Ovarian response after random-start controlled ovarian stimulation to cryopreserve oocytes in cancer patients

Ovarian response after random-start controlled ovarian stimulation to cryopreserve oocytes in cancer patients

To evaluate COS and oocyte retrieval results in ART treatment cycles initiated at any stage of the menstrual cycle (random start) in cancer patients, who could not postpone the onset of cancer treatment. Prospective observational study of 26 women with cancer, with an indication to start cancer trea...

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Bibliographic Details
Published in:JBRA assisted reproduction Vol. 22; no. 4; pp. 352 - 384
Main Authors: Campos, Ana Paula Cb, Geber, Guilherme P, Hurtado, Rodrigo, Sampaio, Marcos, Geber, Selmo
Format: Journal Article
Language:English
Published: Brazil Sociedade Brasileira de Reprodução Humana (Brazilian Society of Assisted Reproduction) 2018
Brazilian Society of Assisted Reproduction
Subjects:
Age
Breast cancer
Cancer therapies
Cervical cancer
Cryopreservation
Embryos
Endometrial cancer
Female
Fertility Preservation
Humans
Medical prognosis
Menstrual Cycle
Menstruation
Neoplasms - complications
Oocyte Retrieval - methods
Oocytes - cytology
Oocytes - growth & development
Original
Ovarian cancer
Ovulation Induction - methods
Patients
Reproductive technologies
Statistical analysis
Time Factors
Ultrasonic imaging
Womens health
Brazil
United States > US
random-start
fertility preservation
oocyte vitrification
controlled ovarian stimulation
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Summary:To evaluate COS and oocyte retrieval results in ART treatment cycles initiated at any stage of the menstrual cycle (random start) in cancer patients, who could not postpone the onset of cancer treatment. Prospective observational study of 26 women with cancer, with an indication to start cancer treatment within the next 20 days and wishing to preserve their fertility. Ovarian stimulation started immediately with FSH followed by GnRH antagonist for pituitary suppression and GnRH agonist for oocyte maturation. Treatment started from day 1 to day 14 of the menstrual cycle was considered to be in the follicular phase, and that started from day 15 to day 28 was considered to be in the luteal phase. Oocyte retrieval was performed 34 h after GnRH agonist administration. After identification and maturity classification, metaphase II oocytes were cryopreserved using vitrification. A total of 13 women had breast cancer, 4 ovarian cancer, 3 Central Nervous System cancer, 3 endometrial cancer, 2 cervical cancer and one bowel cancer. Thirteen patients started treatment during follicular phase and 13 during luteal phase. We found similar results for the duration of treatment, total dose of follicle stimulating hormone, number of ampoules of gonadotropin releasing hormone antagonist, mean number of follicles identified at ultrasound on the day of trigger and retrieval, number of aspirated oocytes and Metaphase II oocytes. Random-start controlled ovarian stimulation for emergency fertility preservation for minimizing delay in oncologic treatment for cancer patients does not interfere with the number of metaphase II oocytes, and therefore can be routinely used for stimulation followed by cryopreservation.
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ISSN:1518-0557
1517-5693
1518-0557
DOI:10.5935/1518-0557.20180065