Current Perspectives and Effectiveness of Fertility Preservation in Cancer Patients—Data from Serbian National Referral Center

Abstract

Background/Objectives: Despite numerous fertility-sparing treatments, there are still uncertainties. We present the experience and effectiveness of the oncofertility program from the University Clinical Center of Serbia. Methods: Study included all malignancy patients undergoing fertility-sparing treatment during a 10-year period. For all patients, we registered malignancy type, therapy type, course and duration, the response to therapy, complications and recurrence, and overall survival. All attempted and achieved pregnancies were recorded. We noted all pregnancy complications and gestational week at pregnancy end and calculated live-birth rates. Results: Fifteen patients with early-stage cervical cancer (squamocellular 11; adenocarcinoma 4) had abdominal radical trachelectomy. Outcomes of our patients were excellent, but just three patients delivered healthy children. In total, 87 patients with early-stage endometrial malignancy (atypical hyperplasia 24, intraepithelial neoplasm 24, carcinoma 39) received hormonal therapy. Complete remission was achieved at 74.7% but only nine achieved pregnancy. Moreover, 52 patients with stage I borderline ovarian tumors were treated. The overall survival rate was 100% and the pregnancy rate was 44.8%. We also treated 39 patients with non-epithelial ovarian cancers (sexcord–stromal tumors 22, malignant germ cell tumors 17). The overall survival rate was 87.2%, but we had just seven successful pregnancies. In our institution, oocytes were cryopreserved in 63, embryos in 6, and ovarian tissue in 8 patients, out of which two achieved pregnancy and one had a term delivery of a healthy child. Conclusions: Our findings support the feasibility of favorable oncologic and reproductive outcomes in carefully selected oncofertility patients following current guidelines.