The impact of malignancy on response to ovarian stimulation for fertility preservation: a meta-analysis

Objective: To evaluate the impact of cancer diagnosis on response to ovarian stimulation for fertility preservation.

Design: Meta-analysis.

Setting: Not applicable.

Patient(s): An electronic-based search was performed with the use of PubMed until May 2018 limited to English-language articles. In the final analysis, 10 case-controlled retrospective cohort studies were included, comparing ovarian response to stimulation between women with cancer and age-matched healthy women (control group).

Intervention(s): None.

Main outcome measure(s): Number of total oocytes retrieved, number of mature oocytes, fertilization rate and two pronuclei embryos obtained.

Result(s): Ten studies that included a total of 713 women with cancer were analyzed in the cancer group (722 cycles), and 1,830 healthy women (1,835 cycles) qualified as controls for the meta-analysis. The pooled results showed no impact of cancer diagnosis on the mean number of total oocytes (P=.517; 95% CI -0.23 to 0.12), mature oocytes (P=.104; 95% CI -0.23 to 0.01), and two pronuclei embryos (P=.136; 95% CI -0.32 to 0.04) and fertilization rates (P=.273; 95% CI -0.29 to 0.183). When the analysis was limited to women with breast cancer diagnosis, there was also no difference in the mean number of total oocytes (P=.812; 95% CI -0.28 to 0.36) and mature oocytes (P=.993; 95% CI -0.16 to 0.16) between the two groups.

Conclusion(s): This meta-analysis indicates that cancer diagnosis is not associated with reduced response to ovarian stimulation.