title: Similar in vitro maturation rates of oocytes retrieved during the follicular or luteal phase offer flexible options for urgent fertility preservation in breast cancer patients.
abstract: OBJECTIVE
  Are in vitro maturation (IVM) rates of cumulus-oocyte complexes (COCs), retrieved from breast cancer patients seeking urgent fertility preservation (FP) before neoadjuvant chemotherapy, different between those recovered in the follicular or in the luteal phase of the cycle?
  
  
  CONCLUSIONS
  The present investigation reveals no major difference in the number of COCs recovered or their IVM rates whatever the phase of the cycle at which egg retrieval is performed, suggesting that IVM is a promising tool for breast cancer patients seeking urgent oocyte cryopreservation.
  
  
  BACKGROUND
  FP now represents a standard of care for young cancer patients having to undergo gonadotoxic treatment. Mature oocyte cryopreservation after IVM of COCs has been proposed for urgent FP, especially in women, who have no time to undergo ovarian stimulation, or when it is contraindicated.
  
  
  METHODS
  From January 2011 to December 2014, we prospectively studied 248 breast cancer patients awaiting neoadjuvant chemotherapy, aged 18-40 years, candidates for oocyte vitrification following IVM, either at the follicular or the luteal phase of the cycle.
  
  
  METHODS
  Serum anti-Müllerian hormone and progesterone levels and antral follicle count (AFC) were measured prior to oocyte retrieval. Patients were sorted into two groups according to the phase of the cycle during which eggs were harvested (Follicular phase group, n = 127 and Luteal phase group, n = 121). Number of COCs recovered, maturation rates after 48 h of culture and total number of oocytes cryopreserved were assessed. Moreover, the oocyte retrieval rate (ORR) was calculated by the number of COCs recovered ×100/AFC.
  
  
  RESULTS
  In the Follicular and the Luteal phase groups, women were comparable in terms of age, BMI and markers of follicular ovarian status. There was no significant difference in the number of COCs recovered (mean ± SEM), 9.3 ± 0.7 versus 11.1 ± 0.8, and ORR (median (range)) 43.1 (1-100) versus 47.8 (7.7-100)%. Moreover, maturation rates after 48 h of culture (median (range)) were comparable in the follicular and luteal phase groups, 66.7 (20-100) versus 64.5 (0-100)%. Finally, the total number of oocytes cryopreserved (mean ± SEM) was similar in both groups (6.2 ± 0.4 versus 6.8 ± 0.5).
  
  
  CONCLUSIONS
  Despite the intact meiotic competence of immature oocytes recovered during the follicular or the luteal phase, there is a dramatic lack of data regarding the outcome of IVM oocytes cryopreserved in cancer patients.
  
  
  CONCLUSIONS
  IVM of oocytes may be an interesting method of FP in urgent situations. Improving the culture conditions will be needed to increase the maturation rates and the overall potential of in vitro matured oocytes.
  
  
  BACKGROUND
  None.
  
  
  BACKGROUND
  N/A.
authors.affiliation: Department of Reproductive Medicine, AP-HP, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France University Paris XIII, 93000 Bobigny, France Unit Inserm U1133, Université Paris-Diderot, 75013 Paris, France michael.grynberg@aphp.fr.
authors.forename: M
authors.initials: M
authors.lastname: Grynberg
authors.affiliation: Unit of Reproductive Biology, AP-HP, Hôpital Antoine Béclère, Clamart F-92141, France Univ Paris-Sud, Clamart F-92140, France.
authors.forename: M
authors.initials: M
authors.lastname: Poulain
authors.affiliation: Department of Obstetric-Gynecology and Reproductive Medicine, Hôpital Antoine Béclère, Clamart F-92140, France.
authors.forename: S
authors.initials: S
authors.lastname: le Parco
authors.affiliation: Department of Cytogenetic and Reproductive Biology, AP-HP, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France.
authors.forename: C
authors.initials: C
authors.lastname: Sifer
authors.affiliation: Unit Inserm U1133, Université Paris-Diderot, 75013 Paris, France Univ Paris-Sud, Clamart F-92140, France Department of Obstetric-Gynecology and Reproductive Medicine, Hôpital Antoine Béclère, Clamart F-92140, France.
authors.forename: R
authors.initials: R
authors.lastname: Fanchin
authors.affiliation: Unit of Reproductive Biology, AP-HP, Hôpital Antoine Béclère, Clamart F-92141, France Univ Paris-Sud, Clamart F-92140, France.
authors.forename: N
authors.initials: N
authors.lastname: Frydman
mesh_terms: D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood; D001943:Breast Neoplasms / Q000150:complications*; D015925:Cryopreservation; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D005498:Follicular Phase; D006801:Humans; D059471:In Vitro Oocyte Maturation Techniques; D008183:Luteal Phase; D054315:Oocyte Retrieval; D011374:Progesterone / Q000097:blood; D013997:Time Factors
chemical_list: D011374:Progesterone; D054304:Anti-Mullerian Hormone
keywords: breast cancer; fertility preservation; in vitro maturation; neoadjuvant chemotherapy; oncofertility