Safety and feasibility of performing two consecutive ovarian stimulation cycles with the use of letrozole gonadotropin protocol for fertility preservation in breast cancer patients

Capsule:
Performing consecutive cycles of ovarian stimulation with letrozole and gonadotropin protocol for fertility preservation to maximize oocyte yield before chemotherapy is a feasible approach in women with breast cancer.

Authors:
Volkan Turan, M.D., Giuliano Bedoschi, M.D., Fred Moy, Ph.D., Kutluk Oktay, M.D.

Volume 100, Issue 6, Pages 1681-1685.e1, December 2013

Abstract:

Objective:
To investigate the safety and feasibility of performing two consecutive ovarian stimulation cycles with the use of letrozole protocol for fertility preservation in breast cancer patients.

Design:
Retrospective cohort study.

Setting:
Academic fertility preservation center.

Patient(s):
Seventy-eight women ≤45 years, diagnosed with stage ≤3 breast cancer, who desired fertility preservation.

Intervention(s):
Two consecutive cycles versus a single ovarian stimulation cycle with a letrozole-follicle–stimulating hormone (FSH) protocol.

Main Outcome Measure(s):
Embryo or oocyte cryopreservation outcomes, time interval from surgery to chemotherapy, and breast cancer recurrence rates.

Result(s):
Sixty-one patients underwent single-cycle stimulation and 17 received two stimulation cycles. The mean total number of oocytes harvested (16.1 ± 13.2 vs. 9.1 ± 5.2) and embryos generated (6.4 ± 2.9 vs. 3.7 ± 3.1) were statistically significantly higher in patients who underwent two cycles versus one cycle. The time interval from surgery to chemotherapy was similar between the two-cycle and single-cycle groups (63.7 ± 7.7 vs. 58.0 ± 12.1 days). After a mean follow-up interval of 58.5 ± 13.6 months, the recurrence rates were similar between the two-cycle (0 of 17) and single-cycle (2 of 49) patients.

Conclusion(s):
It appears to be safe and feasible to perform two consecutive ovarian stimulation cycles to increase the oocyte/embryo yield for fertility preservation.

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