Utilization and fertility preservation outcomes in women undergoing embryo cryopreservation before breast cancer treatment: A meta-analysis

Our aim was to assess fertility preservation (the proportion of women who had at least 1 live birth) and utilization rates (the proportion of women who utilized their cryopreserved embryos) rates among women who cryopreserved their embryos before breast cancer treatments. PubMed and Cochrane library database were searched until December 2024. We included all studies that reported pregnancy outcomes, the number of women who returned for frozen embryo transfer, and the number of women who preserved their fertility. The primary outcome measures were the utilization and fertility preservation rates. Secondary outcome measures were implantation, clinical pregnancy, and live birth rates. Of the 12 studies, 9 met the criteria, encompassing >2126 women with breast cancer who cryopreserved their embryos for fertility preservation. In 9 studies that reported the total number of attempts, 424 women underwent 863 embryo transfers. Based on those studies, the clinical pregnancy and live birth rates were 50% (95% CI: 35-65, I 2: 80%) and 33% (95% CI: 22-46, I 2: 76%), respectively. The utilization and fertility preservation rates were 18% (95% CI: 9-32, I 2: 95%) and 39% (95% CI: 29-51, I 2: 48%), respectively, all from random-effects models. Fertility preservation success with embryos cryopreserved before breast cancer treatments seems to be promising. However, the utilization rate of cryopreserved embryos is low. Additional studies with larger sample size and longer follow up are required to evaluate the long-term utility rates.