Preserving Fertility and Its Outcomes in Iranian Women with Cancer: A Longitudinal Cohort Study

Background & Objective: Preserving fertility in women with cancer before therapeutic interventions is very important. This study was evaluating the ۸ years’ experience of an onco-fertility center from ۲۰۱۳ to ۲۰۲۰ on fertility preservation and its outcomes in female cancer survivors.Materials & Methods: Participants were females with an approved cancer diagnosis of reproductive ages that were referred for fertility preservation. After proper counseling by an expert team, the final decision on the fertility preservation method was made based on the patient's condition and survival expectation. The primary goal was to collect data about the fertility, clinical and survival outcomes of these women and pregnancy rate as a secondary objective that were compared between cancer types.Results: Totally ۳۳۷ participants were recruited with a mean±SD age of ۳۰.۷±۶.۶ years. Gynecological cancers accounted for ۱۶۶ (۴۹.۳%) of all cases followed by breast (۱۰۷ (۳۱.۸%)) and other cancers (۶۴ (۱۹.۰%)) respectively. Of those, ۱۴۴ (۴۲.۷%) cases entered into the ovulation induction cycle and the others did not continue due to lack of correct information and late referral, and inability to postpone treatment as the major reasons. Comparing between ۳ groups (gynecological, breast and other cancers), a higher rate of pregnancy otherwise not statistically different was detected in gynecological cancer survivors. In the breast cancer survivors, the chance of oocyte retrieval and fertility was not lower than in other cancers.Conclusion: Many patients and even their therapists are unfamiliar with the methods of fertility preservation, and when they consider it, the golden time is usually passed. Therefore, having a good consultation with the survivors and patient education may be the most important issue that led to a timely referral for preserving fertility in cancer patients.

Keywords:

fertility preservation , Breast cancer , Gynecological cancers , OVARIAN RESERVE , ovulation induction , Quality of Life