The impact of malignancy on response to ovarian stimulation for fertility preservation: a meta-analysis

Turan, Volkan; Quinn, Molly M.; Dayıoğlu, Nurten; Rosen, Mitchell P.; Oktay, Kutluk

doi:10.1016/j.fertnstert.2018.08.013

Cited by 33 publications

(14 citation statements)

References 21 publications

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“…When compared to planned OC, patients undergoing medical OC were typically < 35 years old, had higher body mass indices (BMI), lived in the South, and underwent antagonist protocols. There was no difference in cancellation or hyperstimulation rates, or oocyte yield (approximately 16 oocytes, 80% maturation rate) between the two groups, as also shown in prior studies [24,27]. Neither oocyte fertilization rates nor live birth rates were reported.…”

Section: Outcomes Of Medical Oocyte Cryopreservationsupporting

confidence: 76%

Oocyte cryopreservation review: outcomes of medical oocyte cryopreservation and planned oocyte cryopreservation

Walker

Lanes

Ginsburg

2022

Reprod Biol Endocrinol

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Background The utilization of oocyte cryopreservation (OC) has become popularized with increasing numbers of reproductive-aged patients desiring to maintain fertility for future family building. OC was initially used for fertility preservation in postmenarchal patients prior to gonadotoxic therapies; however, it is now available to patients to circumvent age-related infertility and other diagnoses associated with early loss of ovarian reserve. The primary aim of this paper is to provide a narrative review of the most recent and robust data on the utilization and outcomes of OC in both patient populations. Summary OC results in similar oocyte yield in patients facing gonadotoxic therapies and patients undergoing planned OC. Available data are insufficient to predict the live birth rates or the number of oocytes needed to result in live birth. However, oocyte yield and live birth rates are best among patients < 37.5 years old or with anti-mullerian hormone levels > 1.995 ng/dL, at the time of oocyte retrieval. There is a high ‘no use’ rate (58.9%) in patients using planned OC with 62.5% returning to use frozen oocytes with a spouse. The utilization rate in medical OC patients is < 10%. There is currently no data on the effects of BMI, smoking, or ethnicity on planned OC outcomes. Conclusion It is too early to draw any final conclusions on outcomes of OC in medical OC and planned OC; however, preliminary data supports that utilization of OC in both groups result in preservation of fertility and subsequent live births in patients who return to use their cryopreserved eggs. Higher oocyte yield, with fewer ovarian stimulation cycles, and higher live birth rates are seen in patients who seek OC at younger ages, reinforcing the importance of age on fertility preservation. More studies are needed in medical OC and planned OC to help guide counseling and decision-making in patients seeking these services.

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Section: Outcomes Of Medical Oocyte Cryopreservationsupporting

confidence: 76%

Oocyte cryopreservation review: outcomes of medical oocyte cryopreservation and planned oocyte cryopreservation

Walker

Lanes

Ginsburg

2022

Reprod Biol Endocrinol

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“…Another review even revealed that BRCA mutations produced fewer oocytes with lower fertilization rates and fewer embryos compared with the controls (Turan et al, 2018a). In terms of oocyte quality, a meta-analysis compared mean number of mature oocytes in women with breast cancer with healthy controls and showed no significant differences between groups (Turan V et al, 2018b). Therefore, pursuing a maximum number of oocyte retrieved in patients at high risk of gonadotoxicity is especially important since this would be their only chance for fertility preservation before anticancer treatments.…”

Section: Discussionmentioning

confidence: 99%

Fertility preservation for women with breast cancer before chemotherapy: a systematic review and meta-analysis

Chen¹,

Chang²,

Chen³

et al. 2022

Reproductive BioMedicine Online

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“…Higher AMH predicts higher oocyte yield in ovarian stimulation of cancer patients (15). Overall, the results of ovarian stimulation with regard to number of oocytes retrieved and proportion fertilized are similar in women with cancer to women without cancer (16). There is, however, evidence of reduced oocyte quality compared to women cryopreserving oocytes for elective purposes (17), which is not reflected by AMH.…”

Section: Amh and Ovarian Stimulation For Fertility Preservation Beformentioning

confidence: 94%

The Clinical Value and Interpretation of Anti-Müllerian Hormone in Women With Cancer

Anderson

2020

Front. Endocrinol.

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Cancer treatments can be damaging to the ovary, with implications for future fertility and reproductive lifespan. There is therefore a need for a biomarker than can usefully provide an assessment of the ovary and its potential for long-term function after cancer treatment, and ideally also be of value pre-treatment, for the prediction of post-treatment function. In this review we assess the value of anti-Müllerian hormone (AMH) in this context. Measurement of AMH at the time of cancer diagnosis has been shown to be predictive of whether or not there will remain some ovarian function post-treatment in women with breast cancer, in conjunction with age. AMH may however be reduced at the time of diagnosis in some conditions, including lymphoma, but probably not in women with breast cancer unless they are carriers of BRCA1 mutations. Following chemotherapy, AMH is often much reduced compared to pretreatment levels, with recovery dependent on the chemotherapy regimen administered, the woman's age, and her pretreatment AMH. Recent data show there may be a long duration of relative stability of AMH levels over 10 to 15 years prior to decline rather than a rapid decline for many young women after cancer. Post-treatment AMH may have utility in determining that ovarian function will not recover, contributing to assessment of the need for ovarian suppression in women with hormonesensitive breast cancer. AMH measurement provides an index of treatment gonadotoxicity, allowing comparison of different treatment regimens, although extrapolation to effects on fertility requires caution, and there are very limited data regarding the use of AMH to estimate time to menopause in the post-cancer setting.

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The impact of malignancy on response to ovarian stimulation for fertility preservation: a meta-analysis

Cited by 33 publications

References 21 publications

Oocyte cryopreservation review: outcomes of medical oocyte cryopreservation and planned oocyte cryopreservation

Oocyte cryopreservation review: outcomes of medical oocyte cryopreservation and planned oocyte cryopreservation

Fertility preservation for women with breast cancer before chemotherapy: a systematic review and meta-analysis

The Clinical Value and Interpretation of Anti-Müllerian Hormone in Women With Cancer

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