In vitro fertilization for cancer patients and survivors.
OBJECTIVE
To determine in vitro fertilization (IVF) outcome in cancer patients.


METHODS
Retrospective record review.


METHODS
Academic, hospital-based assisted reproductive technology (ART) program.


METHODS
Sixty-nine women undergoing 113 IVF/gamete intrafallopian transfer (GIFT) cycles after cancer treatment in one partner, and 13 women undergoing 13 IVF cycles for embryo cryopreservation before chemotherapy/radiation.


METHODS
IVF, intracytoplasmic sperm injection (ICSI), assisted hatching, and gamete intrafallopian transfer as indicated.


METHODS
Delivery rate, spontaneous abortion rate, number of embryos cryopreserved, cancer diagnosis, systemic or local cancer treatment, female age, amount of gonadotropin used, treatment duration, peak estradiol level, and number of oocytes and embryos.


RESULTS
The women undergoing IVF after chemotherapy had poorer responses to gonadotropins than did the women with locally treated cancers even though they were younger (33.5 +/- 1.3 vs. 36.5 +/- 0.5 years; P<.05). The delivery rates after the women had undergone chemotherapy tended to be lower among the systemic treatment group than it was for the local cancer treatment group: (13.3% [2 of 15] vs. 40% [14 of 56, P=NS]). The women who had cryopreserved all embryos before chemotherapy produced more oocytes (18.7 +/- 3.2 vs. 14.5 +/- 1.2) and embryos (11.3 +/- 1.9 vs. 7.5 +/- 0.7) than did the women who had had a history of local cancer treatment. Male factor infertility as a result of cancer treatment is well treated with IVF or intracytoplasmic sperm injection, where indicated (32% delivery rate/cycle), with no difference between the frozen sperm banked before cancer treatment and fresh sperm produced after treatment.


CONCLUSIONS
Chemotherapy diminishes the response to ovulation induction in assisted reproductive technologies. IVF with cryopreservation of embryos allows embryo banking before chemotherapy for women who have been newly diagnosed with cancer. Factors related to the partner affect the success of IVF for male factor infertility as a result of cancer treatment.
Ginsburg
E S
ES
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. eginsburg@partners.org
Yanushpolsky
E H
EH
Jackson
K V
KV
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D000704:Analysis of Variance; D015925:Cryopreservation; D036861:Delivery, Obstetric; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data; D015181:Gamete Intrafallopian Transfer; D006801:Humans; D008297:Male; D008499:Medical Records; D009369:Neoplasms / Q000503:physiopathology / Q000628:therapy*; D018579:Patient Selection; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D017741:Survivors
D004958:Estradiol