Pereira Nigel, Kligman Isaac, Hunt Rosalie, Kopparam Rohini, Wahmann Bridget, Rosenwaks Zev
a The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine , Weill Cornell Medicine , New York , NY , USA.
b Weill Cornell Medical College , New York , NY , USA.
Gynecol Endocrinol. 2019 Mar;35(3):214-216. doi: 10.1080/09513590.2018.1522298. Epub 2018 Nov 7.
We report a case of fertility preservation using random-start controlled ovarian stimulation (COS), intracytoplasmic sperm injection (ICSI) and embryo cryopreservation in a patient with early pregnancy-associated breast cancer. A 34-year-old nulliparous woman at 5 weeks of gestation was diagnosed with estrogen receptor (ER) positive, progesterone receptor (PR) positive and human epidermal growth factor receptor-2 (HER-2) negative infiltrating intraductal carcinoma. Urgent neoadjuvant chemotherapy was deemed necessary and the patient decided to terminate the pregnancy. Random-start COS was initiated 5 days after pregnancy termination using a letrozole-based protocol. The beta human chorionic gonadotropin level on the day of COS start was 119.8 mIU/mL. Twenty-nine oocytes were retrieved after 11 days of COS. Seventeen oocytes underwent successful fertilization and 10 blastocysts were cryopreserved. The patient subsequently initiated neoadjuvant chemotherapy with her oncologist. The current case highlights the feasibility of random-start COS and embryo cryopreservation for fertility preservation immediately after the termination of an early pregnancy in a patient with pregnancy-associated breast cancer.
我们报告了一例在妊娠相关乳腺癌患者中采用随机启动控制性卵巢刺激（COS）、卵胞浆内单精子注射（ICSI）和胚胎冷冻保存进行生育力保存的病例。一名34岁未生育的女性，妊娠5周时被诊断为雌激素受体（ER）阳性、孕激素受体（PR）阳性、人表皮生长因子受体2（HER-2）阴性的浸润性导管癌。紧急新辅助化疗被认为是必要的，患者决定终止妊娠。终止妊娠5天后，采用来曲唑方案启动随机启动COS。启动COS当天的β-人绒毛膜促性腺激素水平为119.8 mIU/mL。COS 11天后取出29个卵母细胞。17个卵母细胞成功受精，10个囊胚被冷冻保存。患者随后与肿瘤学家一起开始新辅助化疗。本病例突出了在妊娠相关乳腺癌患者早期妊娠终止后立即采用随机启动COS和胚胎冷冻保存进行生育力保存的可行性。
