Fertility in cancer patients after cryopreservation of one ovary.

Abstract

This questionnaire study describes the fertility and ovarian function in 143 adult female cancer survivors with only one ovary due to cryopreservation of the other. The women were asked about their ovarian function (as defined by the presence of a spontaneous menstrual cycle), pregnancies and their outcome. The mean follow-up time was 58months after cryopreservation (range 24-129months). The risk of premature ovarian failure was high in the group of patients with leukaemia (13/15; 87%) but low in the breast cancer group (5/54; 9%). Fifty-seven women had actively tried to become pregnant after end of treatment; of these, 41 women obtained a total of 68 pregnancies resulting in 45 live births and five ongoing pregnancies, 15 spontaneous abortions, one ectopic pregnancy and two elective abortions. In the remaining 86 women without a pregnancy wish, there had been five elective abortions. Ninety-three per cent of the pregnancies were after natural conception and only four cases were a result of fertility treatment. The overall risk of premature ovarian failure was low (22%). Patients who retain their ovarian function after treatment of a malignant disease have a good chance of becoming pregnant. The purpose of this study was to assess the function of the ovaries in a group of Danish women who had received treatment for a cancer disease and who had had one ovary taken out and cryopreserved for future use. The women were older than 18years at the time of investigation and more than 2years had passed since the operation. They were sent a questionnaire asking them about their menstrual cycles (or lack of), whether they had been pregnant after treatment and, if so, the course of the pregnancy. A total of 143 women returned the questionnaire. The overall risk of ovarian failure in this group of cancer survivors was 22%. The highest risk of losing the ovarian function was seen in those who had been treated for leukaemia, in whom 87% had lost their ovarian function, but lowest in those treated for breast cancer, in whom only 9% had lost their ovarian function. Fifty-seven of the 143 women had actively tried to become pregnant after treatment and 41 of these (72%) succeeded, obtaining a total of 68 pregnancies resulting in 45 live births, five ongoing pregnancies, 15 spontaneous abortions, one tubal pregnancy and two elective abortions. Ninety-three per cent of these pregnancies were after natural conception and two-thirds occurred within the first 3months of trying. In conclusion, young female cancer survivors who keep their ovarian function despite cancer treatment have a good chance of becoming pregnant after treatment. Having only one ovary does not seem to affect their fertility.