Oocyte cryopreservation

Does the use of oocyte cryopreservation and assisted reproduction result in pregnancy and live birth for women with a history of cancer?

Cryopreservation of mature oocytes is now acknowledged as a successful form of fertility preservation for post pubertal girls and women at risk of premature ovarian insufficiency.^[1] Given the delay between collection and eventual use of the oocytes in patients with cancer, there are few reports detailing success rates.^[2][3][4] A large body of evidence regarding pregnancy and live birth rates for women who have cryopreserved oocytes for a variety of reasons (including cancer), demonstrates comparable pregnancy and live birth rates to infertile patients who have standard IVF treatment.^[5][6]

Ten to fourteen days is required for the stimulation phase and retrieval, and back-to-back and luteal start cycles are possible to ensure maximal opportunity without undue delay of commencement of cancer treatment.^[7] Early referral of cancer patients facilitates the opportunity for a stimulation cycle and should be a high priority. One or two cycles of ovarian stimulation will yield a finite number of oocytes. Even with a large cohort of oocytes retrieved, this will provide only a small number of embryos to conceive with in the future, given the expected attrition rate for any IVF treatment from cryopreserved oocyte to usable embryo.^[5]

Pregnancy rates from oocyte cryopreservation are similar to those from embryo cryopreservation and fresh embryo transfer, hence consideration must be given to the degree of relationship security.