to control confounding factors. Data were adjusted by women age, FSH, and GnRH protocol. The null hypothesis was rejected when p < 0.05. Main results and the role of chance: Patients age in OFG was significantly lower compared to EG (31.3±5.8 vs. 37.0 ±2.9 years; p < 0.01) and also FSH measurement (4.0 [3.3 – 6.2] vs. 9.0 (5.4 – 9.9) mIU/mL; p < 0.01). The presence of a partner was significantly higher in OFG (25 [62.5%] vs. [19.9%]; p < 0.001). GnRH antagonist protocol was used in 80.1% of cycles, and FSH-r was used in 80.4% of cycles. Letrozole was added for 20 breast cancer patients (74%). When adjusting data for age, FSH and Gonadotropin-releasing Hormone (GnRH) protocols, no significant difference in the number of vitrified mature oocytes between the two groups were observed (6.0 [3.0–11.0] vs. 7.0 [3.0–12.0]; p = 0.11). Limitations, reasons for caution: The number of women in the OFG was lower than the EG group. The OFG was composed of different types of tumors in different locations and stages. Thus, it can be questioned whether any patient with a more aggressive tumor might have had a negative impact on the results. Wider implications of the findings: Healthy patients and patients with cancer seem to respond similarly to ovarian stimulation for fertility preservation. The extensive number of cycles performed for EG in contrast to OFG leads to a reflection on patients who are still not referred for reproductive counseling after a cancer diagnosis. Trial registration number Not applicable

scholarly journals Obstetric outcome after oocyte vitrification and warming for fertility preservation in women with cancer

2014 ◽  
Vol 29 (6) ◽  
pp. 722-728 ◽  
Author(s):  
Maria Martinez ◽  
Susana Rabadan ◽  
Javier Domingo ◽  
Ana Cobo ◽  
Antonio Pellicer ◽  
...  
Keyword(s):  
Fertility Preservation ◽  
Obstetric Outcome ◽  
Oocyte Vitrification

P–454 Oocyte vitrification for fertility preservation in women with benign gynecological disease: French national clinical guidelines with a modified Delphi consensus process

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
B Courbière ◽  
E L Roux ◽  
E Mathie. D’Argent ◽  
A Torre ◽  
C Patrat ◽  
...  
Keyword(s):  
Fertility Preservation ◽  
Ovarian Reserve ◽  
Healthcare Professionals ◽  
Diminished Ovarian Reserve ◽  
Oocyte Vitrification ◽  
Modified Delphi ◽  
Gynecological Diseases ◽  
Gynecological Disease ◽  
Benign Gynecological Disease ◽  
Benign Gynecological Diseases

Abstract Study question Is there consensual clinical practices about fertility preservation (FP) for benign gynecological diseases BGD)? Summary answer A consensus study using the modified Delphi method identified 28 consensual practices concerning oocyte vitrification for fertility preservation in women with benign gynecological disease. What is known already Clinical Practical international guidelines are still published in oncology for offering standardized information and care for adults and children with cancer. Recently, the ESHRE Female Fertility Preservation Guideline Development Group published recommendations for healthcare professionals involved in fertility preservation for post-pubertal women and transgender adolescents and young adults. However, benign gynecological indications weren’t distinctly individualized of malignant conditions. There’s a lack of large cohort studies assessing the risks and outcome of FP for benign gynecological diseases. Healthcare professionals need consensus for defining the “good” indications of FP for benign gynecological diseases that could impair fertility. Study design, size, duration A steering group composed by 14 healthcare professionals and a patient representative with lived experience of endometriosis identified 42 potential practices concerning fertility preservation for benign gynecological disease. Then, 114 key stakeholders including various healthcare professionals (n = 108) and patient representatives(n = 6) were asked to answer at two rounds of a modified Delphi via an online survey from February to September 2020. Participants/materials, setting, methods Participants had to score 42 items for the first round and 31 for the second round using a nine-point Likert scale. These statements were distributed into five categories: Information to deliver to age-reproductive women with a BGD (n = 9), technical aspect of fertility preservation for BGD (n = 6), indications of FP for endometriosis (n = 13), indications of FP for none-endometriosis BGD (n = 10), idiopathic diminished ovarian reserve in the absence of gynecologic and endocrinologic diseases (n = 4). Main results and the role of chance Survey response of stakeholders was 75% (86 out of 114) for the round 1 and 87% (75 out of 86) for the round 2. Consensus recommendations were achieved for 28 items, and no consensus between stakeholders was achieved in the remaining items. Stakeholders rated the importance of an age-specific information concerning the risk of diminished ovarian reserve after surgery and the necessity to inform about the benefice/ risk balance of oocyte vitrification, in particular about the chance of live-birth according to the age at the time of oocyte vitrification. They endorsed oocyte vitrification as the reference FP technique for those benign indications. Experts rejected to determine lower and upper age limits in women for fertility preservation. FP shouldn’t be offered in rAFS stages I and II endometriosis without endometriomas. Limitations, reasons for caution Experts were only French native speakers from France, and Belgium. It would have been interesting to conduct this survey with experts from other continents. Wider implications of the findings: At our knowledge, we present here the first guideline s focusing on FP in women with BGD, following a designed scientific Delphi procedure. These guidelines could be useful for gynecologists to better inform women with benign gynecological diseases about the indication or not to offer a FP procedure. Trial registration number Not applicable

scholarly journals First French live-birth after oocyte vitrification performed before chemotherapy for fertility preservation

2016 ◽  
Vol 33 (5) ◽  
pp. 663-666 ◽  
Author(s):  
J. Perrin ◽  
J. Saïas-Magnan ◽  
F. Broussais ◽  
R. Bouabdallah ◽  
C. D’Ercole ◽  
...  
Keyword(s):  
Fertility Preservation ◽  
Live Birth ◽  
Oocyte Vitrification
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