Objective: We investigated how history of malignant neoplasia affected oocyte developmental competence.
Methods: Fifty-two cycles of assisted reproductive technology (ART) in women with a history of malignant disease (case group) were compared with fifty-two matched cycles of ART in women with no cancer history (control group). Propensity score matching involving age and body mass index was used to select controls. Oocyte developmental competence and rates of pregnancy and livebirth were compared as main outcomes. To investigate whether the cancer itself had affected oocyte developmental competence, this outcome variable was compared between case cycles with and without cancer surgical histories.
Results: Numbers of fertilized oocytes (FO), cleaving embryos (CE), and superior CE (SCE) were significantly lower in cases than controls. Rates of fertilization and of development to SCE from retrieved oocytes (RO), FO, or CE also were lower in cases than controls (63, 25, 39, and 43% vs. 72, 36, 50, and 55%, respectively). Cases had significantly lower rates of clinical pregnancy and livebirth per embryo transfer than controls (7.6 and 1.5% vs. 20.4 and 14.0%). Rates of development to SCE from RO, FO, and CE showed no significance for differences between cases with and without cancer operations (22, 37, and 40% vs. 31, 42, and 49%).
Conclusions: A woman's history of malignant neoplasia was associated with decreased oocyte developmental competence, possibly related to patient's background factors predisposing to tumor.
Keywords: assisted reproductive technology; fertility preservation; history of cancer; oocyte developmental competence.