(30) Effect Of Ovarian Tissue Cryopreservation On Oncologic/Autoimmune Therapeutic Timeline

Background: Fertility preservation is an integral part of comprehensive cancer care for young patients as well as other medical conditions requiring gonadotoxic treatment. As of 2019, the American Society for Reproductive Medicine considers ovarian tissue cryopreservation (OTC), the only fertility preservation option for prepubertal patients with ovaries, no longer experimental and a standard fertility preservation option. Despite these recommendations, services remain underutilized. Qualitative studies examining clinician and patient perceived barriers have cited fertility care as a secondary concern with potential impacts on delaying urgent treatment. OTC can be performed quickly, often within 5-7 days of referral, involving laparoscopic unilateral oophorectomy, which has been shown to be safe and effective in prepubertal youth. Our study aims to assess if performing OTC results in any delay in a patient’s oncologic or autoimmune therapy start time.

Methods: A retrospective chart review of 58 patients who had undergone OTC due to anticipated gonadotoxic therapy from 1999 - 2024 in a single university hospital setting treating a primarily insured population. Treatment lag time, calculated from date of expected start date to actual start date was measured along with sociodemographic variables such as ethnicity and age at the time of OTC as well as clinical diagnosis.

Results: Out 58 patients who had undergone OTC, 57 patients had records available to review. 1 patient was excluded as she had no gonadotoxic treatment, yielding 56 patient records for review. The majority of the patients identified as non-Latine white at 51.7% (29/56). Mean age at the time of OTC was 21 years old, ranging from 5 months to 45 years. Mean treatment lag time was 0 days, where 98.2% (55/56) of patients had no treatment delay. The 1 patient who did have a delay, upon further chart evaluation revealed that her delay in care was due to methemaglobinemia, unrelated to her OTC.

Conclusions: In our study population, undergoing OTC did not delay initiation oncologic or autoimmune therapy. OTC can be performed quickly via unilateral oophorectomy in patients with planned gonadotoxic therapy and is crucial to preserve future fertility for the possibility of genetic parenthood.