Preliminary results of a counselling programme for fertility preservation in female cancer patients: The experience of the GEMME DORMIENTI network

Eur J Cancer Care (Engl). 2020 Jan;29(1):e13174. doi: 10.1111/ecc.13174. Epub 2019 Sep 30.

Abstract

Objective: To describe a population of patients referred for fertility preservation (FP), how to efficiently provide FP care, and how FP care changed over time.

Methods: This longitudinal observational study enrolled 281 female cancer patients referred between 2013 and 2016 to the non-profit organisation Gemme Dormienti ONLUS (GD) for FP care. All patients underwent the same battery of instrumental and laboratory diagnostic tests. GnRHa therapy was started at least seven days before CTh treatment.

Results: From 2013 to 2016, we observed a progressive increase in the number of patients referred for FP care. Out of 251 eligible patients, 135 patients were treated with GnRHa only, and 72 patients underwent GnRHa therapy and cryopreservation. The median time from GD referral to oocyte and ovarian tissue cryopreservation was 11 and 5 days respectively. Tissue cryopreservation requests increased during our study period (from four cases in 2013 to 17 cases in 2016). During follow-up, 17β-estradiol and FSH levels were significantly increased (p < .0001), and AMH levels were significantly decreased (p < .0001).

Conclusion: The rapid increase in the number of patients who requested FP care and in the complexity of FP procedures overtime reflects the need to improve quality of life for cancer patients.

Keywords: GnRHa; cancer; counselling; fertility preservation; oocyte cryopreservation; ovarian tissue cryopreservation.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Anti-Mullerian Hormone / blood
  • Antineoplastic Agents / adverse effects*
  • Counseling
  • Cryopreservation
  • Estradiol / blood
  • Female
  • Fertility Preservation / methods*
  • Follicle Stimulating Hormone / blood
  • Gonadotropin-Releasing Hormone / agonists*
  • Humans
  • Infertility, Female / chemically induced
  • Infertility, Female / prevention & control*
  • Longitudinal Studies
  • Luteinizing Hormone / blood
  • Oocyte Retrieval
  • Oocytes
  • Ovarian Follicle
  • Ovarian Reserve
  • Ovary
  • Ovulation Induction
  • Patient Preference
  • Primary Ovarian Insufficiency / chemically induced
  • Primary Ovarian Insufficiency / prevention & control*
  • Progesterone / blood
  • Referral and Consultation
  • Young Adult

Substances

  • Antineoplastic Agents
  • Gonadotropin-Releasing Hormone
  • Progesterone
  • Estradiol
  • Anti-Mullerian Hormone
  • Luteinizing Hormone
  • Follicle Stimulating Hormone