Kaitlyn Wald1, Hakan Cakmak2, Evelyn Mok-Lin2, Marcelle Cedars2, Mitchell Rosen2, Joseph Letourneau2,3. 1. Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 499 Illinois Street, 6th Floor, San Francisco, CA, 94158, USA. Kaitlyn.Wald@ucsf.edu. 2. Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 499 Illinois Street, 6th Floor, San Francisco, CA, 94158, USA. 3. University of Utah Center for Reproductive Medicine, Salt Lake City, UT, USA.
Abstract
PURPOSE: To evaluate the feasibility of utilizing back-to-back random-start ovarian stimulation to increase oocyte yield for fertility preservation prior to cancer treatment. METHODS: A case series of 15 patients who underwent back-to-back random-start stimulation cycles prior to chemotherapy. RESULTS: Of the 15 back-to-back random-start stimulation cases, 13 had breast cancer and 2 had other cancers. The average age was 38 years (range 30-43) and average AFC was 8 (range 3-14). Fourteen of the 15 women (93%) who underwent two ovarian stimulation cycles completed both of them. The average time to complete back-to-back random-start ovarian stimulation was 33 days (range 13-43 days). The average time between the first cycle completion and the second cycle start in our back-to-back random-start stimulations was 9 days (range 0-14 days). Two of the women underwent back-to-back random-start ovarian stimulation prior to starting neoadjuvant chemotherapy for breast cancer. Eleven of our 15 women at least doubled their oocyte or embryo yield relative to their first cycle. Only 1 of the 15 second cycles was canceled. The mature oocyte rate, fertilization rate, and embryo yield were similar among the first and second cycles. CONCLUSIONS: Back-to-back random-start ovarian stimulation may be an effective way to maximize fertility preservation, even in time-limited settings.
PURPOSE: To evaluate the feasibility of utilizing back-to-back random-start ovarian stimulation to increase oocyte yield for fertility preservation prior to cancer treatment. METHODS: A case series of 15 patients who underwent back-to-back random-start stimulation cycles prior to chemotherapy. RESULTS: Of the 15 back-to-back random-start stimulation cases, 13 had breast cancer and 2 had other cancers. The average age was 38 years (range 30-43) and average AFC was 8 (range 3-14). Fourteen of the 15 women (93%) who underwent two ovarian stimulation cycles completed both of them. The average time to complete back-to-back random-start ovarian stimulation was 33 days (range 13-43 days). The average time between the first cycle completion and the second cycle start in our back-to-back random-start stimulations was 9 days (range 0-14 days). Two of the women underwent back-to-back random-start ovarian stimulation prior to starting neoadjuvant chemotherapy for breast cancer. Eleven of our 15 women at least doubled their oocyte or embryo yield relative to their first cycle. Only 1 of the 15 second cycles was canceled. The mature oocyte rate, fertilization rate, and embryo yield were similar among the first and second cycles. CONCLUSIONS:Back-to-back random-start ovarian stimulation may be an effective way to maximize fertility preservation, even in time-limited settings.
Authors: Joseph M Letourneau; Erin E Ebbel; Patricia P Katz; Audra Katz; Wei Z Ai; A Jo Chien; Michelle E Melisko; Marcelle I Cedars; Mitchell P Rosen Journal: Cancer Date: 2011-09-01 Impact factor: 6.860
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