A clinical case of fertility preservation in a patient with acute myeloid leukemia

• Natalya A. Savelyeva
• Yulia A. Fetisova
• Olga Yu. Baranova
• Valeria O. Shpirko

Abstract

Background. Conducting a fertility preservation program among patients with acute leukemia is extremely difficult due to severity of the condition and high risks of both thrombotic and hemorrhagic complications. Limiting the possibility of conducting a fertility preservation program before the start of specific treatment may cause a decrease in reproductive potential even after achieving stable remission of the disease.

Material and methods. This article presents a clinical observation of controlled ovarian stimulation using the random-start protocol and oocyte cryopreservation in a patient with acute myeloid leukemia. The description presents in detail the dynamics of ultrasound examinations and management tactics for this patient.

Conclusion. Fertility preservation in patients with acute myeloid leukemia requires a special approach and multidisciplinary work of oncohematologists and specialists of reproductive medicine. Long-term observations of reproductive function and neonatal outcomes in this cohort of patients are required.

Keywords:assisted reproductive technologies; oncofertility; acute myeloid leukemia; fertility preservation; oocyte cryopreservation

REFERENCES

1. Salama M., Anazodo A., Woodruff T.K. Preserving fertility in female patients with hematological malignancies: a multidisciplinary oncofertility approach. Ann Oncol. 2019; 30 (11): 1760–75.

2. Bedaiwy M.A., Abou-Setta A.M., Desai N., et al. Gonadotropin-releasing hormone analog cotreatment for preservation of ovarian function during gonadotoxic chemotherapy: a systematic review and meta-analysis. Fertil Steril. 2011; 95 (3): 906–14.e1–4.

3. Sönmezer M., Şükür Y.E., Saçinti K.G., et al. Safety of ovarian cryopreservation and transplantation in patients with acute leukemia: a case series. Am J Obstet Gynecol. 2024; 230 (1): 79.e1–10.

4. Moghassemi S., Dadashzadeh A., Camboni A., Feron O., Azevedo R.B., Amorim C.A. Ex vivo purging of cancer cells from ovarian tissue using photodynamic therapy: a novel strategy to restore fertility in leukemia patients. Hum Reprod Open. 2023; 2023 (2): hoad005.

5. Doyle J.O., Richter K.S., Lim J., et al. Successful elective and medically indicated oocyte vitrification and warming for autologous in vitro fertilization, with predicted birth probabilities for fertility preservation according to number of cryopreserved oocytes and age at retrieval. Fertil Steril. 2016; 105 (2): 59–66.e2.

6. Argyle C.E., Harper J.C., Davies M.C. Oocyte cryopreservation: where are we now? Hum Reprod Update. 2016; 22 (4): 440–9.

7. Cobo A., García-Velasco J.A., Coello A., et al. Oocyte vitrification as an efficient option for elective fertility preservation. Fertil Steril. 2016; 105 (3): 755–64.e8.

8. URL: https://springfertility.com/eggcalc

9. Lee S.J., Schover L.R., Partridge A.H., et al. American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J Clin Oncol. 2006; 24 (18): 2917–31.

10. Sekiguchi M., Ito A., Fukuda Y., et al. Optimal timing to retrieve oocytes for fertility preservation in patients with acute myeloid leukemia: two cases of controlled ovarian stimulation using DuoStim with a literature review. Gynecol Endocrinol. 2023; 39 (1): 2217262.

11. Ogawa T., Ogi M., Hirata S. A case of ovarian stimulation for fertility preservation in a patient with Philadelphia chromosome-positive acute lymphoblastic leukemia after treatment with dasatinib. J Obstet Gynaecol Res. 2021; 47 (3): 1182–5.

12. Kato K., Ochi M., Nakamura Y., et al. A multi-centre, retrospective case series of oocyte cryopreservation in unmarried women diagnosed with haematological malignancies. Hum Reprod Open. 2021; 2021 (1): hoaa064.

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