scholarly journals Usefulness of random-start progestin-primed ovarian stimulation for fertility preservation

2022 ◽  
Vol 15 (1) ◽  
Author(s):  
Haipeng Huang ◽  
Yukiko Itaya ◽  
Kouki Samejima ◽  
Shunichiro Ichinose ◽  
Tatsuya Narita ◽  
...  
Keyword(s):  
Fertility Preservation ◽  
Ovarian Stimulation ◽  
Luteal Phase ◽  
Primary Outcome ◽  
Gonadotropin Releasing Hormone ◽  
Secondary Outcome ◽  
Embryo Freezing ◽  
Oocyte Collection ◽  
Hospital Visits ◽  
Patient Stress

Abstract Background Progestin-primed ovarian stimulation (PPOS) has been used in infertility cases in recent years, and several reports have stated that it has oocyte collection results similar to those of gonadotropin-releasing hormone antagonist (GnRH-ant) protocol. For emergency fertility preservation, random-start ovarian stimulation is usually recommended. Therefore we compared the clinical outcomes of random-start PPOS with those of conventional random-start GnRH-ant protocols in fertility-preserving cases. Methods We retrospectively examined 86 cycles of oocyte collection, of which 56 were random-start GnRH-ant and 30 were random-start PPOS for fertility preservation at our hospital between January 2016 and April 2021. The primary outcome was the number of mature oocytes per cycle. The secondary outcome was the number of vitrified blastocysts per cycle for embryo freezing cases. Results No significant differences were noted in the number of days of stimulation, total dose of gonadotropin preparation, and the number of mature oocytes and vitrified blastocysts. The number of hospital visits for monitoring was significantly lower in the PPOS group. The start of menstruation before oocyte collection was significantly less in the PPOS group. Conclusions Random-start PPOS and GnRH-ant were similar in oocyte collection results. PPOS can reduce the number of hospital visits, thus reducing patient stress. PPOS at the start of the luteal phase can prevent the start of menstruation during ovarian stimulation.

scholarly journals Fertility Preservation Success Subsequent to Concurrent Aromatase Inhibitor Treatment and Ovarian Stimulation in Women With Breast Cancer

2015 ◽  
Vol 33 (22) ◽  
pp. 2424-2429 ◽  
Author(s):  
Kutluk Oktay ◽  
Volkan Turan ◽  
Giuliano Bedoschi ◽  
Fernanda S. Pacheco ◽  
Fred Moy
Keyword(s):  
Breast Cancer ◽  
In Vitro Fertilization ◽  
Fertility Preservation ◽  
Embryo Transfer ◽  
Ovarian Stimulation ◽  
Live Birth Rate ◽  
Embryo Cryopreservation ◽  
Vitro Fertilization ◽  
Embryo Freezing

Purpose We have previously reported an approach to ovarian stimulation for the purpose of fertility preservation (FP) in women with breast cancer via embryo freezing with the concurrent use of letrozole. The aim of this study was to provide the pregnancy and FP outcomes when embryos generated with the same protocol are used. Patients and Methods In all, 131 women with stage ≤ 3 breast cancer underwent ovarian stimulation and received concurrent letrozole 5 mg per day before receiving adjuvant chemotherapy and cryopreserving embryos. Results Thirty-three of the 131 women underwent 40 attempts to transfer embryos to their own uterus (n = 18) or via the use of a gestational carrier (n = 22) at a mean age of 41.5 ± 4.3 years with a median 5.25 years after embryo cryopreservation. The overall live birth rate per embryo transfer was similar to the US national mean among infertile women of a similar age undergoing in vitro fertilization–embryo transfer (45.0 v 38.2; P = .2). Seven (38.8%) of the 18 pregnancies were twins with no higher-order pregnancies being encountered. No fetal anomalies or malformations were reported in 25 children after a mean follow-up of 40.4 ± 26.4 months. Seventeen of the 33 women attempting pregnancy had at least one child, translating into an FP rate of 51.5% per attempting woman. Conclusion Embryo cryopreservation after ovarian stimulation with the letrozole and follicle-stimulating hormone protocol preserves fertility in women with breast cancer and results in pregnancy rates comparable to those expected in a noncancer population undergoing in vitro fertilization.

scholarly journals Prediction of Ovarian Response with Ovarian Response Prediction Index (Orpi) during Controlled Ovarian Stimulation in IVF

2020 ◽  
Vol 8 (3) ◽  
Keyword(s):  
Prospective Study ◽  
Roc Curve ◽  
Ovarian Stimulation ◽  
Primary Outcome ◽  
Ovarian Response ◽  
Response Prediction ◽  
Controlled Ovarian Stimulation ◽  
Secondary Outcome ◽  
Exclusion Criteria ◽  
Positive Correlation

(Background): To evaluate ORPI as an index to predict the response to ovarian stimulation. (Methods): It is an observational prospective study of 734 patients who underwent controlled ovarian stimulation during period of 1.5 years (July 2017 to December 2018) .Inclusion and exclusion criteria were taken into consideration when patients were recruited. ORPI is calculated by multiplying AMH level (ng/ml) and AFC (n) and the result is divided by age (years) of the patient. The primary outcome measured was number of MII oocytes and secondary outcome was total number of oocytes retrieved. (Results): Positive correlation of ORPI with MII oocytes and total number of oocytes is seen. Regarding the probability of collecting ≥4 oocytes under the ROC curve, the AUC for ORPI is 0.68 (95%CI 0.65-0.72) with sensitivity of 78.4 and specificity of 51.4 for a cut off of >0.44. For collecting ≥ 15 oocytes ROC curve had an AUC of 0.72 with sensitivity of 66.7 and specificity of 73.4 for a cut off of >1.28. ROC curve for the probability of collecting ≥4 MII oocytes depicted an AUC of 0.67 with cut off of >0.77. (Conclusion): The results of our study concluded that in a patient undergoing IVF treatment, ORPI has a poor ability to predict retrieval of ≥4 oocytes or ≥ 4 MII and fair ability for hyper response with ≥15 oocytes. ORPI can serve as a counselling tool for predicting ovarian response.

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