Application of assisted reproductive technology in fertility pre-servation and promotion for women with malignant tumors
To evaluate the strategies and outcomes of assisted reproductive technology (ART) for fertility enhancement and preservation in women with malignant tumors, and to analyze ART outcomes across different tumor types. We conducted a retrospective analysis of female patients who underwent ART for fertility enhancement and preservation at the Reproductive Medicine Center of the Women's Hospital, Zhejiang University School of Medicine, between January 1, 2018 and December 31, 2023. A total of 163 ART-aided pregnancy patients with malignant tumors were included in the case group, among which 6 patients underwent embryo cryopreservation for fertility preservation before radiotherapy or chemotherapy. Additionally, 11 unmarried women underwent oocyte cryopreservation due to borderline ovarian tumors, ovarian cancer, breast cancer, or hematological malignancies. The control group was selected from women without a history of malignant tumors who received ART treatment during the same period, using propensity score matching at a ratio of 1∶2, resulting in 326 cases. Data were collected through the reproductive medical record system and telephone follow-up (as of October 31, 2024). Baseline characteristics, controlled ovarian hyperstimulation parameters, laboratory indicators, and pregnancy outcomes were compared between case and control groups and among patients with different tumor types, and the tumor recurrence of the patients was followed up. Patients in the case group had significantly lower ovarian reserve (anti-Müllerian hormone, antral follicle count) and a higher proportion of diminished ovarian reserve compared to the control group (all Women of reproductive age with malignant tumors are at risk of diminished fertility. ART can effectively enhance and preserve fertility, enabling favorable pregnancy and live birth outcomes.