Oocyte donation in women cured from cancer provide similar live birth rates compared to women without previous history of cancer

Fragestellung:

What are the reproductive outcomes of women cured from cancer undergoing oocyte donation (OD)?

Methodik:

Retrospective cohort study including 172 women cured from cancer, which underwent OD treatment between 2006 and 2015. We describe the reproductive outcomes of their first OD treatment performed at our clinic. The included patients were treated and cured from cancer by one or more of 4 oncological treatments (CT, RT, surgery, bone marrow transplant). All patients started ART after 5 years of follow-up from cancer and with authorization and declaration of cancer-free from their oncologists. All patients were analyzed for common demographic parameters and for reproductive outcomes.

Ergebnisse:

The average age at OD cycle was 37.2 ± 6.2, all patients were of BMI between 18 – 25. The majority (166; 96.5%) were Caucasians, 2 (1.2%) Asian, and 3 (1.7%) Black; 46 were treated for Hodgkin lymphoma (3 also having thyroid, breast cancer or leukemia), 40 lymphoblastic leukemia, 21 borderline ovary cancer, 20 breast cancer, 15 no Hodgkin lymphoma, 7 colon-rectal cancer, 5 bone cancer (1 with ovarian borderline cancer), 4 thyroid cancer, 4 urinary system cancer, 10 others. The majority of patients (64.5%) were given a mixed therapy: 73.3% QT, 51.2% RT, surgery 41.9%, bone marrow transplant 39%. Time between being disease-free and ART was 10.7 years on average. Iatrogenic menopause affected 104 (60.5%) women. In 147 (85.4%) of the OD cycles, oocytes were fertilized with partner sperm. ET was performed on day 2 – 3 of embryo development in 160 cases (93%). Single embryo transfer was performed in 30 (17.4%) cycles, 2 embryos were transferred in 141 (82%) cases and 3 embryos were transferred in 1 case (0.6%). Overall, clinical pregnancy rate as 40.1%, ongoing pregnancy rate 31.4%, and live birth rate 29.8%. When comparing patients who received a bone marrow transplant or not, the differences in reproductive outcomes were not statistically significant (clinical pregnancy: 43.6% vs. 39.1%, ongoing pregnancy 33.3% vs. 30.8%, and live birth 30.1% vs. 28.4%; p > 0.05). The main limitation of this study is its retrospective design, and the fact that patients were recruited along a period of 10 years. During this time, both oncological and ART treatments have undergone significant changes, possibly affecting the generalizability of the presented results.

Schlussfolgerung:

Live birth rate in women treated and cured of cancer following OD is 29.8%. According to our results, OD treatments in patients cured of cancer provide satisfactory results, with a live birth rate that is comparable to that reported for women that did not suffer from cancer. Physicians should discuss this option with patients cured of cancer in the context of reproductive counseling.