Efficacy of in vitro fertilization after chemotherapy

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.