In vitro fertilization with cryopreserved oocytes or embryos after cancer: The role of gestational carriers.
Academic Article
Overview
abstract
BACKGROUND: Fertility preservation counseling is recommended for reproductive-age cancer patients. Gestational carriers are individuals who carry a pregnancy for someone else. This service creates a path to biological children when cancer treatment necessitates the removal of the uterus. The authors examined the involvement of gestational carriers among women diagnosed with cancer. METHODS: Using data from eight statewide cancer registries linked with the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System, the authors identified women with a cancer diagnosis who subsequently initiated in vitro fertilization (IVF) procedures during 2004 to 2018. Modified Poisson models were used to estimate prevalence ratios (PR) and 95% confidence intervals (CI). Discrete Cox regression models were used to calculate hazard ratios (HR) and CI. Multivariable models adjusted for age, state, and calendar year. RESULTS: Among 1095 women with cancer who used IVF with cryopreserved oocytes or embryos to attempt pregnancy, 19.1% worked with a gestational carrier. Involving gestational carriers was more common among those who initiated IVF for fertility preservation versus after cancer treatment (PR, 1.96; 95% CI, 1.54-2.50) and had chemotherapy versus no chemotherapy (PR, 1.92; 95% CI, 1.50-2.47). Using donor oocytes or embryos (vs. autologous) was more common among women who worked with a gestational carrier (PR, 1.62; 95% CI, 1.17-2.24). Working with a gestational carrier was not associated with conception (HR, 1.06; 95% CI, 0.82-1.37). CONCLUSIONS: Approximately one in five women diagnosed with cancer who used IVF to attempt pregnancy worked with a gestational carrier. The results of this study emphasize the need for information on gestational carriers during fertility preservation counseling.
