Oocyte Cryopreservation Outcomes in Women With Hematological Malignancies Undergoing Chemotherapy—A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
OBJECTIVE: Hematological cancers are among the leading malignancies affecting women of reproductive age. Oocyte cryopreservation (OC) is routinely recommended before initiating gonadotoxic treatments. We aim to evaluate OC outcomes in women with hematological cancers undergoing chemotherapy. DATA SOURCES: A comprehensive literature search was conducted in Medline, Embase, and Cochrane Library until January 2024. STUDY SELECTION: Studies examining fertility outcomes of women undergoing OC before chemotherapy for hematological cancers were included. Comparison groups included healthy controls or patients with other cancers. The primary outcome was the number of mature oocytes frozen per stimulation cycle; secondary outcomes included total cumulus-oocyte complexes, stimulation duration, total gonadotropin dose and fertility outcomes following the utilization of cryopreserved oocytes. DATA EXTRACTION AND SYNTHESIS: A total of 14 cohort studies, 2 case-control studies, and 6 case reports involving 858 hematological cancer patients undergoing OC and 2676 comparators were included. The mean mature oocyte yield ranged from 7 to 19 in the hematological cancer group, and 6 to 14 in the comparator groups (mean difference [MD] 0.11; 95% CI -0.10 to 0.33). A comparable number of total cumulus-oocyte complexes (MD 0.09; 95% CI -0.07 to 0.25) and total dose of gonadotropins were found (MD 0.33; 95% CI -0.32 to 0.98). The analysis found a marginally longer duration of stimulation in the hematological cancer group (MD 0.21; 95% CI 0.11-0.31). Also, the hematological cancer group was found to be statistically younger, (MD -1.32; 95% CI -1.85 to -0.79), the difference is not clinically meaningful. Results for subgroup analyses concurred with the main analysis. Fertility and utilization of cryopreserved oocyte data were lacking. CONCLUSION: These findings suggest that women with hematological cancers undergoing OC may expect similar oocyte yield compared to women with other cancers or healthy controls. Oocyte quality and pregnancy outcomes following the utilization of cryopreserved oocytes in hematological cancer patients remain unclear and should be the subject of further study.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.020 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.012 | 0.025 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".