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.
Design: Retrospective cohort study.
Setting: Academic fertility preservation center.
Patient(s): Seventy-eight women ≤ 45 years, diagnosed with stage ≤ 3 breast cancer, who desired fertility preservation.
Intervention(s): Two consecutive cycles versus a single ovarian stimulation cycle with a letrozole-follicle-stimulating hormone (FSH) protocol.
Main outcome measure(s): Embryo or oocyte cryopreservation outcomes, time interval from surgery to chemotherapy, and breast cancer recurrence rates.
Result(s): 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.
Conclusion(s): It appears to be safe and feasible to perform two consecutive ovarian stimulation cycles to increase the oocyte/embryo yield for fertility preservation.
Keywords: Breast cancer; consecutive cycles; fertility preservation; letrozole; ovarian stimulation.
Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.