Michelle Kappy1, Harry J Lieman2, Staci Pollack2, Erkan Buyuk3,4,5. 1. Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA. 2. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA. 3. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA. erbuyuk@yahoo.com. 4. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine At Mount Sinai, Reproductive Medicine Associates of New York, New York, NY, USA. erbuyuk@yahoo.com. 5. RMA NY, Icahn School of Medicine At Mount Sinai, 635 Madison Ave 10th Floor, New York, NY, USA. erbuyuk@yahoo.com.
Abstract
PURPOSE: Women with cancer may desire fertility preservation (FP) prior to initiating cancer treatment, but undergoing FP may result in treatment delays. This study sought to determine whether such delays existed in our population and which factors were associated with patients' decision to proceed with FP. METHODS: This was a historical cohort study performed at Montefiore Medical Center's Institute for Reproductive Medicine and Health. Reproductive age women diagnosed with cancer and consulted for FP were included. The main outcome measure was the number of days between FP consultation and cancer treatment initiation. Factors associated with patients' decisions to proceed with FP were also analyzed. RESULTS: Thirty out of 51 women in our study underwent FP including embryo cryopreservation, oocyte cryopreservation, ovarian tissue cryopreservation (OTC), both oocyte and embryo cryopreservation, or GnRH agonist treatment. The majority of women who underwent FP chose embryo cryopreservation (36.7%), followed by oocyte cryopreservation (33.3%). Of the 20 patients with partners who underwent FP, 13 (65%) froze embryos. Only 4 of the 30 women who underwent FP had all, or a portion of their services, covered by insurance. The mean treatment delay was 18 days (p = 0.007), with a mean consultation to oncologic treatment gap of 23 ± 16.8 and 41.4 ± 25.9 days in the non-FP and FP groups, respectively. CONCLUSION: Women with cancer diagnosis who underwent FP prior to initiating cancer treatment experienced a statistically significant delay in initiating cancer treatment. However, the clinical significance of this finding is unknown since FP treatments have not been associated with increased recurrence or mortality.
PURPOSE: Women with cancer may desire fertility preservation (FP) prior to initiating cancer treatment, but undergoing FP may result in treatment delays. This study sought to determine whether such delays existed in our population and which factors were associated with patients' decision to proceed with FP. METHODS: This was a historical cohort study performed at Montefiore Medical Center's Institute for Reproductive Medicine and Health. Reproductive age women diagnosed with cancer and consulted for FP were included. The main outcome measure was the number of days between FP consultation and cancer treatment initiation. Factors associated with patients' decisions to proceed with FP were also analyzed. RESULTS: Thirty out of 51 women in our study underwent FP including embryo cryopreservation, oocyte cryopreservation, ovarian tissue cryopreservation (OTC), both oocyte and embryo cryopreservation, or GnRH agonist treatment. The majority of women who underwent FP chose embryo cryopreservation (36.7%), followed by oocyte cryopreservation (33.3%). Of the 20 patients with partners who underwent FP, 13 (65%) froze embryos. Only 4 of the 30 women who underwent FP had all, or a portion of their services, covered by insurance. The mean treatment delay was 18 days (p = 0.007), with a mean consultation to oncologic treatment gap of 23 ± 16.8 and 41.4 ± 25.9 days in the non-FP and FP groups, respectively. CONCLUSION: Women with cancer diagnosis who underwent FP prior to initiating cancer treatment experienced a statistically significant delay in initiating cancer treatment. However, the clinical significance of this finding is unknown since FP treatments have not been associated with increased recurrence or mortality.
Authors: Joseph M Letourneau; Erin E Ebbel; Patricia P Katz; Kutluk H Oktay; Charles E McCulloch; Wei Z Ai; A Jo Chien; Michelle E Melisko; Marcelle I Cedars; Mitchell P Rosen Journal: Cancer Date: 2011-08-17 Impact factor: 6.860
Authors: Stephanie J Lee; Leslie R Schover; Ann H Partridge; Pasquale Patrizio; W Hamish Wallace; Karen Hagerty; Lindsay N Beck; Lawrence V Brennan; Kutluk Oktay Journal: J Clin Oncol Date: 2006-05-01 Impact factor: 44.544
Authors: Molly B Moravek; Rafael Confino; Kristin N Smith; Ralph R Kazer; Susan C Klock; Angela K Lawson; William J Gradishar; Mary Ellen Pavone Journal: Fertil Steril Date: 2018-01-17 Impact factor: 7.329