Ovarian stimulation for fertility preservation in patients with cancer

Quintero, Rodolfo; Helmer, Amy; Huang, Jian; Westphal, Lynn M.

doi:10.1016/j.fertnstert.2008.10.007

Cited by 84 publications

(76 citation statements)

References 10 publications

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“…As far as ovarian response is concerned, several studies have found a similar number of retrieved oocytes between cancer patients and the control group [18,20,21,[24][25][26][27], which is in agreement with the current findings. However, in one of the largest studies in which 223 cancer patients were included, patients with malignancy exhibited a weaker response to COH, especially those with hormone-dependent tumors.…”

Section: Discussionsupporting

confidence: 92%

Ovarian response to controlled ovarian hyperstimulation in women with cancer is as expected according to an age-specific nomogram

Devesa

Martínez

Coroleu

et al. 2014

J Assist Reprod Genet

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Purpose To evaluate the ovarian response to controlled ovarian hyperstimulation (COH) in cancer patients according to an age-specific nomogram for the number of retrieved oocytes. Methods Retrospective observational study carried out in a University affiliated fertility clinic. Forty-eight patients with cancer underwent ovarian stimulation for oocyte cryopreservation. An age -specific nomogram for the number of retrieved oocytes was built with 1536 IVF cycles due to male factor exclusively, oocyte donation and age related fertility preservation. The number of oocytes retrieved in cancer patients was compared to the expected response according to the nomogram using the Z-score. Results The mean number of total retrieved oocytes in patients with cancer was 14.04±8.83. After applying the Z-score to compare the number of retrieved oocytes between women with cancer and the expected response according to the agespecific nomogram, we did not observe a statistically significant difference (Z-score 0.23; 95 % CI [−0.13-0.60]). Conclusion(s) According to our results, patients with cancer exhibit an ovarian response as expected by age. Despite the limitation of the sample size, the obtained results should encourage oncologists for early referral of women with cancer to fertility specialists.

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Section: Discussionsupporting

confidence: 92%

Ovarian response to controlled ovarian hyperstimulation in women with cancer is as expected according to an age-specific nomogram

Devesa

Martínez

Coroleu

et al. 2014

J Assist Reprod Genet

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“…Among all patients, no differences were seen between cancer patients and controls with respect to stimulation parameters and IVF outcomes including total ampules of gonadotropins used, peak estradiol level, number of oocytes retrieved, fertilization rate, and number of 2pn embryos obtained. The similarity between cancer patients and controls with respect to mean number of oocytes retrieved [26,[29][30][31][32][33] as well as number of 2pn embryos obtained [26,34] is consistent with the existing literature. However, contrary to our results, the literature to date suggests that cancer patients typically receive a lower mean-dose of gonadotropins [34,35], achieve a lower peak estradiol level [27,[34][35][36], and according to some studies, have a lower mean number of oocytes retrieved [27,34,36] compared to controls.…”

Section: Discussionsupporting

confidence: 88%

“…Limitations of this study include the small sample size of 63 cancer patients, and particularly the small sample size once results were stratified by stimulation protocol, although this still represents a relatively large cohort when compared to previously published literature [26,[29][30][31][32][33]. Additionally, although the number (21) of cancer patients who underwent transfer is one of the largest reported in the literature, the numbers are still quite small, making it difficult to generalize results obtained in this study to a broader population.…”

Section: Discussionmentioning

confidence: 99%

Ovarian stimulation and in-vitro fertilization outcomes of cancer patients undergoing fertility preservation compared to age matched controls: a 17-year experience

Cardozo

Thomson

Karmon

et al. 2015

J Assist Reprod Genet

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Purpose To compare the in-vitro fertilization (IVF) outcomes of cancer patients who underwent oocyte retrieval and embryo/ oocyte cryopreservation prior to gonadotoxic therapy to those of age and time-matched controls with tubal factor infertility. Methods All cancer patients who underwent embryo/oocyte cryopreservation at our institution from 1997 to 2014 were reviewed. Primary outcomes were total dose of gonadotropins used, number of oocytes retrieved, and number of 2pn embryos obtained. Outcomes were compared to age-matched controls with tubal-factor infertility who underwent a fresh embryo transfer within the same relative time period as the IVF cycle of the cancer patient. Results Sixty-three cancer patients underwent 65 IVF cycles, and 21 returned for frozen embryo transfer. One hundred twenty-two age-matched controls underwent IVF cycles with fresh transfer, and 23 returned for frozen embryo transfer. No difference was seen between cancer patients and controls with respect to total ampules of gonadotropin used (38.0 vs. 35.6 respectively; p=0.28), number of oocytes retrieved (12.4 vs. 10.9 respectively; p=0.36) and number of 2pn embryos obtained (6.6 vs. 7.1 respectively; p=0.11). Cumulative pregnancy rate per transfer for cancer patients compared to controls was 37 vs. 43 % respectively (p=0.49) and cumulative live birth rate per transfer was 30 vs. 32 % respectively (p=0.85). Cancer patients had a higher likelihood of live birth resulting in twins (44 vs. 14 %; p=0.035). Conclusions Most IVF outcomes appear comparable for cancer patients and age-matched controls. Higher twin pregnancy rates in cancer patients may reflect lack of underlying infertility or need for cancer-specific transfer guidelines.

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“…The younger age of patients with hematologic malignancies (mostly Hodgkin lymphoma) in all probability explains the statistical difference. Quintero et al 3 reported higher baseline levels of fsh in patients with breast cancer. In that study, the higher proportion of significantly older patients in the group with a breast malignancy probably explains the upward shift in fsh levels.…”

Section: Levin Md* and B Almog Md*mentioning

confidence: 98%

Effect of Cancer on Ovarian Function in Patients Undergoing In Vitro Fertilization for Fertility Preservation: A Reappraisal

Levin

Almog

2013

Current Oncology

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Ovarian stimulation for fertility preservation in patients with cancer

Cited by 84 publications

References 10 publications

Ovarian response to controlled ovarian hyperstimulation in women with cancer is as expected according to an age-specific nomogram

Ovarian response to controlled ovarian hyperstimulation in women with cancer is as expected according to an age-specific nomogram

Ovarian stimulation and in-vitro fertilization outcomes of cancer patients undergoing fertility preservation compared to age matched controls: a 17-year experience

Effect of Cancer on Ovarian Function in Patients Undergoing In Vitro Fertilization for Fertility Preservation: A Reappraisal

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