Objective: Ovarian failure is a common effect of treatment for cancer. The aim of this study was to describe the practices concerning ovarian protection and fertility preservation in young women treated for cancer.
Study Design: Women between 15 and 49 years old diagnosed with cancer between 2005 and 2014 were studied, abstracted from a representative French National Healthcare database. To assess practices concerning ovarian protection, gonadotropin-releasing hormone (GnRH) agonist consumption and ovarian transposition were analyzed. For fertility preservation, GnRH agonist consumption, ovarian cryopreservation and oocyte cryopreservation were analyzed. Explanatory variables were analyzed using a multilevel model.
Results: A total of 2447 women were identified. Among the 553 patients exposed to ovarian failure, 74 (13%) had ovarian protection (67 received GnRH agonists, 7 underwent ovarian transposition). Among the 227 women exposed to fertility alteration, 53 (23%) had fertility preservation (37 received GnRH agonists, 16 had ovarian or oocyte cryopreservation). Factors associated with ovarian protection were age under 40 years old (OR = 1.56 [1.5-1.62], p = 0.006) and diagnosis of breast cancer (OR = 1.15 [1.08-1.22], p < 0.001). The only factor associated with fertility preservation was breast cancer (OR = 1.17 [1.1-1.24], p < 0.001). The five-year probability of pregnancy was 3.8% and 9.8% (p = 0.26) for women with and without fertility preservation, respectively.
Conclusion: Over the last decade, ovarian protection and fertility preservation concerned 13% and 23%, respectively, of young French women treated for cancer. Awareness about ovarian protection and fertility preservation remain insufficient and need to be extended to improve this major aspect of cancer management.
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