Cavagna F, Pontes A, Cavagna M, Dzik A, Donadio N F, Portela R, Nagai M T, Gebrim L H
Women's Health Reference Center, Hospital Perola Byington, Sao Paulo, Brazil.
Department of Gynecology and Obstetrics, Botucatu Medical School, University of the State of Sao Paulo, Botucatu, Brazil.
Curr Oncol. 2018 Dec;25(6):e527-e532. doi: 10.3747/co.25.3889. Epub 2018 Dec 1.
Fertility preservation is an important concern in breast cancer patients. In the present investigation, we set out to create a specific protocol of controlled ovarian stimulation (cos) for oocyte cryopreservation in breast cancer patients.
From November 2014 to December 2016, 109 patients were studied. The patients were assigned to a specific random-start ovarian stimulation protocol for oocyte cryopreservation. The endpoints were the numbers of oocytes retrieved and of mature oocytes cryopreserved, the total number of days of ovarian stimulation, the total dose of gonadotropin administered, and the estradiol level on the day of the trigger.
Mean age in this cohort was 31.27 ± 4.23 years. The average duration of cos was 10.0 ± 1.39 days. The mean number of oocytes collected was 11.62 ± 7.96 and the mean number of vitrified oocytes was 9.60 ± 6.87. The mean estradiol concentration on triggering day was 706.30 ± 450.48 pg/mL, and the mean dose of gonadotropins administered was 2610.00 ± 716.51 IU. When comparing outcomes by phase of the cycle in which cos was commenced, we observed no significant differences in the numbers of oocytes collected and vitrified, the length of ovarian stimulation, and the estradiol level on trigger day. The total dose of follicle-stimulating hormone and human menopausal gonadotropin administered was statistically greater in the group starting cos in the luteal phase than in the group starting in the late follicular phase.
Our results suggest that using a specific protocol with random-start ovarian stimulation for oocyte cryopreservation in breast cancer patients is effective and could be offered to young women undergoing oncologic treatment.
生育力保存是乳腺癌患者关注的重要问题。在本研究中，我们着手制定一种用于乳腺癌患者卵母细胞冷冻保存的控制性卵巢刺激（COS）的特定方案。
2014年11月至2016年12月，对109例患者进行了研究。将患者分配到一种用于卵母细胞冷冻保存的特定随机起始卵巢刺激方案。观察终点为获取的卵母细胞数量、冷冻保存的成熟卵母细胞数量、卵巢刺激的总天数、促性腺激素的总给药剂量以及扳机日的雌二醇水平。
该队列患者的平均年龄为31.27±4.23岁。COS的平均持续时间为10.0±1.39天。收集的卵母细胞平均数量为11.62±7.96个，玻璃化冷冻的卵母细胞平均数量为9.60±6.87个。扳机日的平均雌二醇浓度为706.30±450.48 pg/mL，促性腺激素的平均给药剂量为2610.00±716.51 IU。比较开始COS的周期阶段的结局时，我们观察到在收集和玻璃化冷冻的卵母细胞数量、卵巢刺激时间长度以及扳机日的雌二醇水平方面无显著差异。黄体期开始COS的组中促卵泡生成素和人绝经期促性腺激素的总给药剂量在统计学上高于卵泡晚期开始的组。
我们的结果表明，采用特定的随机起始卵巢刺激方案用于乳腺癌患者的卵母细胞冷冻保存是有效的，可提供给接受肿瘤治疗的年轻女性。
