Ovarian stimulation in young adult cancer survivors on targeted cancer therapies.

OBJECTIVE: To describe a clinical approach to and outcomes of IVF in reproductive-aged cancer survivors receiving targeted cancer therapies.

DESIGN: Case report.

SETTING: Not applicable.

PATIENT(S): The first case is of a female patient with metastatic lung cancer receiving long-term crizotinib, an anaplastic lymphoma kinase inhibitor. The second case is of a female patient with metastatic colon cancer receiving long-term denosumab, a RANKL antibody. Both patients presented desiring fertility.

INTERVENTION(S): In vitro fertilization.

MAIN OUTCOME MEASURE(S): Live birth and embryo banking.

RESULT(S): The potential impact of targeted therapy on oocytes and pregnancy was investigated via literature review and pharmaceutical company inquiries. After oncologic, fertility, and psychological counseling, both survivors underwent ovarian stimulation, IVF, and preimplantation genetic screening. One couple achieved live births of dizygotic twins via gestational surrogacy. The second couple froze one euploid blastocyst for future fertility. Both survivors are stable from their cancer standpoints.

CONCLUSION(S): Successful fertility treatments are possible in the context of exposure to crizotinib and denosumab.