Skip to main content

Advertisement

SpringerLink
Log in

Fertility preservation in >1,000 patients: patient’s characteristics, spectrum, efficacy and risks of applied preservation techniques

  • Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Introduction

Data on the characteristics of female patients counselled for fertility preservation and the efficacy and risk of the applied procedures are still poor. We therefore analysed the registry of a network of 70 infertility centers which are involved in fertility preservation in Germany, Switzerland and Austria, called FertiPROTEKT (hhtp://www.fertiprotekt.eu).

Materials and methods

1,280 counselled patients (15–40 years) were analysed regarding characteristics and different fertility preservation treatments before cytotoxic therapy in 2007–2009.

Results

34.8% of the counselled patients were diagnosed with breast cancer, 30.5% with Hodgkin’s lymphoma, 25.4% with other malignancies and 9.3% with non-malignant diseases. 89.6% of the treated breast cancer patients were 25–40 years of age, and 87.5% of the lymphoma patients were 15–30 years of age. At the time of counselling, 85.3% of the breast cancer patients and 92.7% of the lymphoma patients were childless.

1,080 patients received a single or combined therapy such as GnRH agonists (n = 823), cryopreservation of ovarian tissue (n = 500), ovarian stimulation (n = 221) and transposition of the ovaries (n = 24). Only one severe complication, requiring postponement of the chemotherapy, was documented. In stimulated patients, 2,417 oocytes (mean n = 11.6, SD ± 7.7) were received. Fertilisation rate per received oocyte was 61.3%.

Conclusions

Fertility preservation programmes mainly involve women without children, diagnosed with breast cancer or Hodgkin’s lymphoma. Fertility preservation techniques can be applied with low risk. The limited and age-dependant success rate of the different therapies require individualised approaches of single or combined fertility preservation techniques.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Schover LR, Rybicke LA, Martin BA, Bringelsen KA (1999) Having children after cancer. A pilot survey of survivors’ attitude and experiences. Cancer 86:697–709

    Article  CAS  PubMed  Google Scholar 

  2. Schover LR, Brey K, Lichtin A, Lipshultz LI, Jeha S (2002) Knowledge and experience regarding cancer, infertility, and sperm banking in younger male survivors. J Clin Oncol 20:1880–1889

    Article  PubMed  Google Scholar 

  3. Quinn GP, Vadaparampil ST, Ji-Hyun L, Jacobsen PB, Bepler G, Lancaster J, Keete DL, Albrecht TL (2009) Physician referral for fertility preservation in oncology patients: a national study of practice behaviors. J Clin Oncol 27:5952–5957

    Article  PubMed  Google Scholar 

  4. Beck-Fruchter R, Weiss A, Shalec E (2008) GnRH agonist therapy as ovarian protectants in female patients undergoing chemotherapy: a review of the clinical data. Hum Reprod Update 14(6):553–561

    Article  CAS  PubMed  Google Scholar 

  5. Blumenfeld Z, von Wolff M (2008) GnRH-analogues and oral contraceptives for fertility preservation in women during chemotherapy. Hum Reprod Update 14(6):543–552

    Article  CAS  PubMed  Google Scholar 

  6. Oktay K, Karlikaya G (2000) Ovarian function after transplantation of frozen, banked autologous ovarian tissue. N Engl J Med 342:1919

    Article  CAS  PubMed  Google Scholar 

  7. Lee SJ, Schover L, Partridge AH, Patrizio P, Wallace W, Hagerty R, Beck LN, Brennan LV, Oktay K (2006) American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J Clin Oncol 24:2917–2931

    Article  PubMed  Google Scholar 

  8. Huober-Zeeb C, Lawrenz B, Popovici R, Strowitzki T, Germeyer A, Stute P, v Wolff M (2010) Improving fertility preservation in cancer: ovarian tissue cryobanking followed by ovarian stimulation can be efficiently combined. Fertil Steril (in press)

  9. FertiPROTEKT (2009) Network for fertility preservation before chemo- and radiotherapy. Available at: http://www.fertiprotekt.de/index.php?lang=uk. Accessed 13 November 2009

  10. Von Wolff M, Thaler C, Frambach T, Zeeb C, Lawrenz B, Popovici R, Strowitzki T (2009) Ovarian stimulation to crypopreserve fertilized oocytes in cancer patients can be started in the luteal phase. Fertil Steril 92(4):1360–1365

    Article  Google Scholar 

  11. Behringer K, Breuer K, Reineke T, May M, Nogova L, Klimm B, Schmitz T, Wildt L, Diehl V, Engert A, German Hodgkin’s Lymphoma Study Group (2005) Secondary amenorrhea after Hodgkin’s lymphoma is influenced by age at treatment, stage of disease, chemotherapy regimen, and the use of oral contraceptives during therapy: a report from the German Hodgkin’s Lymphoma Study Group. J Clin Oncol 23:7555–7564

    Article  PubMed  Google Scholar 

  12. Walshe JM, Denduluri N, Swain S (2006) Amenorrhea in premenopausal women after adjuvant chemotherapy for breast cancer. J Clin Oncol 24:5769–5779

    Article  CAS  PubMed  Google Scholar 

  13. Bines J, Oleske DM, Cobleigh MA (1996) Ovarian function in premenopausal women treated with adjuvant chemotherapy for breast cancer. J Clin Oncol 14:1718–1729

    CAS  PubMed  Google Scholar 

  14. Klock SC, Zhang JX, Kazer R (2010) Fertility preservation for female cancer patients: early clinical experience. Fertil Steril 94(1):149–155

    Article  PubMed  Google Scholar 

  15. Rosendahl M, Andersen CY, Ernst E, Westergaard LG, Rasmussen PE, Loft A, Andersen AN (2008) Ovarian function after removal of an entire ovary for cryopreservation of pieces of cortex prior to gonadotoxic treatment: a follow-up study. Hum Reprod 23(11):2475–2483

    Article  PubMed  Google Scholar 

  16. Quintero RB, Helmer A, Huang JQ, Westphal LM (2010) Ovarian stimulation for fertility preservation in patients with cancer. Fertil Steril 93:865–868

    Article  CAS  PubMed  Google Scholar 

  17. Quintero RB, Helmer A, Murray E, Westphal LM (2005) Fertility preservation in female cancer patients. Fertil Steril 84(1):S70–S71

    Article  Google Scholar 

  18. Oktay K, Sahin G, Ucar KF, Barad D, Blanchette H, Gleicher N (2008) Fertility preservation is an emerging discipline extending beyond cancer patients: Analysis of a large experience. Fertil Steril 90(1):S51

    Article  Google Scholar 

  19. Elassar A, Oktem O, Oktay K (2007) Fertility preservation with ovarian cryopreservation: a decade of experience. Fertil Steril 88(1):S12–S13

    Article  Google Scholar 

  20. Oktay K, Oktem O (2010) Ovarian cryopreservation and transplantation for fertility preservation for medical indications: report of an ongoing experience. Fertil Steril 93:762–768

    Article  PubMed  Google Scholar 

  21. Knopmann J, Noyes N, Talebian S, Krey LC, Grifo JA, Licciardi F (2009) Women with cancer undergoing ART for fertility preservation: a cohort study of their response to exogenous gonadotropins. Fertil Steril 91(4):1476–1478

    Article  Google Scholar 

  22. http://www.deutsches-ivf-register.de. Jahrbuch Deutsches IVF-Register 2008

  23. Dittrich R, Maltaris T, Hoffmann I, Oppelt PG, Beckmann W, Mueller A (2010) Fertility preservation in cancer patients. Minerva Ginecol 62(1):63–80

    CAS  PubMed  Google Scholar 

  24. Von Wolff M, Donnez J, Hovatta O, Keros V, Maltaris T, Montag M, Salle B, Sonmezer M, Andersen CY (2009) Cryopreservation and autotransplantation of human ovarian tissue prior to cytotoxic therapy–A technique in its infancy but already successful in fertility preservation. Eur J Cancer 45(9):1547–1553

    Article  Google Scholar 

Download references

Acknowledgments

We would like to thank all members of the FertiPROTEKT network for data acquisition. A list of all members is available on the network’s website, under http://www.fertiprotekt.eu. We are greatly indebted to Mrs. Elizabeth Kraemer for reviewing our manuscript.

Conflict of interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. University Women’s Hospital, Tübingen, Germany

    Barbara Lawrenz

  2. Department of Gynaecological Endocrinology and Reproductive Medicine, University Women’s Hospital, Heidelberg, Germany

    Julia Jauckus & Thomas Strowitzki

  3. University Women’s Hospital, Klinikum Maistrasse, Munich, Germany

    Markus S. Kupka

  4. Department of Gynaecological Endocrinology and Reproductive Medicine, University Women’s Hospital, Effingerstrasse 102, 3010, Bern, Switzerland

    Michael von Wolff

Authors
  1. Barbara Lawrenz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julia Jauckus
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Markus S. Kupka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thomas Strowitzki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael von Wolff
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael von Wolff.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lawrenz, B., Jauckus, J., Kupka, M.S. et al. Fertility preservation in >1,000 patients: patient’s characteristics, spectrum, efficacy and risks of applied preservation techniques. Arch Gynecol Obstet 283, 651–656 (2011). https://doi.org/10.1007/s00404-010-1772-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-010-1772-y

Keywords

Search

Navigation