Effects of Cancer on Ovarian Response in Controlled Ovarian Stimulation for Fertility Preservation

Capsule:
Cancer does not influence ovarian response in controlled ovarian hyperstimulation for fertility preservation.

Authors:
Benny Almog, M.D., Foad Azem, M.D., David Gordon M.D., David Pauzner, M.D., Ami Amit, M.D., Gali Barkan B.A., Ishai Levin, M.D.

Volume 98, Issue 4, Pages 957-960, October 2012

Abstract:

Objective:
To evaluate the effects of cancer on ovarian response in controlled ovarian hyperstimulation (COH).

Setting:
University-based tertiary medical center.

Study design:
Retrospective analysis study.

Patients:
81 cancer patients who underwent controlled ovarian stimulation cycles for fertility preservation were compared to age and date matched controls that underwent COH for in vitro fertilization (IVF) due to male factor.

Interventions:
Controlled ovarian hyperstimulation and oocytes retrieval

Main outcome measures:
Maximal Estradiol (E2) levels at day of hCG administration, duration of stimulation, total amount of gonadotrophins administrated, number of dominant follicles, number of oocytes retrieved and rate of M2 oocytes.

Results:
The overall number of dominant follicles and the number of oocytes aspirated of the study group and control were comparable (8.8±5.3 vs. 9.7±4.9 and 11.93±8.3 vs. 12.3±7.9 respectively). Total dose of gonadotrophins used and number of stimulation days of the study group (2250 IU (1800-300) and 9.5 (8-11)) were also similar to controls (2100 IU (1700-2900) and 10 (9-13)). Comparison between four subgroups of cancer i.e. breast cancer, soft tissue sarcoma, hematologic malignancies, and gastrointestinal tract cancers, showed no difference in all the above ovarian response indexes. Regression analysis to assess the effect of cancer on ovarian response showed no effect on the main outcome measured.

Conclusions:
Cancer does not influence ovarian response in controlled ovarian hyperstimulation for fertility preservation.

  • I
    have found this article very interesting and
    I agree with the authors that some types of
    cancer do not affect the ovarian response. However,
    due to an unknown factor patients with hormone-dependent cancer have lower ovarian response as has
    been reported by other authors in this issue. I think it is really difficult to establish the real impact of the cancer on
    ovarian response because it is necessary to consider different stages of
    the disease, different protocols of
    stimulation, presence or absence of BRCA mutations, age, phase of the ovarian
    cycle when the stimulation is started and ovarian reserve. These topics are not
    always taken into account in the studies.

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