CHU Rennes, Département de Gynécologie Obstétrique et Reproduction Humaine, F-35033, Rennes, France.
CHU Rennes, Département de Gynécologie Obstétrique et Reproduction Humaine, F-35033, Rennes, France.
J Gynecol Obstet Hum Reprod. 2021 May;50(5):101925. doi: 10.1016/j.jogoh.2020.101925. Epub 2020 Sep 30.
To compare the ovarian response to controlled ovarian hyperstimulation (COH) in patients with hematologic malignancies treated for fertility preservation (FP) and healthy subjects (oocyte donors (OD)).
Retrospective cohort study comparing 41 women (18-37 years) who underwent COH for oocyte vitrification prior to gonadotoxic treatment for hematologic cancer (FP group) from January 2014 to February 2019 and with 117 women undergoing COH as part of an OD protocol (OD group) during the same period. The number of frozen mature oocytes, number of oocytes retrieved, total dose of rFSH, maximal estradiol levels, percentage of maturity, number of dominant follicles >14 mm, days of stimulation were evaluated. Results were adjusted for age, body mass index (BMI), anti-Mullerian hormone (AMH) and rFSH starting dose.
Patients in the FP group were younger and had a lower BMI than those in the OD group. rFSH starting dose was higher in the FP group (median 225UI (125;450) vs 150UI (87.5;337.5), p < 0.0001). After adjusting for age, BMI and starting rFSH dose according to ANCOVA, more frozen mature oocytes (median 10 (0;45) vs 8 (0;22] p = 0.0055) and retrieved oocytes (median 12 (0;49) vs 11 (0;29) p = 0.0468) were found in the FP group. Other outcome measures did not differ between the groups.
Ovarian response after COH in women with a hematologic cancer is similar to that in the general population. A higher number of mature oocytes were collected in the FP group after strong COH.
比较血液恶性肿瘤患者行生育力保存（FP）控制性卵巢刺激（COH）与健康供卵者（OD）的卵巢反应。
回顾性队列研究比较了 2014 年 1 月至 2019 年 2 月期间因血液恶性肿瘤接受性腺毒性治疗前进行卵母细胞玻璃化冷冻保存而接受 COH 的 41 例（18-37 岁）女性（FP 组）和同期行 COH 作为 OD 方案一部分的 117 例女性（OD 组）。比较两组的冷冻成熟卵母细胞数、获卵数、rFSH 总剂量、最大雌二醇水平、成熟率、>14mm 的优势卵泡数和刺激天数。结果根据年龄、体重指数（BMI）、抗苗勒管激素（AMH）和 rFSH 起始剂量进行调整。
FP 组患者年龄较小，BMI 较低。FP 组 rFSH 起始剂量较高（中位数 225UI（125；450）比 150UI（87.5；337.5），p<0.0001）。根据协方差分析调整年龄、BMI 和起始 rFSH 剂量后，FP 组的冷冻成熟卵母细胞数（中位数 10（0；45）比 8（0；22），p=0.0055）和获卵数（中位数 12（0；49）比 11（0；29），p=0.0468）更多。其他结果指标在两组之间无差异。
血液恶性肿瘤患者 COH 后的卵巢反应与普通人群相似。在强烈的 COH 后，FP 组采集到的成熟卵母细胞数量更多。
