Ovarian response to stimulation for fertility preservation in women with hematologic cancer - 13/10/20

Doi : 10.1016/j.jogoh.2020.101925

Tiffany Brun ^a,⁎ , Ludivine Dion ^a, Sylvie Jaillard ^b,^c, Diane Bales ^a, Mathilde Domin ^a, Vincent Lavoué ^a,^d, Jean Levêque ^a,^d, Roch Houot ^e,^f, Solène Duros ^a
^a CHU Rennes, Département de Gynécologie Obstétrique et Reproduction Humaine, F-35033, Rennes, France
^b CHU Rennes, Service de Cytogénétique et Biologie Cellulaire, F-35033, Rennes, France
^c Univ Rennes, CHU Rennes, INSERM, EHESP, IRSET (Institut de recherche en santé, environnement et travail) – UMR_S 1085, F-35000, Rennes, France
^d Univ Rennes INSERM UMR 1242, F-35000 Rennes, France
^e CHU Rennes, Service Hématologie Clinique, Rennes, France
^f Univ Rennes, CHU Rennes MICMAC-Inserm UMR 1236, F-35000 Rennes, France

^⁎Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Tuesday 13 October 2020
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Abstract

Purpose

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)).

Patients and Methods

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.

Results

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.

Conclusion

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.

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Keywords : Fertility preservation, Haematological cancer, Ovarian stimulation, Mature oocytes