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Efficacy of in vitro fertilization after chemotherapy.

Dolmans MM, Demylle D, Martinez-Madrid B, Donnez J

Department of Gynecology, Université Catholique de Louvain, Cliniques Universitaires St. Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium.

OBJECTIVE: To evaluate if in vitro fertilization (IVF) with embryo cryopreservation can be proposed to patients immediately after one or two regimens of chemotherapy. DESIGN: Retrospective study. SETTING: Academic research center and IVF unit. PATIENT(S): Eleven young patients diagnosed with cancer between September 1999 and April 2003 who wanted to preserve their fertility via IVF. INTERVENTION(S): Stimulation and IVF before or soon after chemotherapy treatment. MAIN OUTCOME MEASURE(S): The number and quality of embryos obtained after stimulation in cancer patients undergoing IVF before or soon after chemotherapeutic treatment. RESULT(S): Four patients underwent IVF in the interval between two regimens of chemotherapy. Two of them had no follicular development; one underwent follicular puncture but no oocytes were retrieved; and, in one, six oocytes were harvested but only one good quality embryo was obtained. In the seven patients who underwent IVF before starting chemotherapy, between 4 and 11 embryos were obtained per patient, the majority being good quality embryos. CONCLUSION(S): Because the efficacy of IVF is dramatically reduced after even one round of chemotherapy, IVF should be performed before chemotherapy. For those who require immediate chemotherapy, ovarian tissue cryopreservation and/or oocyte cryopreservation could be used before treatment.

Published 11 April 2005 in Fertil Steril, 83(4): 897-901.
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