Sanghoon Lee1, Kutluk Oktay. 1. Department of Obstetrics and Gynecology, Laboratory of Molecular Reproduction and Fertility Preservation, New York Medical College, Valhalla, New York 10595, USA.
Abstract
OBJECTIVE: To evaluate the efficacy of ovarian stimulation with higher doses of gonadotropins in fertility preservation (FP) cycles with the intention to maximize the likelihood of future pregnancies. DESIGN: Retrospective (secondary analysis). SETTING: Academic medical centers. PATIENT(S): Low-dose (LD, 150 IU; n = 34) versus high-dose (HD, >150 IU; n = 117) FSH start in 151 patients with breast cancer (BCa) undergoing ovarian stimulation for embryo cryopreservation with letrozole (LE) before cancer treatment. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): FP cycle outcomes. RESULT(S): Mean total FSH dose (2,037 ± 679 IU vs. 1,128 ± 381 IU) and FSH level on trigger day (21.1 ± 8.9 vs. 10.6 ± 4.5 mIU/mL) were higher in the HD group, confirming the receipt of higher-dose FSH. There was no difference in other patient characteristics. Despite the larger number of follicles >17 mm in diameter in the HD group (5.0 ± 2.0 vs. 3.4 ± 1.4), neither peak E(2) (498.0 ± 377.5 vs. 397.9 ± 320.3), number of oocytes (13.3 ± 8.7 vs. 12.3 ± 8.0), nor number of embryos (6.3 ± 4.7 vs. 5.4 ± 3.8) were significantly different from the LD group. Of those undergoing frozen embryo transfer (ET), live birth rate (LBR)/ET trended higher in the LD (9/15) compared with HD (2/11) group, with 2.1 ± 0.8 vs. 1.9 ± 0.3 embryos transferred, respectively. CONCLUSION(S): Higher-dose FSH stimulation in LE cycles does not improve outcomes and may be associated with lower LBR. Our findings may support minimal stimulation in young noninfertile women with BCa.
OBJECTIVE: To evaluate the efficacy of ovarian stimulation with higher doses of gonadotropins in fertility preservation (FP) cycles with the intention to maximize the likelihood of future pregnancies. DESIGN: Retrospective (secondary analysis). SETTING: Academic medical centers. PATIENT(S): Low-dose (LD, 150 IU; n = 34) versus high-dose (HD, >150 IU; n = 117) FSH start in 151 patients with breast cancer (BCa) undergoing ovarian stimulation for embryo cryopreservation with letrozole (LE) before cancer treatment. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): FP cycle outcomes. RESULT(S): Mean total FSH dose (2,037 ± 679 IU vs. 1,128 ± 381 IU) and FSH level on trigger day (21.1 ± 8.9 vs. 10.6 ± 4.5 mIU/mL) were higher in the HD group, confirming the receipt of higher-dose FSH. There was no difference in other patient characteristics. Despite the larger number of follicles >17 mm in diameter in the HD group (5.0 ± 2.0 vs. 3.4 ± 1.4), neither peak E(2) (498.0 ± 377.5 vs. 397.9 ± 320.3), number of oocytes (13.3 ± 8.7 vs. 12.3 ± 8.0), nor number of embryos (6.3 ± 4.7 vs. 5.4 ± 3.8) were significantly different from the LD group. Of those undergoing frozen embryo transfer (ET), live birth rate (LBR)/ET trended higher in the LD (9/15) compared with HD (2/11) group, with 2.1 ± 0.8 vs. 1.9 ± 0.3 embryos transferred, respectively. CONCLUSION(S): Higher-dose FSH stimulation in LE cycles does not improve outcomes and may be associated with lower LBR. Our findings may support minimal stimulation in young noninfertile women with BCa.
Authors: Esther B Baart; Elena Martini; Marinus J Eijkemans; Diane Van Opstal; Nicole G M Beckers; Arie Verhoeff; Nicolas S Macklon; Bart C J M Fauser Journal: Hum Reprod Date: 2007-01-04 Impact factor: 6.918
Authors: Stephanie J Lee; Leslie R Schover; Ann H Partridge; Pasquale Patrizio; W Hamish Wallace; Karen Hagerty; Lindsay N Beck; Lawrence V Brennan; Kutluk Oktay Journal: J Clin Oncol Date: 2006-05-01 Impact factor: 44.544
Authors: Alison W Loren; Pamela B Mangu; Lindsay Nohr Beck; Lawrence Brennan; Anthony J Magdalinski; Ann H Partridge; Gwendolyn Quinn; W Hamish Wallace; Kutluk Oktay Journal: J Clin Oncol Date: 2013-05-28 Impact factor: 44.544
Authors: Anna Horbaczewska; Robert Jach; Andrzej Zmaczyński; Olga Kacalska-Janssen; Katarzyna Doroszewska; Magdalena Piróg; Monika Kabzińska-Turek Journal: Prz Menopauzalny Date: 2019-06-14