Ovarian stimulation to cryopreserve fertilized oocytes in cancer patients can be started in the luteal phase
Received 2 April 2008; received in revised form 2 August 2008; accepted 7 August 2008. published online 20 October 2008.
Objective
To analyze if oocytes can be obtained in all patients before cancer treatment within 2 weeks by initiating ovarian stimulation during the follicular or luteal phase.
Design
Prospective controlled multicenter trial.
Setting
Four university-based centers.
Patient(s)
Forty cancer patients before chemotherapy.
Intervention(s)
Twenty-eight patients were stimulated with gonadotropins in the follicular phase (group I). In 12 patients (group II), ovarian stimulation was initiated in the luteal phase, and these received GnRH antagonists and recombinant FSH. In 14 patients, 143 oocytes were further processed for fertilization by intracytoplasmic sperm injection (ICSI).
Main Outcome Measure(s)
Number of oocytes aspirated after ovarian stimulation, cumulative FSH/hMG dosage, viability and maturity of oocytes, and fertilization rate by ICSI.
Result(s)
Patients in group I (age 27.6 ± 4.9 yrs) were stimulated on average for 10.6 days, and patients in group II (age 31.2 ± 5.7 yrs) for 11.4 days. Total amount of FSH was on average 2,255 IU (I) and 2,720 IU (II) per patient. Average and median numbers of aspirated oocytes were, respectively, 13.1 and 11.5 (I) versus 10.0 and 8.5 (II); 83.7% (I) and 80.4% (II) of the oocytes were mature and viable and could be treated by ICSI. Fertilization rate was 61.0% (I) versus 75.6% (II).
Conclusion(s)
This pilot study suggests that oocytes can be obtained before cancer treatment efficiently irrespective of the phase of the menstrual cycle.
aDepartment of Gynecologic Endocrinology and Reproductive Medicine, Women's University Hospital, University of Heidelberg, Heidelberg, Germany
bGynecologic Endocrinology and Reproductive Medicine, Women's Hospital, Ludwig-Maximilians-University of Munich, Campus Grosshadern, Grosshadern, Germany
cDepartment of Obstetrics and Gynecology, University of Wuerzburg, Wuerzburg, Germany
dWomen's Hospital, University of Tuebingen, Tuebingen, Germany
eDepartment of Gynecologic Endocrinology and Reproduction, Women's Hospital of St. Gallen, St. Gallen, Switzerland
Reprint requests: Michael von Wolff, Department of Gynecologic Endocrinology and Reproductive Medicine, University of Heidelberg, Voßstraße 9, 69115 Heidelberg, Germany (FAX: 49-6221-565356).
M.v.W. has nothing to disclose. C.T. has nothing to disclose. T.F. has nothing to disclose. C.Z. has nothing to disclose. B.L. has nothing to disclose. R.P. has nothing to disclose. T.S. has nothing to disclose.
ABSTRACT