Fertility preservation through oocyte or embryo vitrification prior to oncological treatment: a 12-year experience

Fertility preservation in women with cancer represents a major medical challenge at the intersection of oncological and reproductive concerns. With therapeutic advancements, the survival rates of cancer patients have significantly improved, offering the possibility of motherhood. Currently, there is a lack of data on the return of cryopreserved oocytes/embryos and pregnancy outcomes following cancer treatment.

We conducted a retrospective, single-center, descriptive cohort study, including women who underwent fertility preservation through oocyte or embryo cryopreservation before a medium risk of gonadotoxicity chemotherapy for cancer at our Department of Reproductive Medicine and Oncofertility between January 2012 and May 2024.

A total of 327 women were included, with 318 cases of oocyte cryopreservation and nine embryo cryopreservation. The average follow-up duration was 5.1 ± 2.7 years. Among the 49 women who expressed a desire for pregnancy post-cancer treatment, 65.3% of them (n = 32/49) reported at least one live birth. Of the 35 live births recorded, 80% (n = 28/35) resulted from spontaneous pregnancies, five were achieved after thawing vitrified oocytes (11.4%), and three after oocyte donation (8.6%). The return rate of cryopreserved oocytes was 6.92% (22/318), with a live birth rate per woman of 22.7% (5/22) following oocyte warming.

Although fertility preservation (FP) must be proposed systematically in age-reproductive women facing cancer with a medium risk of gonadotoxicity chemotherapy, physicians must be aware of the low rate of oocyte return and the potential for spontaneous pregnancies despite a post-cancer diminished ovarian reserve. Fertility consultations should also be better integrated into oncologic post-treatment care.