The impact of previous history of malignant tumors/precancerous lesions on IVF/ICSI outcomes: a retrospective cohort study.

BACKGROUND

The incidence of malignant tumors/precancerous lesions is rising, yet their impact on pregnancy outcomes in women undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) remains unclear.

METHODS

A single-center retrospective cohort study was conducted at the Reproductive Medicine and Genetics Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology between January 2015 and December 2022. Propensity score matching (PSM) was applied to match the baseline data of the two groups, and the primary outcome were the conservative/optimistic cumulative live birth rates (CLBR) across multiple cycles.

RESULTS

A total of 1004 patients were enrolled, including 251 individuals in the malignant tumors/precancerous lesions group (363 oocyte retrieval cycles) and 753 PSM controls (895 oocyte retrieval cycles). Compared with the controls, patients with a history of malignant tumors/precancerous lesions exhibited significantly lower ovarian reserve and poorer embryo outcomes (all p < 0.05). Both conservative and optimistic CLBR were lower in the malignant tumors/precancerous lesions group across multiple cycles (p < 0.05). After multiple oocyte retrievals, the conservative CLBR for malignant tumors/precancerous lesions plateaued at around 53% after four cycles, while optimistic CLBR reached 70% after four cycles. Among patients with prior malignant tumors/precancerous lesions who completed follow-up, the overall recurrence rate after IVF/ICSI treatment was 7.03% with no adverse events.

CONCLUSIONS

Patients with a previous history of malignant tumors/precancerous lesions demonstrated inferior live birth outcomes compared to controls. Multiple ovarian stimulations improved live birth opportunities without significantly increasing the risk of tumor recurrence.