Timing should no Longer be an Obstacle to Oocyte Cryopreservation in Patients with Cancer

Mangili, Giorgia; Papaleo, Enrico; Sigismondi, Cristina; Masciangelo, Rossella; Sarais, Veronica; Giorgione, Veronica; Nale, Roberta; Privitera, Laura; Carnelli, Letizia; Mattei, Valentina Di; Candiani, Massimo

doi:10.5301/tj.5000586

Cited by 4 publications

(5 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In women recruited after January 2017 when collected oocytes were counted separately for the two ovaries (n = 23), the median (IQR) number of oocytes retrieved in the active and resting ovaries was 7 (4-10) and 9 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14), respectively (p = 0.38). The median (IQR) ratio between the number of oocytes retrieved and the number of developed follicles was 0.67 (0.57-1.00) and 0.84 (0.67-1.00), respectively (p = 0.24).…”

Section: Resultsmentioning

confidence: 99%

“…Indeed, women with cancer who are candidate to oocytes cryopreservation can promptly initiate controlled ovarian stimulation (COS), regardless of the cycle phase [3][4][5][6] . This approach has allowed to overcome most concerns about the possible detrimental impact of a delay in the initiation of radio or chemotherapy on cancer prognosis [7][8][9] . Noteworthy, in selected situations, women have even sufficient time to perform two COS cycles in a row, thus increasing the total number of frozen oocytes 10,11 .…”

mentioning

confidence: 99%

See 1 more Smart Citation

The presence of dominant follicles and corpora lutea does not perturb response to controlled ovarian stimulation in random start protocols

Filippi

Somigliana

Busnelli

et al. 2020

Sci Rep

View full text Add to dashboard Cite

The advent of random start protocols to shorten the time needed to store oocytes in women with malignancies has represented an important improvement in the field of fertility preservation. However, Randomized Controlled Trials are difficult to implement in this area and available evidence that supports this approach remains modest. To shed more light on this issue, we compared the follicular development between the ovary carrying the dominant follicle or the corpus luteum and the contralateral resting ovary in 90 women who underwent random start controlled ovarian stimulation (COS). In fact, ovarian response did not differ between the two ovaries. Subgroup analyses according to the phase of the cycle at the initiation of COS, the type of malignancy, the use of letrozole and the magnitude of the ovarian response did not allow to identify any condition showing a difference in the follicular response between the active and the resting ovaries. In conclusion, follicular growth does not seem to be perturbed by the presence of a dominant follicle or a corpus luteum.

show abstract

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

The presence of dominant follicles and corpora lutea does not perturb response to controlled ovarian stimulation in random start protocols

Filippi

Somigliana

Busnelli

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…The stimulation required for oocyte retrieval could delay oncologic treatment, given that the conventional COS, when initiated in the beginning of the follicular phase may require up to 6 weeks to be concluded. Random-start ovarian stimulation, which means initiating COS immediately, regardless of the patient’s menstrual-cycle phase, has become a well-established approach in fertility preservation strategies, allowing oocyte retrieval in no more than two weeks, in the majority of the cases [ 17 , 18 ]. Currently, random-start ovarian stimulation is routinely and successfully employed for emergency IVF [ 19 – 21 ] and the outcome of ovarian stimulation seems to be similar after stimulation initiation during any phase of the menstrual cycles [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

A specific controlled ovarian stimulation (COS) protocol for fertility preservation in women with breast cancer undergoing neoadjuvant chemotherapy

Cavagna

Pontes

Cavagna

et al. 2017

View full text Add to dashboard Cite

Aim of the studyThe authors present a novel and specific controlled ovarian stimulation protocol for fertility preservation in women with estrogen-positive receptor breast cancer undergoing neoadjuvant chemotherapy. The protocol foresees random start ovarian stimulation and the use of letrozole associated to tamoxifen.Material and methodsForty breast cancer patients were included in the study. COS was performed either with recombinant FSH or hMG. Concomitantly with COS, letrozole in a dose of 5 mg and tamoxifen in a dose of 20 mg were given orally on a daily basis. The trigger was performed with 0.2 mg of triptorelin, in the presence of follicles ≥ 19 mm. Oocyte retrieval was scheduled 35–36 hours after triptorelin injection. Our main outcome measures were the number of oocytes collected and number of oocytes vitrified, the length of ovarian stimulation, total dose of gonadotropins administered, and levels of estradiol on the day of the trigger.ResultsThe mean age of patients was 30.43 ±4.25 years. Nineteen women commenced COS in the luteal phase, eleven in the early follicular phase and ten in the late follicular phase. The mean number of collected oocytes was 11.78 ±9.12 and the mean number of vitrified oocytes was 9.72 ±7.36. The mean duration of COS was 10.03 ±1.33 days. The mean estradiol concentrations on the triggering day was 623.10 ±441.27, and the mean dose of gonadotropins administered was 2540 ±713.10.ConclusionsThe authors suggest that the protocol is efficient and may be a safe option for oocyte vitrification in these patients.

show abstract

“…In fact, the decision to undergo fertility preservation before cancer treatments is not an easy one to make: patients may feel overwhelmed, adding further concerns to the understandable worry about their lives and their future as a result of the recent diagnosis. Moreover, because these techniques can be undertaken only before starting cancer treatment, these decisions usually have to be taken rapidly ( Mangili et al, 2017 ). The literature shows that fertility preservation counseling is associated with better decision-making outcomes in the long term, specifically less regret and conflict about the decision, better coping with the burden of cancer treatment ( Letourneau et al, 2012a ; Mersereau et al, 2013 ; Benedict et al, 2015 ; Deshpande et al, 2015 ), and improved social well-being ( Skaczkowski et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Factors Associated With a High Motivation to Undergo Fertility Preservation in Female Cancer Patients

et al. 2021

Self Cite

View full text Add to dashboard Cite

Objective: Fertility loss due to cancer treatment can be a devastating experience for women and the couple. Undergoing fertility preservation can be a complex decision from both a medical and emotional point of view. The aim of the present study was to evaluate which socio-demographic and psychological factors predict a high motivation to undergo fertility preservation.Methods: Fifty-eight female cancer patients who accessed an Oncofertility Unit completed: a questionnaire to collect socio-demographic characteristics and the level of motivation, the Beck-Depression Inventory-II, the State-Trait Anxiety Inventory-Y, and the Fertility Problem Inventory.Results: Almost half of the sample (44.8%) declared a high motivation. At multiple logistic regression analysis only the “Need for parenthood” subscale of the FPI predicted a high motivation. We alternatively evaluated as possible predictor the construct “Representations about the importance of parenthood” (i.e., the sum of the “Need for Parenthood” and “Rejection of childfree lifestyle” subscales) in place of the two separate subscales. At multiple logistic regression analysis, only this variable predicted a high motivation to undergo fertility preservation.Conclusion: The most important predictor of a high motivation to undergo fertility preservation is the individual desire for parenthood. This implies that, regardless of socio-demographic characteristics, any woman of childbearing age should receive an appropriate counseling about fertility preservation.

show abstract

Timing should no Longer be an Obstacle to Oocyte Cryopreservation in Patients with Cancer

Abstract: Renewed organization of the Oncofertility Unit and the newest random-start COS protocol allowed us to shorten the time for oocyte cryopreservation and start anticancer treatment on time.

Cited by 4 publications

References 20 publications

The presence of dominant follicles and corpora lutea does not perturb response to controlled ovarian stimulation in random start protocols

The presence of dominant follicles and corpora lutea does not perturb response to controlled ovarian stimulation in random start protocols

A specific controlled ovarian stimulation (COS) protocol for fertility preservation in women with breast cancer undergoing neoadjuvant chemotherapy

Factors Associated With a High Motivation to Undergo Fertility Preservation in Female Cancer Patients

Contact Info

Product

Resources

About