COMPARING SOCIOECONOMIC DEMOGRAPHICS AND OOCYTE OUTCOMES OF PATIENTS WITH A NEW DIAGNOSIS OF CANCER UNDERGOING OOCYTE CRYOPRESERVATION TO PLANNED FERTILITY PRESERVATION CONTROLS

Document Type

Conference Proceeding

Publication Date

12-1-2025

Publication Title

Fertil Steril

Keywords

gonadotropin, adult, aged, cancer diagnosis, Caucasian, cohort analysis, complication, conference abstract, controlled study, demographics, diagnosis, female, fertility, fertility preservation, groups by age, household income, human, infertility therapy, major clinical study, male, malignant neoplasm, medical record review, oocyte, oocyte cryopreservation, oocyte number, oocyte retrieval, retrospective study, sociodemographics

Abstract

OBJECTIVE: To compare sociodemographic factors and oocyte outcomes between individuals with a new diagnosis of cancer and planned fertility preservation controls. MATERIALS AND METHODS: We performed a retrospective cohort study of all patients seeking care at a clinic affiliated with our national infertility practice between the years 2012 and 2024. To identify patients with a new diagnosis of cancer, we manually reviewed physician notes that contained an oncofertility associated keyword to determine study eligibility. We included all patients who presented for oocyte cryopreservation after a recent (within 12 months) diagnosis of cancer. We excluded all patients who previously underwent an oocyte retrieval, patients who completed gonadotoxic therapy, and patients who lacked a current cancer diagnosis. For our control cohort, we identified all planned fertility preservation cycles during this same study period. Patients were stratified into their Society for Assisted Reproductive Technology (SART) age groups for comparisons. We performed descriptive statistics comparing demographics and oocyte counts. RESULTS: Our search of oncofertility keywords in patient documents generated a list of 6592 patient encounters. After chart review, 295 unique patients were included in the final oncofertility cohort. There were 9161 patients included in the control group. Patients with a new diagnosis of cancer were on average younger than their counterparts (30.8 v 35.1 years, p<0.001). A slightly higher percentage of white patients were observed in the oncofertility cohort (42.0% vs 39.4%, p<0.001). Both groups had high urbanicity rates and mean household incomes based on their zip codes greater than $100,000. Patients presenting for fertility preservation with a new diagnosis of cancer were less likely to live in a state with an oncofertility insurance mandate (22.0% v 37.9%, p<0.001). Median days of ovarian stimulation were similar between the two cohorts, but the total dose of gonadotropins used was lower among the oncofertility cycles. The median number of days between an initial appointment to cycle start was 10 days for the oncofertility cohort, compared to 97 days for the control group. Oocyte counts were similar between groups, but patients in the oncofertility cycle were more likely to undergo multiple cycles (oncofertility: 2 cycles, control: 1 cycle, p<0.001). CONCLUSIONS: Patients with new cancer diagnoses experience similar oocyte yields as patients undergoing planned fertility preservation, but fertility preservation cycles for anticipated gonadotoxic treatment were not more likely to be performed in states with an insurance mandate. IMPACT STATEMENT: Patients with a new diagnosis of cancer who undergo oocyte cryopreservation yield a similar number of oocytes retrieved compared to those who undergo planned fertility preservation. These promising results should underscore the need for an oncofertility insurance mandate to further mitigate disparities in oncofertility care.

Volume

124

Issue

6

First Page

e201

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