NYMC Faculty Publications

Safety and Feasibility of Performing Two Consecutive Ovarian Stimulation Cycles With the Use of Letrozole-Gonadotropin Protocol for Fertility Preservation in BreastCancer Patients

Author Type(s)

Faculty

DOI

10.1016/j.fertnstert.2013.08.030

Journal Title

Fertility and Sterility

First Page

1681

Last Page

1685

Document Type

Article

Publication Date

12-1-2013

Department

Pathology, Microbiology and Immunology

Second Department

Obstetrics and Gynecology

Keywords

Adult, Breast Neoplasms, Cohort Studies, Comorbidity, Drug Therapy, Combination, Drug-Related Side Effects and Adverse Reactions, Feasibility Studies, Female, Fertility Agents, Fertility Preservation, Gonadotropins, Humans, Infertility, Female, Letrozole, New York, Nitriles, Ovulation Induction, Prevalence, Retrospective Studies, Risk Factors, Treatment Outcome, Triazoles

Disciplines

Medicine and Health Sciences

Abstract

OBJECTIVE: To investigate the safety and feasibility of performing two consecutive ovarian stimulation cycles with the use of letrozole protocol for fertility preservation in breast cancer patients.

DESIGN: Retrospective cohort study.

SETTING: Academic fertility preservation center.

PATIENT(S): Seventy-eight women ≤ 45 years, diagnosed with stage ≤ 3 breast cancer, who desired fertility preservation.

INTERVENTION(S): Two consecutive cycles versus a single ovarian stimulation cycle with a letrozole-follicle-stimulating hormone (FSH) protocol.

MAIN OUTCOME MEASURE(S): Embryo or oocyte cryopreservation outcomes, time interval from surgery to chemotherapy, and breast cancer recurrence rates.

RESULT(S): Sixty-one patients underwent single-cycle stimulation and 17 received two stimulation cycles. The mean total number of oocytes harvested (16.1 ± 13.2 vs. 9.1 ± 5.2) and embryos generated (6.4 ± 2.9 vs. 3.7 ± 3.1) were statistically significantly higher in patients who underwent two cycles versus one cycle. The time interval from surgery to chemotherapy was similar between the two-cycle and single-cycle groups (63.7 ± 7.7 vs. 58.0 ± 12.1 days). After a mean follow-up interval of 58.5 ± 13.6 months, the recurrence rates were similar between the two-cycle (0 of 17) and single-cycle (2 of 49) patients.

CONCLUSION(S): It appears to be safe and feasible to perform two consecutive ovarian stimulation cycles to increase the oocyte/embryo yield for fertility preservation.

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