IVF outcomes in cancer survivors: lower ovarian response and early embryo development but comparable success in frozen embryo transfer cycles - a retrospective cohort study.

OBJECTIVE: To evaluate whether women who have undergone cancer chemotherapy or radiotherapy achieve assisted reproductive technology (ART) outcomes comparable to those of non-cancer patients with equivalent ovarian reserve, and to explore the association between ART outcomes and the interval after chemotherapy or radiotherapy. DESIGN: Retrospective cohort study. PATIENTS: 32 cancer survivors who had received chemotherapy or radiotherapy and 160 matched control women had similar ovarian functions without malignancy. MAIN OUTCOMES: Number of oocytes retrieved, embryo development, cumulative pregnancy rate and cumulative live birth rate. RESULT: This study performed inverse probability of treatment weighting (IPTW) to minimize potential confounding factors. After IPTW adjustment, the baseline characteristics were well balanced between the survivor and control groups. In the weighted regression analysis, the survivors exhibited a lower number of MII oocytes (β=-3.06 95%CI [-5.568, -0.555], P = 0.02), and a reduced high-quality embryo rate (β=-0.25 95%CI [-0.375, -0.128], P < 0.001). However, in the FET cycle, there was no difference in cumulative pregnancy rate and cumulative live birth rate and abortion rate. Besides, there was no strong relationship between the interval after chemo or radio therapy and ART outcomes. CONCLUSION: This study demonstrated that when women with a history of chemotherapy or radiotherapy had similar ovarian function with women who had not experienced cancer still exhibited reduced number of MII oocyte and lower high-quality embryo rate and there was no difference in FET outcomes between survivor and control group. We also found no significant difference in different treat-to- IVF/ICSI interval in FET cycle outcomes.