Embryo preservation often works for cancer patients

By Karla Gale

NEW YORK (Reuters Health) - Freezing embryos before undergoing cancer treatment that may cause infertility is as successful for women with cancer as it is for women without cancer, new study findings indicate.

The investigators, who presented their findings this week at the 64th annual meeting of the American Society of Reproductive Medicine in San Francisco, recommend this means preserving fertility for cancer patients, because the ovaries are severely compromised by chemotherapy and radiation.

"There have been few data looking at the clinical performance outcome of those few young cancer patients who do seek embryo cryopreservation" before they undergo toxic treatment, presenter Dr. Bo Yu told Reuters Health.

The research team at New York-Presbyterian Hospital/Columbia University Medical Center reviewed the records of 12 patients younger than age 40 (9 with breast cancer and 1 each with colon cancer, rectal cancer, and synovial cell sarcoma) and 48 age-matched control subjects.

The numbers of mature eggs obtained were similar in the two groups (10.8 vs. 9.2), the investigators reported, and the fertilization rates were also comparable (64 percent vs. 67 percent).

"In early stage cancer, there is a window of at least 6 weeks after surgery that allows patients to recover from surgery and has been proven to be a safe waiting period before starting chemotherapy or radiation," Yu noted. "This is the window of opportunity for patients to consider fertility preservation treatments without causing any delay in the start of cancer treatment."

In a second study, the physicians evaluated the effect of chemotherapy on ovarian function in 26 young women with stage I and II breast cancer. The patients were treated with Adriamycin, cyclophosphamide and paclitaxel for 6 months.

Chemotherapy decreased ovarian reserve "rapidly and dramatically." Although hormone levels recovered quickly, with 58 percent of women regaining menstrual function by 52 weeks, all ovarian reserves remained below the normal range.

However, despite the concern of reduced fertility after chemotherapy, "we have documented that pregnancy can occur," the investigators reported.

"One thing we hope to achieve through publishing our research is to increase awareness among physicians and patients of the gonadotoxic effects of chemotherapy," she said. "Physicians should counsel patients newly diagnosed with cancer to consider fertility preservation treatments before...injury occurs."