Fertility preservation in >1,000 patients: patient's characteristics, spectrum, efficacy and risks of applied preservation techniques

Arch Gynecol Obstet. 2011 Mar;283(3):651-6. doi: 10.1007/s00404-010-1772-y. Epub 2010 Dec 1.

Abstract

Introduction: Data on the characteristics of female patients counselled for fertility preservation and the efficacy and risk of the applied procedures are still poor. We therefore analysed the registry of a network of 70 infertility centers which are involved in fertility preservation in Germany, Switzerland and Austria, called FertiPROTEKT ( hhtp://www.fertiprotekt.eu ).

Materials and methods: 1,280 counselled patients (15-40 years) were analysed regarding characteristics and different fertility preservation treatments before cytotoxic therapy in 2007-2009.

Results: 34.8% of the counselled patients were diagnosed with breast cancer, 30.5% with Hodgkin's lymphoma, 25.4% with other malignancies and 9.3% with non-malignant diseases. 89.6% of the treated breast cancer patients were 25-40 years of age, and 87.5% of the lymphoma patients were 15-30 years of age. At the time of counselling, 85.3% of the breast cancer patients and 92.7% of the lymphoma patients were childless. 1,080 patients received a single or combined therapy such as GnRH agonists (n = 823), cryopreservation of ovarian tissue (n = 500), ovarian stimulation (n = 221) and transposition of the ovaries (n = 24). Only one severe complication, requiring postponement of the chemotherapy, was documented. In stimulated patients, 2,417 oocytes (mean n = 11.6, SD ± 7.7) were received. Fertilisation rate per received oocyte was 61.3%.

Conclusions: Fertility preservation programmes mainly involve women without children, diagnosed with breast cancer or Hodgkin's lymphoma. Fertility preservation techniques can be applied with low risk. The limited and age-dependant success rate of the different therapies require individualised approaches of single or combined fertility preservation techniques.

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Agents / adverse effects*
  • Austria
  • Breast Neoplasms / drug therapy
  • Cryopreservation
  • Female
  • Germany
  • Gonadotropin-Releasing Hormone / adverse effects
  • Gonadotropin-Releasing Hormone / agonists
  • Hodgkin Disease / drug therapy
  • Humans
  • Infertility, Female / prevention & control*
  • Ovulation Induction / adverse effects
  • Registries
  • Reproductive Techniques, Assisted / adverse effects*
  • Switzerland
  • Tissue Preservation
  • Young Adult

Substances

  • Antineoplastic Agents
  • Gonadotropin-Releasing Hormone