Combining fertility preservation procedures to spread the eggs across different baskets: a feasibility study

Area of Science:

• Reproductive Medicine
• Oncofertility
• Cryobiology

Background:

• Fertility preservation (FP) is crucial for patients undergoing gonadotoxic treatments.
• A lack of clear algorithms necessitates patient-tailored FP strategies.
• Combining procedures like oocyte vitrification and ovarian tissue cryopreservation (OTC) can broaden reproductive options.

Purpose of the Study:

• To evaluate the reproductive potential of combined fertility preservation techniques.
• To assess reproductive outcomes in patients who attempted pregnancy post-FP.
• To explore the feasibility of integrating in vitro maturation (IVM) with other FP methods.

Main Methods:

• Retrospective observational study of 207 female patients undergoing urgent medical FP (2012-2018).
• Descriptive analysis of stand-alone and combined FP procedures.
• Evaluation of live birth rates in patients attempting pregnancy post-FP.

Main Results:

• Controlled ovarian stimulation (COS) yielded 10.8 MII oocytes; IVM yielded 9.2 MII oocytes.
• Combined OTC and IVM (OTO-IVM) yielded 4.0 MII oocytes and ovarian fragments.
• 15% of patients returned to attempt pregnancy, with a 75% live birth rate using fresh oocytes and 42.1% using cryopreserved material.

Conclusions:

• Combining different FP procedures is a feasible strategy to enhance reproductive potential.
• Patient-tailored approaches are effective, but further follow-up studies are needed.
• These combined methods show promise for improving reproductive outcomes in patients undergoing gonadotoxic treatments.