Miyuki Harada

Trends in fertility preservation treatments in Japan until 2023: analysis of the Japan Oncofertility Registry

Abstract Background Fertility preservation for patients with cancer or other diseases who receive gonadotoxic treatment has gained importance as cancer survival rates increase. In Japan, a database for registering all fertility preservation patients, named the Japan Oncofertility Registry (JOFR), was established in 2018. This study aimed to analyze recent trends in fertility preservation in Japan utilizing data from the JOFR. Methods Data was extracted from the JOFR for patients who consulted fertility preservation teams until May 2024. A descriptive analysis was conducted to examine trends in patient demographics, cancer types, fertility preservation treatments, complications, and outcomes. The data covered the period from diagnosis to fertility preservation and subsequent usage or disposal of frozen specimens. Results A total of 11,510 patients were recorded, with 9491 undergoing fertility preservation treatments. The number of patients increased steadily after 2006. After 2021, the number of female patients was much higher than the number of male patients. The most common primary diseases were breast cancer among women and testicular tumors and leukemia among men. There were some complications including ovarian hyperstimulation syndrome (5.0%), bleeding (0.12%), and infections (0.05%) for women. Seven hundred and sixty clinical pregnancies were recorded, with 440 using preserved specimens. The discard rate was 16.3% for men and 3.7% for women. Conclusion The study highlights recent trends in the growing number of cases undergoing fertility preservation in Japan. It also identifies several issues to be solved in fertility preservation in Japan, regarding its efficacy and safety, as well as the medical provision system.

Does polycystic ovary syndrome independently affect oncologic and reproductive outcomes in patients with endometrial cancer receiving fertility-sparing treatment?

Survival and reproductive outcomes after fertility‐sparing surgery performed for borderline epithelial ovarian tumor in Japanese adolescents and young adults: Results of a retrospective nationwide study

AbstractObjectiveEpithelial borderline ovarian tumor (BOT) frequently occurs in young women. Because progression‐free survival, overall survival, and reproductive function are important outcomes, BOT is often treated by fertility‐sparing surgery (FSS). We conducted a Japan‐wide study to understand post‐FSS prognosis in relation to clinical characteristics and types of FSS performed.MethodsWe analyzed clinical and outcome data pertaining to 531 adolescent and young adult (AYA) patients (aged 15–39 years) who underwent FSS for BOT between 2009 and 2013.ResultsMedian (range) age was 30 (15–39) years, and median observation time was 70 (2–120) months. The disease was of FIGO stage I in 492 (93%) patients. Histopathologically, tumors were of the mucinous (n = 372, 70%), serous (n = 120, 23%), seromucinous (n = 23, 4%), and other (n = 16, 3%) types. Five‐year overall survival was 99.5% among patients with stage I and 100% among those with stage II–IV. Five‐year progression‐free survival was 96.7% and 69.3%, respectively. Multivariate analysis in cases of stage I showed a positive peritoneal cytology to be a significant risk factor for recurrence (HR, 5.199; p = 0.0188). The post‐FSS pregnancy rate was relatively low for patients aged ≥30 years (OR, 0.868; 95% CI, 1.16–3.00; p = 0.0090).ConclusionPost‐FFS outcomes in terms of overall and progression‐free survival are favorable, especially for AYA patients with stage I BOT. However, the relapse rate is high for patients with FIGO stage II–IV and for those with stage I but a positive peritoneal cytology. A long‐term prospective observation is needed before reproductive outcomes can be fully established.