Preliminary outcome of oncofertility patients in Croatia

Oncofertility is a relatively new field of medicine focuses on developing methods to preserve reproductive function in patients diagnosed with cancer. The major technique of fertility preservation includes hormonal stimulation of ovulation, followed by IVF and then cryopreservation of the resulting oocytes or embryos for use at a later date. Aim. The primary outcome of this study was to determine efficiency of oncofertility program considering oncological diagnosis and ovarian stimulation protocol. Secondary outcome was to establish possible recommendation for oncofertility program based on ovarian reserve marker, estradiol level and presence of estrogen and progesteron receptors in breast cancer cells. Materials and methods. We conducted a retrospective study of 30 female patients (24–41 yrs) with different oncological diagnosis, who attended Human Reproduction Unit, at Department of Obstetrics and Gynecology at University Hospital Centre Zagreb, from November 2013 until February 2018. Inclusion criteria were oncological diagnosis, as well as treatment with specific ovarian stimulation protocol. Results. We found that patients with malignant disease are predominantly in the group of poor responders. Same protocol yielded a different response through the obtained number of oocytes. Isolated gonadotropins resulted with highest average estradiol level contrary to protocol of isolated aromatase inhibitor, where lowest average estradiol level was obtained. Discussion. Ovarian stimulation protocols should be individualized based on time available prior to cancer diagnosis, latency time needed for inclusion into oncofertility protocol as well on fertility status of the patient. Conclusion. Further follow-up and alternative protocol may be crucial for female cancer patients, in enabling of remarkable possibility for fertility preservation and improvement of their overall health care