Impact of extent and biochemical parameters of lymphoma on fertility preservation outcome

Objective: To evaluate the impact of lymphoma aggressiveness on ovarian response during fertility preservation treatment. Design: Retrospective cohort study. Setting: University-affiliated tertiary hospital. Patient(s): Women with lymphoma who underwent ovarian stimulation for fertility preservation in the period from 2009 to 2018. Intervention(s): None. Main Outcome Measure(s): Primary outcome: the number of mature oocytes; secondary outcomes: the number of retrieved oocytes, estradiol level, and number of follicles >14 mm on the day of oocyte maturation trigger. Result(s): Patients with stage I–II lymphoid neoplasms (localized disease) were compared with those with stage III–IV lymphomas (advanced disease). Women with favorable levels of biochemical prognostic markers were also compared with those with unfavorable levels. Women with favorable levels of biochemical prognostic markers (n = 74) had a higher number of mature oocytes compared with patients with unfavorable serum levels (n = 67): 11 (7.8–16) versus 9 (5–11), respectively. The number of mature oocytes was similar between patients with localized (n = 75) and advanced (n = 66) lymphomas. Women with unfavorable combination of stage and biochemical factors had lower number of mature oocytes compared to patients with favorable combination: 8 (5–10) versus 11 (7–16), respectively. Multivariate logistic regression showed that favorable levels of biochemical markers as well as a combination of extent and biochemical parameters were statistically significantly associated with the result of over 10 mature oocytes. Conclusion(s): Highly-aggressive lymphoid neoplasms have a negative impact on ovarian function and response during fertility preservation treatment.