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Fertil Steril. 2013 Dec;100(6):1673-80. doi: 10.1016/j.fertnstert.2013.07.1992. Epub 2013 Aug 26.

Effective method for emergency fertility preservation: random-start controlled ovarian stimulation.

Author information

1
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California.

Abstract

OBJECTIVE:

To determine whether random-start controlled ovarian stimulation (COS), in which a patient is stimulated on presentation regardless of her menstrual-cycle phase, has outcomes similar to conventional early follicular phase-start COS for fertility preservation in cancer patients.

DESIGN:

Retrospective cohort study.

SETTING:

Academic medical center.

PATIENT(S):

Women recently diagnosed with cancer and in preparation for gonadotoxic therapy.

INTERVENTION(S):

Random- versus conventional-start COS.

MAIN OUTCOME MEASURE(S):

PRIMARY OUTCOME:

number of mature oocytes retrieved; secondary outcomes: pattern of follicular development, oocyte yield, and fertilization rate.

RESULT(S):

The number of total and mature oocytes retrieved, oocyte maturity rate, mature oocyte yield, and fertilization rates were similar in random- (n = 35) and conventional-start (n = 93) COS cycles. No superiority was noted when comparing COS started in the late follicular (n = 13) or luteal phase (n = 22). The addition of letrozole, in the case of estrogen-sensitive cancers, did not adversely affect COS outcomes or oocyte maturity and competence in either random- or conventional-start protocols.

CONCLUSION(S):

Random-start COS is as effective as conventional-start COS in fertility preservation. This protocol would minimize delays and allow more patients to undergo fertility preservation and still proceed with cancer treatment within 2-3 weeks.

KEYWORDS:

Random start; controlled ovarian stimulation; fertility preservation

[Indexed for MEDLINE]

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