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Comparison of Oocyte and Embryo Quality Between Random Start and Controlled Ovarian Stimulation Cycles in Cancer Patients Undergoing Fertility Preservation

  • Reproductive Endocrinology: Original Article
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Abstract

Conventional assisted reproductive technology (ART) cycles may delay cancer treatment and compromise survival, and also increase patients’ psychological burden as a result of delayed chemotherapy. The aim of this study was to compare the success rates of random start and conventional start GnRH antagonist protocols in terms of oocyte and embryo outputs in cancer patients. Data of 111 patients with a newly diagnosed cancer who underwent ART for fertility preservation at a university-based infertility clinic between January 2010 and September 2019 were reviewed. The study group underwent random start controlled ovarian hyperstimulation (RS-COH) and the control group underwent conventional start COH (CS-COH). The main outcome measures were the number of total oocytes, MII oocytes, and embryo yield. A total of 46 patients (41.5%) underwent RS-COH and 65 (58.5%) underwent CS-COH. Baseline characteristics were similar between the groups. The most common cancer type in both groups was breast cancer (60.9% vs. 52.3%, respectively). The median duration of stimulation was significantly longer in RS-COH than in CS-COH (12 vs. 10 days; P = 0.005). The median number of MII oocytes was significantly higher in RS-COH than in CS-COH (7 vs. 5 oocytes, respectively; P = 0.020). The MII/AFC ratio was significantly higher in the RS-COH group compared to the CS-COH group (74% and 57% respectively; p = 0.02). In the linear regression analyses, RS-COH protocol did not have a significant impact on MII/AFC (standardized ß coefficient − 0.514; P = 0.289 {adjusted R2 for the model = 0.779}), oocyte yield (standardized ß coefficient − 0.070; P = 0.829 {adjusted R2 for the model = 0.840}), and MII rate (standardized ß coefficient − 0.504; P = 0.596 {adjusted R2 for the model = 0.271}). In conclusion, RS-COH protocol is as effective as CS-COH protocols for fertility preservation in cancer patients.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey

    Güler İsrafilova & Acar Koç

  2. Department of Obstetrics and Gynecology, Center for Human Reproduction and Infertility, Ankara University School of Medicine, Dikimevi, 06100, Ankara, Turkey

    Yavuz Emre Şükür, Cem Somer Atabekoğlu, Batuhan Özmen, Bülent Berker, Ruşen Aytaç & Murat Sönmezer

  3. Department Histology and Embryology, Center for Human Reproduction and Infertility, Ankara University School of Medicine, Ankara, Turkey

    Sinan Özkavukcu

  4. Private Clinic, Obstetrics and Gynecology, Ankara, Turkey

    Meltem Aksu Sönmezer

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  1. Güler İsrafilova
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  2. Yavuz Emre Şükür
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  3. Sinan Özkavukcu
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Correspondence to Murat Sönmezer.

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İsrafilova, G., Şükür, Y.E., Özkavukcu, S. et al. Comparison of Oocyte and Embryo Quality Between Random Start and Controlled Ovarian Stimulation Cycles in Cancer Patients Undergoing Fertility Preservation. Reprod. Sci. 28, 2200–2207 (2021). https://doi.org/10.1007/s43032-020-00412-2

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