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• W2889567114 abstract "To evaluate the effects of cancer stage and grade on fertility preservation outcome and ovarian stimulation response. Retrospective cohort study. We evaluated 402 fertility preservation treatment cycles. The inclusion criteria were age 18-38 years, first stimulation cycle, GnRH-antagonist protocol only, and early follicular phase stimulation start only. Patients with ovarian pathology, previous ovarian surgery and previous chemo- or radiotherapy were excluded. Women with low-stage cancer (stage I, II and no lymph node involvement) were compared with those with high-stage disease (stage III, IV or lymph node involvement). Similarly those with low-grade (grade I, II) and high-grade (grade III, IV) disease were compared. Primary outcome was the number of mature oocytes retrieved. Secondary outcomes included total number of oocytes retrieved, total number of vitrified oocytes, and number of frozen embryos. A power calculation was performed. A sample size of 60 in each group has 80% power of showing a 20% difference in primary outcome with an alpha of 5%. To determine factors associated with good fertility preservation outcome (over 10 mature oocytes retrieved), we used multivariate logistical regression. A total of 147 patients were included in the analysis. The demographic and ovarian reserve parameters of study groups in stage- and grade-based analyses were similar. Compared to women with low-stage cancer (n = 83), those with high-stage cancer (n = 64) required a higher dose of gonadotropin (p = 0.02). The number of mature oocytes retrieved and frozen oocytes as well as the number of immature oocytes (GV and MI) and maturation rate were similar between the two groups. However, in cycles where fertilization of retrieved oocytes was performed (n = 53), the fertilization rate (p = 0.03) and the number of vitrified embryos (p = 0.01) were higher in the low-stage group. Compared to patients with low-grade cancer (n = 62), those with high-grade disease (n = 85) had significantly lower number of mature retrieved (10.5 (7-15) vs. 8 (5-10.5); p = 0.002) and totally vitrified (11.5 (8-15) vs. 10 (6.5-11); p = 0.005) oocytes. Similarly the number of vitrified embryos was lower in high-grade group (p=0.03) in cycles where the fertilization was performed. In multivariate logistical analysis, the grade of cancer was found to be one of the factors significantly associated with good fertility preservation outcome (p=0.004; OR=3.93; 95%CI 1.50 - 10.33), along with AFC and number of follicles >14 mm on the trigger day. In women with malignancy, the grade of cancer has a significant negative impact on the number of mature oocytes retrieved and cryopreserved embryos." @default.
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• W2889567114 date "2018-09-01" @default.
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• W2889567114 title "Effects of stage and grade of cancer on fertility preservation outcome in female patients" @default.
• W2889567114 doi "https://doi.org/10.1016/j.fertnstert.2018.07.519" @default.
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