Ovarian response to controlled ovarian hyperstimulation in cancer patients is diminished even before oncological treatment

Capsule:
In a large series, we confirmed that the ovarian response to controlled ovarian hyperstimulation in cancer patients is lower than expected for their age compared with a historical control.

Authors:
Javier Domingo, M.D., Vicente Guillén, M.D., Yanira Ayllón, M.D., María Martínez, M.D., Elkin Muñoz, M.D., Antonio Pellicer, M.D., Juan A. Garcia-Velasco, M.D.
Volume 97, Issue 4 , Pages 930-934, April 2012

Objective:
To evaluate the results of controlled ovarian stimulation before chemotherapy for oocyte vitrification to preserve fertility in women diagnosed with cancer and compare them with a historical control group.

Design:
A retrospective, multicenter, observational study performed between March 2007 and January 2011.

Setting:
University-affiliated infertility clinics.

Patient(s):
Of 272 patients affected by cancer in our Fertility Preservation Program, 223 women underwent a stimulated cycle for oocyte vitrification according to our protocols before cancer treatment. Their results were compared with a historical control group of 98 patients diagnosed with male factor infertility who were stimulated for a conventional IVF cycle.

Intervention(s):
Controlled ovarian stimulation and oocyte retrieval.

Main Outcome Measure(s):
Days of stimulation, total dose of gonadotropins, estrogen levels, and number of oocytes retrieved and vitrified.

Result(s):
No differences were found in days of stimulation, but significant differences in E2 levels and the number of retrieved oocytes were measured, especially in the hormone-dependent cancer group.

Conclusion(s):
Patients with hormone-dependent cancer had a weaker response to controlled ovarian stimulation compared with patients with non-hormone-dependent cancer. Whether the oncological disease already affects the ovaries before chemo-/radiotherapy remains to be elucidated.

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