Nakasuji Takashi, Kawai Kiyotaka, Ishikawa Tomonori, Teraoka Kaori, Takeuchi Shiho, Miyagawa Tomoko, Nara Kazuko, Kidera Nobuyuki, Harada Tatsuya, Miyasaka Naoyuki
Comprehensive Reproductive Medicine, Graduate School Tokyo Medical and Dental University (TMDU) Tokyo Japan.
Reproductive Medicine Kameda Medical Center Chiba Japan.
Reprod Med Biol. 2019 Jan 2;18(2):167-172. doi: 10.1002/rmb2.12263. eCollection 2019 Apr.
Fertility preservation is an important issue for young cancer patients. Random-start controlled ovarian stimulation and double ovarian stimulation have been proposed for efficient oocyte retrieval within the limited time before cancer therapy. We aimed to clarify the efficacy of these new protocols within the Japanese population.
We performed a retrospective observational study at a multicenter from February 2012 to August 2017. The study entailed 50 cycles with 34 patients who underwent fertility preservation due to breast cancer. Follicular phase or luteal phase ovarian stimulation with aromatase inhibitor was performed. A second ovarian stimulation was started with or without waiting until the next menstruation. We measured the number of retrieved oocytes and cryopreserved oocytes/embryos, the ratio of mature oocytes, and the fertilization rate.
The numbers of retrieved oocytes and frozen oocytes/embryos were not significantly different between follicular phase and luteal phase ovarian stimulation. The number of retrieved oocytes was not reduced at the second ovum pick up compared to the first ovum pick up in the double ovarian stimulation.
Random-start controlled ovarian stimulation and double ovarian stimulation with aromatase inhibitor for breast cancer patients were effective protocols for retrieving a greater number of oocytes within the limited time.
生育力保存对于年轻癌症患者而言是一个重要问题。随机启动控制性卵巢刺激和双侧卵巢刺激已被提出，旨在在癌症治疗前的有限时间内高效获取卵母细胞。我们旨在阐明这些新方案在日本人群中的疗效。
我们于2012年2月至2017年8月在多中心进行了一项回顾性观察研究。该研究纳入了34例因乳腺癌接受生育力保存的患者的50个周期。采用芳香化酶抑制剂进行卵泡期或黄体期卵巢刺激。第二次卵巢刺激在等待或不等待至下次月经后启动。我们测量了获取的卵母细胞数量、冷冻保存的卵母细胞/胚胎数量、成熟卵母细胞比例以及受精率。
卵泡期和黄体期卵巢刺激在获取的卵母细胞数量以及冷冻的卵母细胞/胚胎数量方面无显著差异。在双侧卵巢刺激中，与首次取卵相比，第二次取卵时获取的卵母细胞数量未减少。
对于乳腺癌患者，采用芳香化酶抑制剂进行随机启动控制性卵巢刺激和双侧卵巢刺激是在有限时间内获取更多卵母细胞的有效方案。
