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Triggering final oocyte maturation with gonadotropin-releasing hormone agonist (GnRHa) versus human chorionic gonadotropin (hCG) in breast cancer patients undergoing fertility preservation: an extended experience

  • Fertility Preservation
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

ABSTRACT

Purpose

To analyze the cycle outcomes and the incidence of ovarian hyperstimulation syndrome (OHSS), when oocyte maturation was triggered by gonadotropin-releasing hormone agonist (GnRHa) versus human chorionic gonadotropin (hCG) in breast cancer patients undergoing fertility preservation.

Methods

One hundred twenty-nine women aged ≤ 45 years, diagnosed with stage ≤ 3 breast cancer, with normal ovarian reserve who desired fertility preservation were included in the retrospective cohort study. Ovarian stimulation was achieved utilizing letrozole and gonadotropins. Oocyte maturation was triggered with GnRHa or hCG. Baseline AMH levels, number of oocytes, maturation and fertilization rates, number of embryos, and the incidence of OHSS was recorded.

Results

The serum AMH levels were similar between GnRHa and hCG groups (2.7 ± 1.9 vs. 2.1 ± 1.8; p = 0.327). There was one case of mild or moderate OHSS in the GnRHa group compared to 12 in the hCG group (2.1 % vs. 14.4 %, p = 0.032). The maturation and fertilization rates, and the number of cryopreserved embryos were significantly higher in the GnRHa group.

Conclusions

GnRHa trigger improved cycle outcomes as evidenced by the number of mature oocytes and cryopreserved embryos, while significantly reducing the risk of OHSS in breast cancer patients undergoing fertility preservation.

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Acknowledgments

We thank all patients and staff involved in our clinical study.

Disclosures

None.

Details of Ethics Approval

The study was approved by the New York Medical College Institutional Review Board and was registered at clinicaltrials.gov (NCT00504699).

Funding

This work is partially funded by NICHD grants R01 HD053112 and R21 HD061259.

Author information

Authors and Affiliations

  1. Laboratory of Molecular Reproduction & Fertility Preservation, Obstetrics and Gynecology, New York Medical College, Valhalla, NY, USA

    Jhansi Reddy, Volkan Turan, Giuliano Bedoschi & Kutluk Oktay

  2. Clinical Pathology, New York Medical College, Valhalla, NY, USA

    Fred Moy

  3. Innovation Institute for Fertility Preservation and IVF, 139 E 23rd Street, New York, NY, USA

    Giuliano Bedoschi & Kutluk Oktay

Authors
  1. Jhansi Reddy
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  2. Volkan Turan
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  3. Giuliano Bedoschi
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  4. Fred Moy
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  5. Kutluk Oktay
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Corresponding author

Correspondence to Kutluk Oktay.

Additional information

Capsule GnRHa trigger appears to be superior to hCG trigger in fertility preservation cycles as it improves oocyte and embryo yield and minimizes OHSS risks.

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Reddy, J., Turan, V., Bedoschi, G. et al. Triggering final oocyte maturation with gonadotropin-releasing hormone agonist (GnRHa) versus human chorionic gonadotropin (hCG) in breast cancer patients undergoing fertility preservation: an extended experience. J Assist Reprod Genet 31, 927–932 (2014). https://doi.org/10.1007/s10815-014-0248-6

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  • DOI: https://doi.org/10.1007/s10815-014-0248-6

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