title: Fertility preservation in patients with haematological disorders: a retrospective cohort study.
abstract: This study investigated the factors associated with utilization of fertility preservation and the differences in treatments and outcomes by prior chemotherapy exposure in patients with haematological diseases. This study included all 67 women with haematological diseases seen for fertility preservation consultation at two university hospitals between 2006 and 2011. Of the total, 49% had lymphoma, 33% had leukaemia, 7% had myelodysplastic syndrome and 4% had aplastic anaemia; 46% had prior chemotherapy; and 33% were planning for bone marrow transplantation, 33% pursued ovarian stimulation and 7% used ovarian tissue banking; and 48% of patients did not pursue fertility preservation treatment. All five cycle cancellations were in the post-chemotherapy group: three patients with leukaemia and two with lymphoma. Patients with prior chemotherapy had lower baseline antral follicle count (10 versus 22) and received more gonadotrophins to achieve similar peak oestradiol concentrations, with no difference in oocyte yield (10.5 versus 10) after adjustment for age. Embryo yield was similar between those who had prior chemotherapy and those who had not. Half of the patients with haematological diseases who present for fertility preservation have been exposed to chemotherapy. While ovarian reserve is likely impaired in this group, oocyte yield may be acceptable.
authors.affiliation: Department of Obstetrics and Gynecology, University of Pennsylvania, United States. Electronic address: Suneeta.Senapati@uphs.upenn.edu.
authors.forename: Suneeta
authors.initials: S
authors.lastname: Senapati
authors.affiliation: Department of Obstetrics and Gynecology, University of Pennsylvania, United States.
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Morse
authors.affiliation: Department of Obstetrics and Gynecology, University of Pennsylvania, United States.
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, United States.
authors.forename: Jayeon
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, United States.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Mersereau
authors.affiliation: Department of Obstetrics and Gynecology, University of Pennsylvania, United States.
authors.forename: Brenda
authors.initials: B
authors.lastname: Efymow
authors.affiliation: Department of Obstetrics and Gynecology, University of Pennsylvania, United States.
authors.forename: Clarisa R
authors.initials: CR
authors.lastname: Gracia
mesh_terms: D015331:Cohort Studies; D064420:Drug-Related Side Effects and Adverse Reactions / Q000378:metabolism; D004958:Estradiol / Q000378:metabolism; D005260:Female; D059247:Fertility Preservation / Q000379:methods* / Q000706:statistics & numerical data*; D006062:Gonadotropins / Q000008:administration & dosage / Q000494:pharmacology; D006402:Hematologic Diseases / Q000503:physiopathology* / Q000532:radiotherapy; D006801:Humans; D006080:Ovarian Follicle / Q000187:drug effects; D012044:Regression Analysis; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies
chemical_list: D006062:Gonadotropins; D004958:Estradiol
keywords: IVF; cancer; fertility preservation; haematological disease; ovarian reserve