Oocyte Vitrification for Fertility Preservation in Women with Benign Gynecologic Disease: National Clinical Practice Guidelines Developed by a Modified Delphi Consensus Process

Abstract

International guidelines are published in oncology to provide standardized information and fertility preservation (FP) care for adults and children with cancer. For benign gynecologic diseases (BGD), many recommendations are based on data coming from oncofertility studies rather than studies with a stronger and broader evidence base. The purpose of the study was to conduct a modified Delphi process for generating FP guidelines for BGD. A steering committee identified 42 potential FP practices for BGD. Then 114 key stakeholders were asked to participate in a modified Delphi process via two online survey rounds and a final meeting. Consensus was reached for 28 items. Among them, stakeholders rated age-specific information concerning the risk of diminished ovarian reserve after surgery as important but rejected proposals setting various upper and lower age limits for FP. All women should be informed about the benefit/risk balance of oocyte vitrification, in particular about the likelihood of live birth according to age. FP should not be offered in rASRM stages I and II endometriosis without endometriomas. These guidelines could be useful for gynecologists to identify situations at risk of infertility and to better inform women with BGDs who might need personalized counseling for FP.