Random-start ovarian stimulation in patients with cancer.
OBJECTIVE
Awaiting menses to start ovarian stimulation for oocyte/embryo cryopreservation in patients with cancer may result in a significant delay of cancer treatment that may lead to patients forgoing fertility preservation. The purpose of this review is to describe the new protocols to facilitate the start of ovarian stimulation, including random-start ovarian stimulation.


RESULTS
In random-start protocols, the number of total and mature oocytes retrieved, oocyte maturity rate, mature oocyte yield and fertilization rates are similar to those in conventional (early follicular phase start) protocols. Starting ovarian stimulation in the late follicular or luteal phase did not show any superiority against the other. The presence of corpus luteum or luteal phase progesterone levels did not adversely affect synchronized follicular development, number of mature oocytes retrieved, and/or fertilization rates.


CONCLUSIONS
Random-start ovarian stimulation provides a significant advantage by decreasing total time for the IVF cycle, and in emergent settings, ovarian stimulation can be started at a random cycle date for the purpose of fertility preservation without compromising oocyte yield and maturity.
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California, USA.
Hakan
H
Cakmak
Mitchell P
MP
Rosen
D000328:Adult; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D015925:Cryopreservation / Q000379:methods*; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000517:prevention & control*; D000077289:Letrozole; D008183:Luteal Phase / Q000502:physiology*; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D009570:Nitriles / Q000627:therapeutic use*; D054315:Oocyte Retrieval / Q000379:methods; D009865:Oocytes / Q000502:physiology*; D010062:Ovulation Induction / Q000379:methods; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*
D047072:Aromatase Inhibitors; D006063:Chorionic Gonadotropin; D009570:Nitriles; D014230:Triazoles; D000077289:Letrozole; D005640:Follicle Stimulating Hormone