Faculty Bibliography

PURPOSE: To compare oocyte cryopreservation cycles performed in cancer patients to those of infertile women. METHODS: Cancer patients referred for fertility preservation underwent counseling in compliance with the ASRM; those electing oocyte cryopreservation were included. Ovarian stimulation was achieved with injectable gonadotropins and freezing was performed using slow-cooling and vitrification methods. RESULTS: Fifty cancer patients (mean age 31 y) underwent oocyte cryopreservation; adequate ovarian stimulation was achieved in 10 +/- 0.3 days. The outcome from these cycles included a mean peak estradiol of 2,376 pg/ml and an average of 19 oocytes retrieved (15 mature oocytes were cryopreserved/cycle). All patients tolerated ovarian hyperstimulation. There were no significant differences noted between cryopreservation cycles performed in cancer patients and in women without malignancy. CONCLUSIONS: Oocyte cryopreservation appears to be a feasible fertility preservation method for reproductive-age women diagnosed with cancer. This modality is not only effective but also, providing a multidiscipline effort, can be completed in timely fashion

OBJECTIVE: To report the use of previously cryopreserved oocytes for the treatment of secondary infertility. DESIGN: Case report. SETTING: University-based IVF program. PATIENT(S): A 41-year-old woman with 18 months of secondary infertility and a previous history (age 38) of elective oocyte cryopreservation. INTERVENTION(S): Previously cryopreserved oocytes. MAIN OUTCOME MEASURE(S): Fertilization, embryo development, pregnancy, and outcome. RESULT(S): The patient achieved pregnancy and delivery following thaw of oocytes electively cryopreserved 39 months before use. Before thawing the oocyte, the patient attempted pregnancy naturally for 12 months, followed by two unsuccessful clomiphene citrate ovulation induction cycles with intrauterine insemination and one fresh IVF cycle resulting in a chromosomally abnormal twin gestation that aborted. CONCLUSION(S): Although oocyte cryopreservation is still labeled an experimental procedure, this case demonstrates that oocyte cryopreservation used for electively deferred reproduction can subsequently serve in the treatment for secondary infertility when the patient becomes her own oocyte donor

Annually, more than 50 000 cancer diagnoses are made in the USA in patients under the age of 35 years. Despite this staggering statistic, medical advancements have substantially improved survival rates. Thus, for both male and female patients with cancer, quality-of-life issues, such as fertility preservation and parenthood, have become an essential component of treatment. Unfortunately, many of the treatments to eradicate malignant processes can also compromise reproductive function. In these cases, fertility preservation should be discussed and initiated with early treatment planning, to allow the best chance for future parenthood, when appropriate. The effects of cancer and cancer treatments on fertility and future parenthood, including health risks for patients, their gametes, and offspring are discussed

OBJECTIVE: To determine whether there is a difference in pregnancy outcomes, stratified by age, between women undergoing elective single blastocyst transfer (eSBT) versus those undergoing double blastocyst transfer (2BT). DESIGN: Retrospective analysis. SETTING: University IVF center. PATIENT(S): A total of 1,141 nondonor IVF cycles in women aged <40 years from January 2004-March 2007. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Eggs retrieved, embryos cryopreserved, implantation rates, clinical pregnancy rates (PR), live birth rates (LBR), spontaneous abortion rates (SAB). RESULT(S): Pregnancy outcomes in 52 cycles of women <40 years of age who underwent eSBT were compared with 1,086 cycles of women who underwent 2BT in fresh IVF cycles from January 2004-March 2007. Overall, the eSBT was associated with a statistically significant 92% reduction in the twinning rate (from 25%-2%) while maintaining a high clinical PR (63% in the eSBT group vs. 61% in the 2BT group). CONCLUSION(S): Women who are <40 years of age undergoing nondonor fresh IVF cycles can electively choose to transfer a single blastocyst for the purpose of significantly reducing their risk of multiples without compromising their PR