Fertility preservation
All 32 patients treated with (chemo) radiotherapy received pre-treatment
fertility counselling. An overview of patient decisions and treatment
flow regarding FP procedures is presented in Supplementary 1 .
After counselling, 26 patients (81.3%) started FP procedures whereas 5
patients (15.6%) decided to not preserve fertility and 1 patient
(3.1%) with neuroendocrine tumor was advised to not start FP due to
oncologic reasons. Personal reasons for not pursuing FP after counseling
included fear of postponing cancer treatment or the complexity of
gestational carrier procedures.
While 26 patients started FP procedures, oocyte cryopreservation failed
in 5 patients due to poor ovarian response. 2 of them underwent
emergency ovarian tissue cryopreservation (OTC) and 3 decided to not
start alternative FP procedures. Fertility was successfully preserved in
23 (88.5%) of the 26 patients who started FP procedures.
9 patients underwent more than one procedure; i.e. a combination of the
aforementioned. Ovarian transposition was performed to retain hormonal
function in 5 patients or for fertility preservation purposes in 2
patients. Vaginal oocyte pickup procedures and laparoscopic retrieval of
ovarian tissue were performed succesfully in all patients. FP procedures
were all performed within 6 weeks after diagnosis, therefore it did not
interfere with cancer treatment.