ArticleHuman reproduction open2025
Controlled ovarian stimulation for oocyte preservation in childhood cancer survivors who have undergone chemotherapy.
Article in Human reproduction open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
study questionWhat are the outcomes of controlled ovarian stimulation (COS) in childhood cancer survivors (CCS) undergoing fertility preservation (FP) after cancer treatment? SUMMARY ANSWER: CCS who have undergone chemotherapy often show poor outcomes with COS and may need multiple cycles to achieve an adequate number of oocytes for future pregnancy. WHAT IS KNOWN ALREADY: Up to 65% of CCS experience infertility from gonadotoxic treatments. Although it is ideal to consider FP at diagnosis, age and oncological factors often limit this option. After recovery, pubescent survivors, especially those who could not preserve fertility earlier, may be offered oocyte cryopreservation. STUDY DESIGN SIZE DURATION: A retrospective study including 20 CCS who underwent COS for oocyte storage between 2015 and 2022. PARTICIPANTS/MATERIALS SETTING
methodsThis study involved young CCS who had been previously treated with chemotherapy and were evaluated at an FP center in a tertiary medical center. CCS were encouraged to pursue endocrine surveillance after recovering from cancer and were offered oocyte storage in case diminished ovarian reserve was evident, as dictated by elevated basal FSH (>10 IU/l), decreased anti-Müllerian hormone (AMH; <25th percentile for age), or low antral follicle count (<7). MAIN RESULTS AND THE ROLE OF CHANCE: Mean age at cancer diagnosis was 13.24 ± 5.6 years. Seventeen patients (85%) had been treated with alkylating agents, with five receiving cumulative doses greater than 4000 mg/m LIMITATIONS REASONS FOR CAUTION: The study is exploratory in its nature, limited by its small sample size and its retrospective design. WIDER IMPLICATIONS OF THE
findingsOocyte storage is feasible yet limited in young CCS. Despite their young age at the time of FP, CCS who have undergone chemotherapy often show poor outcomes with COS. Ongoing reproductive monitoring after recovery is crucial to identify those who would benefit from FP following cancer treatment. STUDY FUNDING/COMPETING INTERESTS: The Fertility Preservation Unit funds (Sheba Medical Center) were used to support the authors throughout the study period and manuscript preparation. None of the authors declare any conflicts of interest. TRIAL REGISTRATION NUMBER: N/A.
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