Time from referral to ovarian tissue cryopreservation in a cohort of Danish women.

INTRODUCTION: Young women with a cancer diagnosis often have very little time to decide whether or not to commence on fertility preserving strategies before initiating potentially sterilizing cancer treatment. Minimizing the interval from opting for fertility preservation to completion of the procedure will reduce the potential risk of delaying cancer treatment. In the current study, we have evaluated the period of time from referral to ovarian tissue cryopreservation (OTC) to actual freezing of the tissue in a cohort of Danish women.

MATERIAL AND METHODS: The study population comprised 277 consecutive patients with both malignant and non-malignant diseases referred for OTC from four centers in the Danish network. Statistical analysis was conducted to analyze the impact of age, diagnosis, and referring center on the time from OTC-referral to OTC. A literature search for 'random start'-protocols for controlled ovarian stimulation for fertility preservation in cancer patients was performed.

RESULTS: The time from OTC-referral to OTC was significantly influenced by both diagnosis, age, and referring center. Women with malignant diseases other than breast cancer, such as like sarcomas, pelvic cancers, and hematological cancers experienced a significantly shorter interval to OTC (5 days) than women with breast cancer (7 days) and non-malignant diseases including systemic, ovarian and hereditary conditions (13-17.5 days). Women over the age of 30 experienced a significantly longer time to OTC (P<0.03), and the diagnosis of the patient determined the length of the interval (P<0.001). According to the literature, fertility preservation by oocyte vitrification require 13-14 days, as the average time for one round of controlled ovarian stimulation was 11 days and oocyte collection can be performed 2 days later.

CONCLUSIONS: It is in the interest of both cancer patients and clinicians to perform fertility preservation as fast and safe as possible. In a Danish setting, OTC provides a short interval of around 6 days from the patient choose this option to completion of the procedure. This is considerable less time than what is needed to perform controlled ovarian stimulation and oocyte vitrification, and therefore OTC might be considered the preferred choice of fertility preservation when urgency is needed. This article is protected by copyright. All rights reserved.