Random-start ovarian stimulation in women desiring elective cryopreservation of oocytes

Abstract

The current study investigates the utility of random-start ovarian stimulation in women desiring elective oocyte cryopreservation. Women in the study cohort underwent random-start ovarian stimulation, and were subdivided based on the phase of the menstrual cycle that ovarian stimulation began, i.e. early follicular, late follicular or luteal phase. Women undergoing conventional cycle day (CD) 2/3 ovarian stimulation start were controls. A total of 1302 women were included - 859 (66.0%) conventional CD 2/3, 342 (26.3%) early follicular, 42 (3.2%) late follicular and 59 (4.5%) luteal ovarian stimulation starts. There was no difference in the demographics or baseline ovarian stimulation characteristics. The duration of ovarian stimulation (11 versus 9 days; P < 0.001) and total dosage of gonadotrophins administered (4095.5 versus 3155 IU; P < 0.001) was higher in the random-start group. The number of total and MII oocytes in the control and random-start groups was similar. A non-significant trend towards increased cycle cancellation was noted in the late follicular start group (7.1%). Study findings indicate the number of total and MII oocytes derived from random-start protocols initiated during any phase of the menstrual cycle is similar to conventional CD 2/3 ovarian stimulation start protocols in women desiring elective oocyte cryopreservation.

Random‐start ovarian stimulation with aromatase inhibitor for fertility preservation in women with Japanese breast cancer

“…The number of retrieved oocytes in the LPS was similar to that of the FPS. This result was consistent with the findings reported in previousstudies . A previous study showed that there was no elevated rate of abnormality at birth after LPS compared to FPS .…”

“…This result was consistent with the findings reported in previousstudies. 15,16 A previous study showed that there was no elevated rate of abnormality at birth after LPS compared to FPS. 17 Another study showed that euploid blastocyst rate calculated either per biopsied blastocyst or injected MII oocyte was not significantly different between FPS and LPS groups.…”

Oocyte cryopreservation for future fertility: comparison of ovarian response between cancer and non-cancer patients

“…Therefore, we advocate the need for a multidisciplinary approach for these patients, enforced through improved communication between all areas involved in order to avoid unnecessary delays in the evaluation and treatment of patients. Although ovarian stimulation takes some time, randomly started cycles may produce mature oocytes in up to 14 days in the vast majority of the cases, as in our sample (Letourneau et al ., 2017; Vaiarelli et al ., 2017; Pereira et al ., 2017). The associated costs are also an issue, and ideally the government and health insurances should reimburse clinics for the procedure, as it happens in European countries.…”

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

“…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 …”

“…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…”