Oocyte and embryo cryopreservation before gonadotoxic treatments: Principles of safe ovarian stimulation, a systematic review

Womens Health (Lond). 2022 Jan-Dec:18:17455065221074886. doi: 10.1177/17455065221074886.

Abstract

Objective: Review the safety of fertility preservation through ovarian stimulation with oocyte or embryo cryopreservation, including cycle and medication options.

Evidence review: A systematic review of peer-reviewed sources revealed 2 applicable randomized control trials and 60 cohort studies as well as 20 additional expert opinions or reviews.

Results: The capacity for future family building is important for the majority of reproductive age people, despite life-altering medical or oncologic diagnosis. Modern fertility preservation generates a high rate of oocyte yield while utilizing protocols that can be started at multiple points in the menstrual cycle and suppressing supra-physiologic levels of estrogen. Finally, more than one quarter of fertility preservation patients will return to later utilize fertility services.

Conclusion: For most patients, fertility preservation can safely be pursued and completed within 2 weeks without affecting disease severity or long-term survival.

Keywords: cancer; chemotherapy; cryopreservation; embryos; fertility preservation; oocytes; safety.

Publication types

  • Systematic Review

MeSH terms

  • Cohort Studies
  • Cryopreservation / methods
  • Female
  • Fertility Preservation* / methods
  • Humans
  • Neoplasms*
  • Oocytes / physiology
  • Ovulation Induction / adverse effects
  • Ovulation Induction / methods