Abstract
Objective: To evaluate the efficacy of ovarian stimulation with higher doses of gonadotropins in fertility preservation (FP) cycles with the intention to maximize the likelihood of future pregnancies. Design: Retrospective (secondary analysis). Setting: Academic medical centers. Patient(s): Low-dose (LD, 150 IU; n = 34) versus high-dose (HD, >150 IU; n = 117) FSH start in 151 patients with breast cancer (BCa) undergoing ovarian stimulation for embryo cryopreservation with letrozole (LE) before cancer treatment. Intervention(s): None. Main Outcome Measure(s): FP cycle outcomes. Result(s): Mean total FSH dose (2,037 ± 679 IU vs. 1,128 ± 381 IU) and FSH level on trigger day (21.1 ± 8.9 vs. 10.6 ± 4.5 mIU/mL) were higher in the HD group, confirming the receipt of higher-dose FSH. There was no difference in other patient characteristics. Despite the larger number of follicles >17 mm in diameter in the HD group (5.0 ± 2.0 vs. 3.4 ± 1.4), neither peak E2 (498.0 ± 377.5 vs. 397.9 ± 320.3), number of oocytes (13.3 ± 8.7 vs. 12.3 ± 8.0), nor number of embryos (6.3 ± 4.7 vs. 5.4 ± 3.8) were significantly different from the LD group. Of those undergoing frozen embryo transfer (ET), live birth rate (LBR)/ET trended higher in the LD (9/15) compared with HD (2/11) group, with 2.1 ± 0.8 vs. 1.9 ± 0.3 embryos transferred, respectively. Conclusion(s): Higher-dose FSH stimulation in LE cycles does not improve outcomes and may be associated with lower LBR. Our findings may support minimal stimulation in young noninfertile women with BCa.
| Original language | English |
|---|---|
| Journal | Fertility and Sterility |
| Volume | 98 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2012 Oct 1 |
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Keywords
- breast cancer
- fertility preservation
- Follicle-stimulating hormone
- letrozole
- starting dose
ASJC Scopus subject areas
- Reproductive Medicine
- Obstetrics and Gynaecology
Cite this
Does higher starting dose of FSH stimulation with letrozole improve fertility preservation outcomes in women with breast cancer? / Lee, Sanghoon; Oktay, Kutluk.
In: Fertility and Sterility, Vol. 98, No. 4, 01.10.2012.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Does higher starting dose of FSH stimulation with letrozole improve fertility preservation outcomes in women with breast cancer?
AU - Lee, Sanghoon
AU - Oktay, Kutluk
PY - 2012/10/1
Y1 - 2012/10/1
N2 - Objective: To evaluate the efficacy of ovarian stimulation with higher doses of gonadotropins in fertility preservation (FP) cycles with the intention to maximize the likelihood of future pregnancies. Design: Retrospective (secondary analysis). Setting: Academic medical centers. Patient(s): Low-dose (LD, 150 IU; n = 34) versus high-dose (HD, >150 IU; n = 117) FSH start in 151 patients with breast cancer (BCa) undergoing ovarian stimulation for embryo cryopreservation with letrozole (LE) before cancer treatment. Intervention(s): None. Main Outcome Measure(s): FP cycle outcomes. Result(s): Mean total FSH dose (2,037 ± 679 IU vs. 1,128 ± 381 IU) and FSH level on trigger day (21.1 ± 8.9 vs. 10.6 ± 4.5 mIU/mL) were higher in the HD group, confirming the receipt of higher-dose FSH. There was no difference in other patient characteristics. Despite the larger number of follicles >17 mm in diameter in the HD group (5.0 ± 2.0 vs. 3.4 ± 1.4), neither peak E2 (498.0 ± 377.5 vs. 397.9 ± 320.3), number of oocytes (13.3 ± 8.7 vs. 12.3 ± 8.0), nor number of embryos (6.3 ± 4.7 vs. 5.4 ± 3.8) were significantly different from the LD group. Of those undergoing frozen embryo transfer (ET), live birth rate (LBR)/ET trended higher in the LD (9/15) compared with HD (2/11) group, with 2.1 ± 0.8 vs. 1.9 ± 0.3 embryos transferred, respectively. Conclusion(s): Higher-dose FSH stimulation in LE cycles does not improve outcomes and may be associated with lower LBR. Our findings may support minimal stimulation in young noninfertile women with BCa.
AB - Objective: To evaluate the efficacy of ovarian stimulation with higher doses of gonadotropins in fertility preservation (FP) cycles with the intention to maximize the likelihood of future pregnancies. Design: Retrospective (secondary analysis). Setting: Academic medical centers. Patient(s): Low-dose (LD, 150 IU; n = 34) versus high-dose (HD, >150 IU; n = 117) FSH start in 151 patients with breast cancer (BCa) undergoing ovarian stimulation for embryo cryopreservation with letrozole (LE) before cancer treatment. Intervention(s): None. Main Outcome Measure(s): FP cycle outcomes. Result(s): Mean total FSH dose (2,037 ± 679 IU vs. 1,128 ± 381 IU) and FSH level on trigger day (21.1 ± 8.9 vs. 10.6 ± 4.5 mIU/mL) were higher in the HD group, confirming the receipt of higher-dose FSH. There was no difference in other patient characteristics. Despite the larger number of follicles >17 mm in diameter in the HD group (5.0 ± 2.0 vs. 3.4 ± 1.4), neither peak E2 (498.0 ± 377.5 vs. 397.9 ± 320.3), number of oocytes (13.3 ± 8.7 vs. 12.3 ± 8.0), nor number of embryos (6.3 ± 4.7 vs. 5.4 ± 3.8) were significantly different from the LD group. Of those undergoing frozen embryo transfer (ET), live birth rate (LBR)/ET trended higher in the LD (9/15) compared with HD (2/11) group, with 2.1 ± 0.8 vs. 1.9 ± 0.3 embryos transferred, respectively. Conclusion(s): Higher-dose FSH stimulation in LE cycles does not improve outcomes and may be associated with lower LBR. Our findings may support minimal stimulation in young noninfertile women with BCa.
KW - breast cancer
KW - fertility preservation
KW - Follicle-stimulating hormone
KW - letrozole
KW - starting dose
UR - http://www.scopus.com/inward/record.url?scp=84867028444&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84867028444&partnerID=8YFLogxK
U2 - 10.1016/j.fertnstert.2012.06.015
DO - 10.1016/j.fertnstert.2012.06.015
M3 - Article
C2 - 22771027
AN - SCOPUS:84867028444
VL - 98
JO - Fertility and Sterility
JF - Fertility and Sterility
SN - 0015-0282
IS - 4
ER -