Maximize the safety and efficacy of fertility preservation by random start/dual ovarian stimulation for early breast cancer patients
Objective: What is the more efficient and safer protocol during controlled ovarian hyperstimulation (COH) for early-stage breast cancer patients seeking emergency fertility preservation before adjuvant chemo/radiotherapy? Materials and methods: This retrospective, case-series study involved two earl...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | Taiwanese Journal of Obstetrics & Gynecology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1028455923000323 |
| _version_ | 1827980690674679808 |
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| author | Shih-Hung Richard Young Yi-En Chang Wei-Chung Vivian Yang Buo-Jia Lu Szu-Yuan Chou Chi-Huang Chen |
| author_facet | Shih-Hung Richard Young Yi-En Chang Wei-Chung Vivian Yang Buo-Jia Lu Szu-Yuan Chou Chi-Huang Chen |
| author_sort | Shih-Hung Richard Young |
| collection | DOAJ |
| description | Objective: What is the more efficient and safer protocol during controlled ovarian hyperstimulation (COH) for early-stage breast cancer patients seeking emergency fertility preservation before adjuvant chemo/radiotherapy? Materials and methods: This retrospective, case-series study involved two early-stage (Ia) breast cancer patients that requested for fertility preservation within 3 weeks. Random start/dual stimulation protocols with aromatase inhibitor (AI) were used to maximize oocyte yield and suppress serum estradiol (E2) level. Results: E2 levels on trigger day during dual COH were between 112.0 and 407.0 pg/mL. Duration of COH could be shortened to only 17 days, and up to 41 oocytes were successfully retrieved with two retrievals. Conclusion: This remarkable efficient and safe protocol involves the combination of random start/dual stimulation with step-up AI dosage beforehand which not only maximize oocyte yield within the shortest possible timeframe, but also to maintain the low level of E2 to avoid over-stimulating estrogen-sensitive cancer cells and to decrease the risk of developing ovarian hyperstimulation syndrome (OHSS). |
| first_indexed | 2024-04-09T21:57:20Z |
| format | Article |
| id | doaj.art-6090730ec0a448a490f3c31fc17b0630 |
| institution | Directory Open Access Journal |
| issn | 1028-4559 |
| language | English |
| last_indexed | 2024-04-09T21:57:20Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Taiwanese Journal of Obstetrics & Gynecology |
| spelling | doaj.art-6090730ec0a448a490f3c31fc17b06302023-03-24T04:21:57ZengElsevierTaiwanese Journal of Obstetrics & Gynecology1028-45592023-03-01622330333Maximize the safety and efficacy of fertility preservation by random start/dual ovarian stimulation for early breast cancer patientsShih-Hung Richard Young0Yi-En Chang1Wei-Chung Vivian Yang2Buo-Jia Lu3Szu-Yuan Chou4Chi-Huang Chen5Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Hung-Chi Women & Children's Hospital, Taoyuan, TaiwanDivision of Reproductive Medicine, Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, TaiwanThe PhD Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, TaiwanDivision of Reproductive Medicine, Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, TaiwanDivision of Reproductive Medicine, Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, TaiwanDivision of Reproductive Medicine, Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Corresponding author. Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan #252, WuXing Street, XinYi Dist. Taipei, 11031, Taiwan.Objective: What is the more efficient and safer protocol during controlled ovarian hyperstimulation (COH) for early-stage breast cancer patients seeking emergency fertility preservation before adjuvant chemo/radiotherapy? Materials and methods: This retrospective, case-series study involved two early-stage (Ia) breast cancer patients that requested for fertility preservation within 3 weeks. Random start/dual stimulation protocols with aromatase inhibitor (AI) were used to maximize oocyte yield and suppress serum estradiol (E2) level. Results: E2 levels on trigger day during dual COH were between 112.0 and 407.0 pg/mL. Duration of COH could be shortened to only 17 days, and up to 41 oocytes were successfully retrieved with two retrievals. Conclusion: This remarkable efficient and safe protocol involves the combination of random start/dual stimulation with step-up AI dosage beforehand which not only maximize oocyte yield within the shortest possible timeframe, but also to maintain the low level of E2 to avoid over-stimulating estrogen-sensitive cancer cells and to decrease the risk of developing ovarian hyperstimulation syndrome (OHSS).http://www.sciencedirect.com/science/article/pii/S1028455923000323Aromatase inhibitorsBreast cancerEstradiolEstrogen-sensitiveFertility preservationOvarian hyperstimulation syndrome |
| spellingShingle | Shih-Hung Richard Young Yi-En Chang Wei-Chung Vivian Yang Buo-Jia Lu Szu-Yuan Chou Chi-Huang Chen Maximize the safety and efficacy of fertility preservation by random start/dual ovarian stimulation for early breast cancer patients Taiwanese Journal of Obstetrics & Gynecology Aromatase inhibitors Breast cancer Estradiol Estrogen-sensitive Fertility preservation Ovarian hyperstimulation syndrome |
| title | Maximize the safety and efficacy of fertility preservation by random start/dual ovarian stimulation for early breast cancer patients |
| title_full | Maximize the safety and efficacy of fertility preservation by random start/dual ovarian stimulation for early breast cancer patients |
| title_fullStr | Maximize the safety and efficacy of fertility preservation by random start/dual ovarian stimulation for early breast cancer patients |
| title_full_unstemmed | Maximize the safety and efficacy of fertility preservation by random start/dual ovarian stimulation for early breast cancer patients |
| title_short | Maximize the safety and efficacy of fertility preservation by random start/dual ovarian stimulation for early breast cancer patients |
| title_sort | maximize the safety and efficacy of fertility preservation by random start dual ovarian stimulation for early breast cancer patients |
| topic | Aromatase inhibitors Breast cancer Estradiol Estrogen-sensitive Fertility preservation Ovarian hyperstimulation syndrome |
| url | http://www.sciencedirect.com/science/article/pii/S1028455923000323 |
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