Relatively Few Women Who Cryopreserve an Ovary Experience Cancer Treatment-Related Ovarian Failure
(ChemotherapyAdvisor) – Most women who cryopreserve an ovary prior to cancer treatment to maintain fertility do not experience premature ovarian failure (POF), according to a study published in the journal Reproductive Biomedicine Online.
The study identified a “fairly low overall risk of premature ovarian failure of 22%,” reported lead author Kirsten L. Tryde Schmidt, PhD, Copenhagen University Hospital, Copenhagen, Denmark, and coauthors. “The risk was highest in the group with leukemia or other malignancies requiring treatment with bone marrow transplantation (BMT) and lowest among the women with breast cancer.”
Chemotherapy and radiation therapy in girls and premenopausal women can cause POF, most frequently among older women and patients administered alkylating agent chemotherapies, abdominal radiotherapy or BMT, the authors noted.
The authors conducted a questionnaire study of 143 female cancer survivors who had cryopreserved one ovary. At a mean follow-up of 58 months (range 24-129 months) after cryopreservation, POF had affected 13 of 15 study participants treated for leukemia (87%), compared to only 5 of 54 (9%) of women with breast cancer, the authors reported.
Among 57 study participants who had attempted to become pregnant after cancer treatment, 41 women had become pregnant, giving birth to 45 infants. A total of 15 spontaneous abortions and one ectopic pregnancy had occurred during that period; 5 pregnancies are ongoing.
“Ninety-three percent of the pregnancies were after natural conception and only four cases were a result of fertility treatment,” the authors noted. “Patients who retain their ovarian function after treatment of a malignant disease have a good chance of becoming pregnant.”
Women with breast cancer who are younger “may not need cryopreservation of ovarian tissue with the actual protocol employed,” they added. “For female cancer survivors who have received a potentially gonadotoxic treatment and have one of their ovaries removed for cryopreservation, it is reassuring to know that most of them will not lose their ovarian function, at least not during the first years after treatment, and that it will allow many of them to be able to obtain a pregnancy during that period.”
The authors recommended “that women suffering from a disease requiring treatment with BMT should be offered fertility preservation and that women suffering from cancers not requiring treatment with BMT should be offered fertility preservation after assessment of the planned protocol and individual counseling.”