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

摘要

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 E 2 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.