Effect of breast cancer prognostic factors on ovarian reserve and response in fertility preservation

被引:1
作者
Grynberg, Michael [1 ,2 ,3 ]
Zeghari, Faycal [1 ]
Peigne, Maeliss
Benoit, Alexandra
Rakrouki, Sophia [2 ]
Sifer, Christophe [3 ]
Mayeur, Anne [4 ,5 ]
Sais, Emine [4 ,5 ]
Sonigo, Charlotte [1 ,6 ]
机构
[1] Univ Paris Saclay, Antoine Beclere Hosp, Assistance Publ Hop Paris, Dept Reprod Med & Fertil Preservat, F-92140 Clamart, France
[2] Univ Sorbonne Paris Nord, Jean Verdier Hosp, Assistance Publ Hop Paris, Dept Reprod Med & Fertil Preservat, F-93143 Bondy, France
[3] Univ Paris Diderot, INSERM, U1133, Paris, France
[4] Univ Paris Saclay, Antoine Beclere Hosp, Assistance Publ Hop Paris, Dept Biol Reprod, F-92140 Clamart, France
[5] Univ Paris Saclay, Antoine Beclere Hosp, Assistance Publ Hop Paris, CECOS, F-92140 Clamart, France
[6] Univ Paris Sud, Unite Inserm U1185, Le Kremlin Bicetre, France
关键词
breast cancer; fertility preservation; ovarian stimulation; ovarian reserve; oocyte vitrification; ANTI-MULLERIAN HORMONE; IN-VITRO FERTILIZATION; LIVE BIRTH; STIMULATION; WOMEN; RECOMMENDATIONS; STATISTICS; PREGNANCY; IMPACT; STAGE;
D O I
10.1016/j.rbmo.2024.104109
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Research question: Do breast cancer prognostic factors influence ovarian reserve and response to ovarian stimulation in the context of fertility preservation? Design: Observational, bicentric retrospective study of 352 women with breast cancer who underwent ovarian stimulation using a random start gonadotrophin releasing hormone antagonist protocol and vitrified oocytes between November 2015 and August 2022. Serum anti-Mu<euro>llerian hormone (AMH) levels and antral follicle count (AFC) were measured. The number of oocytes recovered, maturation rate and follicular output rate (FORT) were analysed according to patients' characteristics and breast cancer prognostic factors. Results: Median age was 34 years (31.1-37.1). Median AFC and serum AMH level were 17 (12-26) follicles and 2 (1.2-3.4) ng/ml, respectively. After ovarian stimulation, 10.5 (6.0-16.0) oocytes were recovered, with eight (4-13) being mature. Mean oocyte maturation rate was 79% (62-92). Antral follicle count (>12) significantly affected the risk of recovering fewer than eight mature oocytes (P < 0.0001, multivariate analysis). Follicular responsiveness to FSH, assessed by the follicular output rate (FORT index) and number of oocytes recovered, were 31% (21-50) and 10.5% (6.0-16.0), respectively. FORT index and ovarian stimulation outcomes were not influenced by breast cancer prognostic factors. Conclusion: Breast cancer prognostic factors do not influence ovarian reserve markers or response to ovarian stimulation in fertility preservation. Therefore, tumour grade, triple-negative status, HER2 overexpression and high Ki67 should not alter the fertility-preservation strategy when considering ovarian stimulation for oocyte vitrification.
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页数:9
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