Current status of fertility preservation in a Spanish tertiary public hospital: multidisciplinary approach and experience in over 1500 patients

Purpose Currently, 15% of gynaecological and 9% of haematological malignancies are diagnosed before the age of 40. The increased survival rates of cancer patients who are candidates for gonadotoxic treatments, the delay in childbearing to older ages, and the optimization of in vitro fertilisation techniques have all contributed to an increased interest in fertility preservation (FP) treatments. This study reviews the experience of the Fertility Preservation Programme (FPP) of a tertiary public hospital with a multidisciplinary approach.

This retrospective study included all the available (FP) treatments, performed in patients of childbearing age between 2006 and 2022.

1556 patients were referred to the FPP: 332 oocyte vitrification cycles, 115 ovarian cortex cryopreservation with 11 orthotopic autotransplantations, 175 gonadotropin-releasing hormone (GnRH) agonist treatments, 109 fertility-sparing treatments for gynaecological cancer, and 576 sperm cryopreservation were performed. Malignancy was the main indication for FP (the main indications being breast cancer in women and haematological malignancies in men), although non-oncological pathologies, such as endometriosis and autoimmune diseases, have increased in recent years. Currently, the most widely used FP technique is oocyte vitrification, the increase of which has been associated with a decrease in the use of cortex CP and GnRH agonists.

The increase in FP treatment reflects the implementation of reproductive counselling in oncology programmes. A multidisciplinary approach in a tertiary public hospital allows individualised FP treatment for each patient. In recent years, there has been a change in trend with the introduction of new indications for FP and a change in techniques due to their optimisation. Similar content being viewed by others Abbreviations - FP: - Fertility preservation - SLE: - Systemic lupus erythematosus - IVF: - In vitro fertilisation - FPP: - Fertility preservation programme - CP: - Cryopreservation - GnRH: - Gonadotrophin-releasing hormone - BOT: - Borderline ovarian tumours - SD: - Standard deviation

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Fertility-sparing surgery and reproductive-outcomes in patients with borderline ovarian tumors. Gynecol Oncol. 2020;157(2):411–7. https://doi.org/10.1016/j.ygyno.2020.02.007. Author information Authors and Affiliations Corresponding author Ethics declarations Conflict of interest All authors declare that they have no conflict of interest related to this project. Ethical approval (research involving human participants and/or animals) This study involving human participants was reviewed and approved by the Ethical Committee of the Hospital Clinic of Barcelona. Informed consent According to legislation, participant informed consent was not necessary because of the retrospective nature of the study, the use of anonymized recorded clinical data, and the impossibility of identifying participants directly or through identifiers in the study results. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Barral, Y., Borrás, A., Carrillo, P. et al. Current status of fertility preservation in a Spanish tertiary public hospital: multidisciplinary approach and experience in over 1500 patients. Clin Transl Oncol 26, 1129–1138 (2024). https://doi.org/10.1007/s12094-023-03330-2 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s12094-023-03330-2