Safety and feasibility of performing two consecutive ovarian stimulation cycles with the use of letrozole-gonadotropin protocol for fertility preservation in breast cancer patients.
OBJECTIVE
To investigate the safety and feasibility of performing two consecutive ovarian stimulation cycles with the use of letrozole protocol for fertility preservation in breast cancer patients.


METHODS
Retrospective cohort study.


METHODS
Academic fertility preservation center.


METHODS
Seventy-eight women ≤ 45 years, diagnosed with stage ≤ 3 breast cancer, who desired fertility preservation.


METHODS
Two consecutive cycles versus a single ovarian stimulation cycle with a letrozole-follicle-stimulating hormone (FSH) protocol.


METHODS
Embryo or oocyte cryopreservation outcomes, time interval from surgery to chemotherapy, and breast cancer recurrence rates.


RESULTS
Sixty-one patients underwent single-cycle stimulation and 17 received two stimulation cycles. The mean total number of oocytes harvested (16.1 ± 13.2 vs. 9.1 ± 5.2) and embryos generated (6.4 ± 2.9 vs. 3.7 ± 3.1) were statistically significantly higher in patients who underwent two cycles versus one cycle. The time interval from surgery to chemotherapy was similar between the two-cycle and single-cycle groups (63.7 ± 7.7 vs. 58.0 ± 12.1 days). After a mean follow-up interval of 58.5 ± 13.6 months, the recurrence rates were similar between the two-cycle (0 of 17) and single-cycle (2 of 49) patients.


CONCLUSIONS
It appears to be safe and feasible to perform two consecutive ovarian stimulation cycles to increase the oocyte/embryo yield for fertility preservation.
Innovation Institute for Fertility Preservation, New York, New York; Laboratory of Molecular Reproduction and Fertility Preservation, Obstetrics and Gynecology, New York Medical College, Valhalla, New York.
Volkan
V
Turan
Giuliano
G
Bedoschi
Fred
F
Moy
Kutluk
K
Oktay
D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000628:therapy; D015331:Cohort Studies; D015897:Comorbidity; D004359:Drug Therapy, Combination; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000517:prevention & control; D005240:Feasibility Studies; D005260:Female; D005299:Fertility Agents / Q000008:administration & dosage; D059247:Fertility Preservation / Q000379:methods / Q000706:statistics & numerical data*; D006062:Gonadotropins / Q000008:administration & dosage*; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology* / Q000517:prevention & control*; D000077289:Letrozole; D009518:New York; D009570:Nitriles / Q000008:administration & dosage*; D010062:Ovulation Induction / Q000379:methods / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage*
D005299:Fertility Agents; D006062:Gonadotropins; D009570:Nitriles; D014230:Triazoles; D000077289:Letrozole
Breast cancer; consecutive cycles; fertility preservation; letrozole; ovarian stimulation