Random Start Ovarian Stimulation for Oocyte or Embryo Cryopreservation in Women Desiring Fertility Preservation Prior to Gonadotoxic Cancer Therapy

Danis, Rachel Blair; Pereira, Nigel; Elias, Rony T.

doi:10.2174/1389201018666170808122531

Cited by 51 publications

(41 citation statements)

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“…Over the years, further improvements aiming to increase the efficacy and safety of FP have been introduced at our center. They include the use of ovarian stimulation regimens incorporating aromatase inhibitors for women with hormone‐sensitive breast cancer and implementation of random‐start COS protocols aimed at shortening the delay in retrieving oocytes …”

Section: Methodsmentioning

confidence: 99%

“…They include the use of ovarian stimulation regimens incorporating aromatase inhibitors for women with hormone-sensitive breast cancer 11,12 and implementation of random-start COS protocols aimed at shortening the delay in retrieving oocytes. [13][14][15][16] The option of CoOT has been presented to all women and particularly discussed when time constraints or concerns regarding hormonal stimulation were present. Laparoscopic retrieval for…”

Section: Reproductive Counseling Of Adult Womenmentioning

confidence: 99%

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A prospective study of women and girls undergoing fertility preservation due to oncologic and non‐oncologic indications in Sweden–Trends in patients’ choices and benefit of the chosen methods after long‐term follow up

Rodriguez‐Wallberg

Marklund

Lundberg

et al. 2019

Acta Obstet Gynecol Scand

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Introduction In Scandinavian countries, programs for fertility preservation are offered free of charge at tertiary‐care university hospitals to all patients facing treatments with risk of subsequent sterility. In this prospective study we aimed to investigate trends in female patients’ choices after counseling and fertility preservation outcomes during follow up in relation to benign vs malignant indications. Material and methods Data on 1254 females including 1076 adults and 178 girls who received fertility preservation counseling for either oncologic (n = 852) or benign indications (n = 402) at Karolinska University Hospital, Stockholm, between 1 October 1998 and 1 December 2018 were analyzed. As appropriate, t tests and chi‐square tests were used to compare groups. Logistic regression was used to compare outcomes among groups depending on indications. Results Adult women generally elected to undergo oocyte retrieval after controlled ovarian stimulation for cryopreservation of embryos or oocytes (n = 538, 73%), whereas a minor proportion opted for cryopreservation of ovarian tissue retrieved through laparoscopy (n = 221, 27%). More than half of the women with a partner chose either not to fertilize their oocytes aiming at cryopreservation of oocytes or to share obtained oocytes attempting both cryopreservation of oocytes and cryopreservation of embryos. All pre‐pubertal (n = 48) and 73% of post‐pubertal girls (n = 66) elected cryopreservation of ovarian tissue. In recent years, an increasing number of teenagers have opted for controlled ovarian stimulation aiming at cryopreservation of oocytes, either before (n = 24, 17%) or after completion of cancer treatment (n = 15, 10%). During follow up, 27% of the women returned for a new reproductive counseling, additional fertility preservation or to attempt pregnancy. Utilization rates among individuals who were alive and of childbearing age by December 2018 indicated 29%, 8% and 5% for embryos, oocytes and ovarian tissue with live birth rates of 54%, 46% and 7%, respectively. Women with benign indications were significantly younger than women with previous malignant indications at the time of attempting pregnancy. Although the pregnancy rates were similar among both groups, the live birth rate was significantly higher in women with benign vs previous malignant indications (47% vs 21%, P = .002). Conclusions Trends in fertility preservation choices have changed over time. Women with previous malignancy had lower live birth rates than women with benign fertility preservation indications.

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Section: Methodsmentioning

confidence: 99%

Section: Reproductive Counseling Of Adult Womenmentioning

confidence: 99%

A prospective study of women and girls undergoing fertility preservation due to oncologic and non‐oncologic indications in Sweden–Trends in patients’ choices and benefit of the chosen methods after long‐term follow up

Rodriguez‐Wallberg

Marklund

Lundberg

et al. 2019

Acta Obstet Gynecol Scand

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“…Danis et al [29] published a systematic review of 19 studies published between January 2000 and June 2017 to evaluate the utility of random-start ovarian stimulation for fertility preservation. This recent review suggested that random-start stimulation was associated with a reduced time interval between the initiation of ovarian stimulation and oocyte or embryo cryopreservation.…”

Section: Random-start Ovarian Stimulationmentioning

confidence: 99%

Controlled ovarian hyperstimulation for fertility preservation in women with breast cancer: Practical issues

Park

Jeong

Cho

et al. 2021

Clin Exp Reprod Med

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In Korean women, a westernized lifestyle is associated with an increased risk of breast cancer. Fertility preservation has become an increasingly important issue for women with breast cancer, in accordance with substantial improvements in survival rate after cancer treatment. The methods of controlled ovarian hyperstimulation (COH) for fertility preservation in breast cancer patients have been modified to include aromatase inhibitors to reduce the potential harm associated with increased estradiol levels. Random-start COH and dual ovarian stimulation are feasible options to reduce the total duration of fertility preservation treatment and to efficiently collect oocytes or embryos. Using a gonadotropin-releasing hormone agonist as a trigger may improve cycle outcomes in breast cancer patients undergoing COH for fertility preservation. In young breast cancer patients with BRCA mutations, especially BRCA1 mutations, the possibility of diminished ovarian reserve may be considered, although further studies are necessary. Herein, we review the current literature on the practical issues surrounding COH for fertility preservation in women with breast cancer.

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“…At the same time, with the improvements in cancer treatment, oocyte freezing has gained importance for patients who are diagnosed with cancer at an early age and desire to maintain fertility. Other factors that reduce fertility include having a poor ovarian reserve, a history of early menopause in the family, systemic disease (Systemic lupus erythematosus, rheumatoid arthritis groups) that have to be put on lifelong immunosuppression and having advanced stage endometriosis that requires oophorectomy and disrupts the quality of life (1,2). Fertility protection procedures are prominent for this group of patients.…”

Section: Introductionmentioning

confidence: 99%

Oocyte Cryopreservation: Retrospective Analysis Of 5 Years Experience

Göktepe

Türkyılmaz

Durdağ

et al. 2020

Gynecol Obstet Reprod Med

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OBJECTIVE: To analyze demographic and clinical data of patients who resorted to oocyte freezing between January 2014 and December 2018. STUDY DESIGN: Patients who applied to the Reproductive Endocrinology and Infertility Unit of Ankara University School of Medicine between January 2014 and December 2018 with the request of oocyte freezing were included in this study. The files and computer records of the patients were analyzed retrospectively and sociodemographic, clinical and laboratory data were evaluated. RESULTS: A total of 46 cycles were recorded in 40 patients over a 5-year period. The main indications were low ovarian reserve and/or advanced age (68.3%) and malignancy diagnosis (31.7%). There was a significant difference between elective fertility preservation and oncofertility preservation (Onco-FP) groups in terms of the age (38.4±4.7 vs 28.4±6.1; p=0.001). There was a significant difference between two groups in favor of oncofertility group in terms of anti-Mullerian hormone level, basal follicle-stimulating hormone level, antral follicle count, trigger day estradiol (E2) level, number of obtained oocytes, MII oocytes, and frozen oocytesCONCLUSION: According to our study, the most prominent oocyte cryopreservation indication was advanced age and/or low ovarian reserve. The number of oocytes collected from patients in the Onco-FP group and thus the number of frozen oocytes was significantly higher than in the elective fertility preservation group, due to younger ages and better ovarian reserve in the Onco-FP group. Abdominal administration of the technique is particularly important for virgin patients in our country. Oocyte freezing is a fertility protection method available in a wide range of indications for reproductive-aged women.

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Random Start Ovarian Stimulation for Oocyte or Embryo Cryopreservation in Women Desiring Fertility Preservation Prior to Gonadotoxic Cancer Therapy

Cited by 51 publications

References 0 publications

A prospective study of women and girls undergoing fertility preservation due to oncologic and non‐oncologic indications in Sweden–Trends in patients’ choices and benefit of the chosen methods after long‐term follow up

A prospective study of women and girls undergoing fertility preservation due to oncologic and non‐oncologic indications in Sweden–Trends in patients’ choices and benefit of the chosen methods after long‐term follow up

Controlled ovarian hyperstimulation for fertility preservation in women with breast cancer: Practical issues

Oocyte Cryopreservation: Retrospective Analysis Of 5 Years Experience

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