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• W2892271304 abstract "Since 2011, we have been initiating ovarian stimulation (random-start), at the time of the initial fertility preservation (FP) consultation, to minimize delays in cancer treatment. In this study, we aim to determine if random-start controlled ovarian stimulation (COS) is an effective method for FP, and if starting stimulation during a particular phase in the menstrual yields different results. Retrospective cohort. From 6/2011 to 3/2018, 1120 cancer patients were referred to our clinic for FP. All referred patients with no prior chemotherapy treatment, who underwent emergent FP treatment with an antagonist protocol, were included. Three hundred and eight patients met the inclusion criteria, with a total of 110 cycles initiated in the early follicular phase and 150 and 106 cycles initiated during the late follicular and luteal phases, respectively. ANOVA, T test and descriptive statistics were used to analyze the data as appropriate. There was no difference in age, BMI and AFC across the groups. Number of dominant follicles (≥13mm) on the day of trigger, mature oocytes retrieved, maturity rate (MII/total oocyte ratio) and mature oocyte yield (MII/AFC ratio) were similar across the groups (Table). There were significantly higher fertilization rates in random-start COS cycles compared to early follicular start. Additionally, number of high quality embryos frozen on Day 3 per MII oocyte retrieved was significantly higher in random-start cycles compared with early follicular start. The peak estradiol levels per mature follicle measured was significantly lower in random-start COS cycles. Ovarian Stimulation throughout the menstrual cycle yields similar oocyte maturity/developmental competence and high quality embryos. To minimize delays in cancer treatment, random-start COS should be considered the standard of care for patients undergoing emergent FP.Tabled 1Comparison between early, late follicular and luteal phase COS; means (SEM). NS: not significant.Oocyte & Embryo CryopreservationEarly Follicular Start (n=110)Late Follicular Start (n=150)Luteal Start (n=106)p valueTotal Stim Dose3594 (112)3817 (97)4191 (128)0.0016Days of Stim9.8 (0.2)10.2 (0.1)10.8 (0.2)<0.001Follicles ≥ 13 mm12.9 (0.7)14.0 (0.7)14.6 (0.8)NSMature Oocytes (MII) Retrieved12.3 (0.7)12.3 (0.8)12.8 (0.9)NSMII Oocyte / Total Oocyte Ratio0.75 (0.03)0.73 (0.02)0.74 (0.02)NSMII Oocyte / AFC Ratio0.98 (0.06)1.00 (0.07)0.99 (0.06)NSOocyte & Embryo Cryopreservation w/out LetrozoleEarly Follicular Start (n=40)Late Follicular Start (n=63)Luteal Start (n=41)p valueEstradiol / Follicles ≥ 13 mm216 (18)212 (10)168 (10)0.0175Embryo CryopreservationEarly Follicular Start (n=62)Late Follicular Start (n=54)Luteal Start (n=46)p valueFertilization Rate (2PN/MII)0.72 (0.03)0.84 (0.04)0.87 (0.03)0.0034Frozen Embryos / MII Oocyte0.60 (0.03)0.75 (0.05)0.81 (0.03)0.0008 Open table in a new tab" @default.
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• W2892271304 date "2018-09-01" @default.
• W2892271304 modified "2023-10-16" @default.
• W2892271304 title "Random-start ovarian stimulation does not negatively impact egg yield/quality and produces high quality embryos in cancer patients" @default.
• W2892271304 doi "https://doi.org/10.1016/j.fertnstert.2018.07.522" @default.
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