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Long-term outcomes in cancer patients who did or did not pursue fertility preservation.
- Source :
-
Fertility and sterility [Fertil Steril] 2018 Feb; Vol. 109 (2), pp. 349-355. Date of Electronic Publication: 2018 Jan 17. - Publication Year :
- 2018
-
Abstract
- Objective: To compare long-term outcomes of cancer patients who pursued fertility preservation (FP) with those who did not and compare random-start (RS) and menstrual cycle-specific (CS) protocols for FP.<br />Design: Retrospective cohort.<br />Setting: Single urban academic institution.<br />Patient(s): Oncology patients who contacted the FP patient navigator, 2005-2015.<br />Intervention(s): None.<br />Main Outcome Measure(s): Time to cancer treatment, disease-free survival, and reproductive outcomes in FP versus no-FP patients and cycle outcomes for RS versus CS protocols. Data were analyzed by χ <superscript>2</superscript> and logistic regression.<br />Result(s): Of 497 patients who met the inclusion criteria, 41% elected FP. The median number of days to cancer treatment was 33 and 19 days in the FP and no-FP groups, respectively. There was no difference in cancer recurrence or mortality. There were no differences in stimulation parameters, outcomes, or days to next cancer treatment in RS versus CS protocols. Twenty-one patients returned to use cryopreserved specimens, resulting in 16 live births. Eight of 21 returning patients used a gestational carrier. Thirteen FP (6.4%) and 16 no-FP (5.5%) patients experienced a spontaneous pregnancy.<br />Conclusion(s): FP is both safe and efficacious for eligible cancer patients. Only 10% of patients returned to use cryopreserved specimens, and almost half used a gestational carrier, suggesting the need for further research into reproductive decision-making in cancer survivors.<br /> (Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Chi-Square Distribution
Choice Behavior
Cryopreservation
Disease-Free Survival
Female
Fertility
Humans
Infertility, Female etiology
Infertility, Female physiopathology
Linear Models
Live Birth
Logistic Models
Neoplasms diagnosis
Neoplasms mortality
Patient Acceptance of Health Care
Patient Navigation
Pregnancy
Retrospective Studies
Risk Factors
Surrogate Mothers
Time Factors
Young Adult
Cancer Survivors psychology
Fertility Preservation methods
Infertility, Female therapy
Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1556-5653
- Volume :
- 109
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Fertility and sterility
- Publication Type :
- Academic Journal
- Accession number :
- 29338854
- Full Text :
- https://doi.org/10.1016/j.fertnstert.2017.10.029