Department of Obstetrics and Gynecology, McGill University Health Centre, Montreal, Quebec, Canada.
Department of Obstetrics and Gynecology, McGill University Health Centre, Montreal, Quebec, Canada.
Fertil Steril. 2020 Feb;113(2):400-407.e1. doi: 10.1016/j.fertnstert.2019.09.033.
To evaluate the impact of lymphoma aggressiveness on ovarian response during fertility preservation treatment.
Retrospective cohort study.
University-affiliated tertiary hospital.
PATIENT(S): Women with lymphoma who underwent ovarian stimulation for fertility preservation in the period from 2009 to 2018.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Primary outcome: the number of mature oocytes; secondary outcomes: the number of retrieved oocytes, estradiol level, and number of follicles >14 mm on the day of oocyte maturation trigger.
RESULT(S): Patients with stage I-II lymphoid neoplasms (localized disease) were compared with those with stage III-IV lymphomas (advanced disease). Women with favorable levels of biochemical prognostic markers were also compared with those with unfavorable levels. Women with favorable levels of biochemical prognostic markers (n = 74) had a higher number of mature oocytes compared with patients with unfavorable serum levels (n = 67): 11 (7.8-16) versus 9 (5-11), respectively. The number of mature oocytes was similar between patients with localized (n = 75) and advanced (n = 66) lymphomas. Women with unfavorable combination of stage and biochemical factors had lower number of mature oocytes compared to patients with favorable combination: 8 (5-10) versus 11 (7-16), respectively. Multivariate logistic regression showed that favorable levels of biochemical markers as well as a combination of extent and biochemical parameters were statistically significantly associated with the result of over 10 mature oocytes.
CONCLUSION(S): Highly-aggressive lymphoid neoplasms have a negative impact on ovarian function and response during fertility preservation treatment.
评估淋巴瘤侵袭性对生育力保存治疗中卵巢反应的影响。
回顾性队列研究。
大学附属医院。
2009 年至 2018 年间接受卵巢刺激以进行生育力保存的患有淋巴瘤的女性。
无。
主要结局：成熟卵母细胞数量；次要结局：获卵数、雌二醇水平和卵母细胞成熟触发日 >14mm 的卵泡数。
将 I 期-II 期淋巴肿瘤（局限性疾病）患者与 III 期-IV 期淋巴瘤（进展期疾病）患者进行比较。还比较了具有有利生化预后标志物水平的女性与具有不利生化标志物水平的女性。具有有利生化预后标志物水平的女性（n = 74）比具有不利血清水平的女性（n = 67）有更多的成熟卵母细胞：分别为 11（7.8-16）和 9（5-11）。局限性（n = 75）和进展性（n = 66）淋巴瘤患者的成熟卵母细胞数量相似。具有不利分期和生化因素组合的女性的成熟卵母细胞数量低于具有有利组合的女性：分别为 8（5-10）和 11（7-16）。多变量逻辑回归显示，有利的生化标志物水平以及程度和生化参数的组合与获得超过 10 个成熟卵母细胞的结果具有统计学显著相关性。
高度侵袭性的淋巴肿瘤对生育力保存治疗中卵巢功能和反应有负面影响。
