Comparison of Oocyte and Embryo Quality Between Random Start and Controlled Ovarian Stimulation Cycles in Cancer Patients Undergoing Fertility Preservation


Israfilova G., ŞÜKÜR Y. E., ÖZKAVUKCU İ. S., Sonmezer M. A., ATABEKOĞLU C. S., ÖZMEN B., ...Daha Fazla

REPRODUCTIVE SCIENCES, cilt.28, sa.8, ss.2200-2207, 2021 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 28 Sayı: 8
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1007/s43032-020-00412-2
  • Dergi Adı: REPRODUCTIVE SCIENCES
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE, Food Science & Technology Abstracts, MEDLINE
  • Sayfa Sayıları: ss.2200-2207
  • Anahtar Kelimeler: Controlled ovarian hyperstimulation, Cryopreservation, Fertility preservation, Oocyte yield, Random start, BREAST-CANCER, HORMONE ANTAGONIST, LUTEAL-PHASE, WOMEN, LETROZOLE, SAFETY
  • Ankara Üniversitesi Adresli: Evet

Özet

Conventional assisted reproductive technology (ART) cycles may delay cancer treatment and compromise survival, and also increase patients' psychological burden as a result of delayed chemotherapy. The aim of this study was to compare the success rates of random start and conventional start GnRH antagonist protocols in terms of oocyte and embryo outputs in cancer patients. Data of 111 patients with a newly diagnosed cancer who underwent ART for fertility preservation at a university-based infertility clinic between January 2010 and September 2019 were reviewed. The study group underwent random start controlled ovarian hyperstimulation (RS-COH) and the control group underwent conventional start COH (CS-COH). The main outcome measures were the number of total oocytes, MII oocytes, and embryo yield. A total of 46 patients (41.5%) underwent RS-COH and 65 (58.5%) underwent CS-COH. Baseline characteristics were similar between the groups. The most common cancer type in both groups was breast cancer (60.9% vs. 52.3%, respectively). The median duration of stimulation was significantly longer in RS-COH than in CS-COH (12 vs. 10 days; P = 0.005). The median number of MII oocytes was significantly higher in RS-COH than in CS-COH (7 vs. 5 oocytes, respectively; P = 0.020). The MII/AFC ratio was significantly higher in the RS-COH group compared to the CS-COH group (74% and 57% respectively; p = 0.02). In the linear regression analyses, RS-COH protocol did not have a significant impact on MII/AFC (standardized ss coefficient - 0.514; P = 0.289 {adjusted R-2 for the model = 0.779}), oocyte yield (standardized ss coefficient - 0.070; P = 0.829 {adjusted R-2 for the model = 0.840}), and MII rate (standardized ss coefficient - 0.504; P = 0.596 {adjusted R-2 for the model = 0.271}). In conclusion, RS-COH protocol is as effective as CS-COH protocols for fertility preservation in cancer patients.