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Purpose To investigate if breast cancer stage and grade affect fertility preservation outcomes. Methods We performed a retrospective cohort study that included premenopausal women with breast cancer undergoing fertility preservation diagnosed between January 2011 and January 2019. The primary outcome measure was the number of mature oocytes (MII) per antral follicle count (AFC). Secondary outcome measures included total oocytes retrieved, total mature oocytes retrieved, and greater than 10 mature oocytes preserved. Univariate and multivariate models were used to assess the association of low vs. high stage (low stage I-II and high stage III-IV) and grade I vs. grade II/III with each outcome, with adjustment for confounders. Results A total of 267 premenopausal breast cancer patients undergoing fertility preservation were included in our study, with the majority presenting with low stage (N = 215, 80.5%), grade II/III (N = 235, 88.1%) disease. Baseline AFC, total gonadotropin dose, days of stimulation, and follicles ≥ 13 mm on the day of trigger did not differ by stage or grade. After adjusting for age, BMI, and baseline AFC, we found that the mean MII per AFC did not differ by stage (1.0 vs. 1.1, P = 0.3) or grade (1.0 vs. 1.0, P = 0.92). Similarly, total oocytes retrieved, total MII retrieved, and percentage of patients who were able to preserve greater than 10 MII did not differ by breast cancer stage or grade (all P > 0.2). Conclusion Breast cancer grade and stage do not impact ovarian stimulation or fertility preservation outcome.

Objective: To investigate if differences in self-reported satisfaction with fertility clinics and doctors differ by race/ethnicity. Study Design: We used cross-sectional survey data from FertilityIQ online questionnaires completed by patients receiving U.S. fertility care from July 2015 to December 2020. Univariate and multivariate logistic and linear regression analyses performed to assess association of race/ethnicity on patient reported clinic and physician satisfaction. Results: Our total sample size included 21,472 patients (15,986 Caucasian, 1,856 Black, 1,780 LatinX, 771 East Asian, 619 South Asian, 273 Middle Eastern, 187 Native American self-reported). When adjusting for all confounders (demographic and patient satisfaction), we found that Black patients rated their doctors more highly (OR 1.30, 95% CI 1.04-1.62 p=0.022 logistic and Coef 0.082, 95% CI 0.013-0.15 p=0.02 linear), while other ethnic groups did not show significant differences compared to Caucasian patients. East Asians had borderline lower satisfaction with clinic satisfaction in logistic regression (OR 0.74 95% CI 0.55-1.00 p=0.05), while significant differences were not found for other ethnic groups for clinic satisfaction. Conclusions: In summary, some but not all minority groups differed in their self-reported perception of satisfaction with fertility clinic and doctors compared to Caucasian patients. Cultural differences towards surveys may contribute to some of these findings, and satisfaction by racial/ethnic group may also be modified by results of care.

Objective: To investigate if differences in self-reported satisfaction with fertility clinics and doctors differ by race/ethnicity. Study Design: We used cross-sectional survey data from FertilityIQ online questionnaires completed by patients receiving U.S. fertility care from July 2015 to December 2020. Univariate and multivariate logistic and linear regression analyses performed to assess association of race/ethnicity on patient reported clinic and physician satisfaction.

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