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

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.

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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

Abstract

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.

Read the full text at: http://www.fertstert.org/article/S0015-0282(12)00122-7/fulltext

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.