OBJECTIVE: To assess the advantages and disadvantages of using letrozole for controlled ovarian stimulation (COH) in young patients with estrogen receptor-positive (ER+) breast cancer, wishing to cryopreserve oocytes. DESIGN: Retrospective cohort analysis. SETTING: Sixteen Italian units for reproductive medicine and in vitro fertilization. METHODS: Data of 50 ER+ breast cancer patients undergoing COH to cryopreserve oocytes before gonadotoxic chemotherapy with a letrozole plus gonadotropins (Le+Gn) protocol were compared with those of 25 young women with ER- breast cancer, submitted to COH using a protocol with gonadotropins alone (Gn-only). RESULTS: The Le+Gn protocol implied a significantly lower total Gn consumption and allowed to maintain significantly lower circulating E2 levels at all checkpoints throughout stimulation (peak E2 value 446 ± 357 versus 1553 ± 908 pg/ml, respectively; p = 0.001). On the other side, the Le+Gn protocol allowed a significantly lower yield of oocytes available for cryostorage (6.6 ± 3.5 versus 8 ± 5, respectively; p = 0.038). CONCLUSIONS: In breast cancer patients, the association of letrozole to Gn significantly reduces the number of oocytes available for cryostorage in comparison with the use of Gn alone. On the other side, it is associated with significantly lower E2 levels during the whole stimulation cycle, a safety issue that has been traditionally considered advantageous in case of ER+ cancers.
OBJECTIVE: To assess the advantages and disadvantages of using letrozole for controlled ovarian stimulation (COH) in young patients with estrogen receptor-positive (ER+) breast cancer, wishing to cryopreserve oocytes. DESIGN: Retrospective cohort analysis. SETTING: Sixteen Italian units for reproductive medicine and in vitro fertilization. METHODS: Data of 50 ER+ breast cancerpatients undergoing COH to cryopreserve oocytes before gonadotoxic chemotherapy with a letrozole plus gonadotropins (Le+Gn) protocol were compared with those of 25 young women with ER- breast cancer, submitted to COH using a protocol with gonadotropins alone (Gn-only). RESULTS: The Le+Gn protocol implied a significantly lower total Gn consumption and allowed to maintain significantly lower circulating E2 levels at all checkpoints throughout stimulation (peak E2 value 446 ± 357 versus 1553 ± 908 pg/ml, respectively; p = 0.001). On the other side, the Le+Gn protocol allowed a significantly lower yield of oocytes available for cryostorage (6.6 ± 3.5 versus 8 ± 5, respectively; p = 0.038). CONCLUSIONS: In breast cancerpatients, the association of letrozole to Gn significantly reduces the number of oocytes available for cryostorage in comparison with the use of Gn alone. On the other side, it is associated with significantly lower E2 levels during the whole stimulation cycle, a safety issue that has been traditionally considered advantageous in case of ER+ cancers.
Authors: Molly B Moravek; Rafael Confino; Angela K Lawson; Kristin N Smith; Ralph R Kazer; Susan C Klock; William J Gradishar; Jacqueline S Jeruss; Mary Ellen Pavone Journal: Breast Cancer Res Treat Date: 2021-01-04 Impact factor: 4.872
Authors: F Cavagna; A Pontes; M Cavagna; A Dzik; N F Donadio; R Portela; M T Nagai; L H Gebrim Journal: Curr Oncol Date: 2018-12-01 Impact factor: 3.677
Authors: Matteo Lambertini; Lucia Del Mastro; Maria C Pescio; Claus Y Andersen; Hatem A Azim; Fedro A Peccatori; Mauro Costa; Alberto Revelli; Francesca Salvagno; Alessandra Gennari; Filippo M Ubaldi; Giovanni B La Sala; Cristofaro De Stefano; W Hamish Wallace; Ann H Partridge; Paola Anserini Journal: BMC Med Date: 2016-01-04 Impact factor: 8.775
Authors: A N Schüring; T Fehm; K Behringer; M Goeckenjan; P Wimberger; M Henes; J Henes; M F Fey; M von Wolff Journal: Arch Gynecol Obstet Date: 2017-11-24 Impact factor: 2.344