Fertility preservation in women with malignant and borderline ovarian tumors: Experience of the French ESGO-certified center and pregnancy-associated cancer network (CALG)

S Geoffron; A Lier; E de Kermadec; N Sermondade; J Varinot; I Thomassin-Naggara; S Bendifallah; E Daraï; N Chabbert-Buffet; K Kolanska

doi:10.1016/j.ygyno.2021.03.030

Fertility preservation in women with malignant and borderline ovarian tumors: Experience of the French ESGO-certified center and pregnancy-associated cancer network (CALG)

Gynecol Oncol. 2021 Jun;161(3):817-824. doi: 10.1016/j.ygyno.2021.03.030. Epub 2021 Apr 1.

Authors

S Geoffron¹, A Lier², E de Kermadec³, N Sermondade⁴, J Varinot⁵, I Thomassin-Naggara⁶, S Bendifallah⁷, E Daraï⁷, N Chabbert-Buffet⁸, K Kolanska⁷

Affiliations

¹ Department of Gynaecology, Obstetrics and Reproductive Medicine, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, University Institute of Cancer, Paris, France; Jossigny Hospital, France.
² Department of Gynaecology, Obstetrics and Reproductive Medicine, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, University Institute of Cancer, Paris, France; Department of Gynaecology and Obstetrics, Pregnancy associated cancer network (CALG), Paris, France.
³ Dana Farber Cancer Institute, Boston, USA.
⁴ Department of Reproductive biology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, University Institute of Cancer, Paris, France.
⁵ INSERM UMR S 938, Biology and therapy of cancer, St Antoine research center, Paris, France; Department of Pathology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, University Institute of Cancer, Paris, France.
⁶ INSERM UMR S 938, Biology and therapy of cancer, St Antoine research center, Paris, France; Department of Radiology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, University Institute of Cancer, Paris, France.
⁷ Department of Gynaecology, Obstetrics and Reproductive Medicine, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, University Institute of Cancer, Paris, France; Department of Gynaecology and Obstetrics, Pregnancy associated cancer network (CALG), Paris, France; INSERM UMR S 938, Biology and therapy of cancer, St Antoine research center, Paris, France.
⁸ Department of Gynaecology, Obstetrics and Reproductive Medicine, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, University Institute of Cancer, Paris, France; Department of Gynaecology and Obstetrics, Pregnancy associated cancer network (CALG), Paris, France; INSERM UMR S 938, Biology and therapy of cancer, St Antoine research center, Paris, France. Electronic address: [email protected].

PMID: 33812696
DOI: 10.1016/j.ygyno.2021.03.030

Abstract

Objective: To describe strategy and results of fertility preservation (FP) in patients with malignant and borderline ovarian tumors.

Methods: Consecutive cohort study of 43 women with malignant or borderline ovarian tumors who underwent FP between February 2013 and July 2019. The study was conducted in national expert center in Tenon University Hospital, Sorbonne University: French ESGO-certified ovarian cancer center and pregnancy-associated cancer network (CALG). Main outcome measure was FP technique proposed by multidisciplinary committee, FP technique used, time after surgery, number of fragments, histology and follicle density (if ovarian tissue freezing), number of expected, retrieved and frozen oocytes (if ovarian stimulation).

Results: Pathological diagnosis was malignant epithelial ovarian tumor in five women (11.6%), rare malignant ovarian tumor in 14 (32.6%), borderline in 24 (55.8%), and mostly unilateral (79.1%) and stage I (76.7%). Mean age at diagnosis was 26.8 ± 6.9 years and mean tumor size 109.7 ± 61 mm. Before FP, mean AFC was 11.0 ± 6.1 and AMH levels were 2.7 ± 4.6 ng/mL. Six ovarian tissue-freezing procedures were performed (offered to 13). Twenty-four procedures of ovarian stimulation and oocyte freezing were performed after surgical treatment for 19 women (offered to 28) with a median interval of 188 days. The mean number of mature oocytes retrieved per stimulation was 12.4 ± 12.8. At least 10 mature oocytes were frozen for 52.6% of the women. No FP was offered to five women.

Conclusion: Oocyte and ovarian tissue cryopreservation should be offered to patients with malignant and borderline ovarian tumors. More data are needed to confirm ovarian stimulation and ovarian tissue grafting safety.

Keywords: Borderline ovarian tumors; Fertility preservation; Oocyte freezing; Ovarian tissue freezing; Rare malignant ovarian tumors.

MeSH terms

Adult
Carcinoma, Ovarian Epithelial / therapy*
Female
Fertility Preservation*
France
Humans
Ovarian Neoplasms / therapy*
Pregnancy
Pregnancy Outcome
Universities