Is letrozole during ovarian stimulation useful in breast cancer patients undergoing fertility preservation to reduce early luteal progesterone levels following GnRH-agonist trigger?
Abstract Background In absence of contraindication, breast cancer patients of reproductive age can undergo fertility preservation with controlled ovarian stimulation for oocyte/embryo cryopreservation before the administration of potentially gonadotoxic treatments. High hormonal levels induced by ov...
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | Reproductive Biology and Endocrinology |
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| Online Access: | https://doi.org/10.1186/s12958-022-00958-7 |
| _version_ | 1818253025586708480 |
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| author | Imane Lalami Julie Labrosse Isabelle Cedrin-Durnerin Marjorie Comtet Claire Vinolas Fabien Krief Christophe Sifer Maeliss Peigne Michael Grynberg |
| author_facet | Imane Lalami Julie Labrosse Isabelle Cedrin-Durnerin Marjorie Comtet Claire Vinolas Fabien Krief Christophe Sifer Maeliss Peigne Michael Grynberg |
| author_sort | Imane Lalami |
| collection | DOAJ |
| description | Abstract Background In absence of contraindication, breast cancer patients of reproductive age can undergo fertility preservation with controlled ovarian stimulation for oocyte/embryo cryopreservation before the administration of potentially gonadotoxic treatments. High hormonal levels induced by ovarian stimulation might have an adverse impact on hormone-positive breast cancer. Whether letrozole supplementation during ovarian stimulation (COSTLES) reduces serum progesterone levels after GnRHa trigger remains unknown. We aimed to determine whether COSTLES might be useful for breast cancer patients undergoing fertility preservation to reduce early luteal progesterone levels following GnRH-agonist (GnRHa)trigger. Methods All women who underwent COS with GnRH antagonist protocol with GnRHa trigger were included. Serum progesterone level measured 12 h after GnRHa trigger was compared between patients undergoing COS with letrozole supplementation (COSTLES group) and patients undergoing COS without letrozole (Control group) for fertility preservation purposes. Results A total of 246 patients were included, of which 84 patients (34.1%) in the COSTLES group and 162 patients (65.6%) in the Control group. All patients in the COSTLES group were BC patients (n = 84, 100%), while the Control group included 77 BC patients (47.5%). Patients in the two groups were comparable. The mean number of oocytes recovered and vitrified at metaphase 2 stage did not significantly differ between the two groups. Serum progesterone levels on the day after GnRHa trigger were significantly lower in the COSTLES group (8.6 ± 0.7 vs. 10.5 ± 0.5 ng/mL, respectively, p < 0.03), as well as serum E2 levels (650.3 ± 57.7 vs. 2451.4.0 ± 144.0 pg/mL, respectively, p < 0.01). However, the GnRHa-induced LH surge was significantly higher in in the COSTLES group (71.9 ± 4.6 vs. 51.2 ± 2.6 UI/L, respectively, p < 0.01). Conclusions Our results show that COSTLES for fertility preservation in breast cancer patients using GnRHa trigger reduces serum progesterone levels compared to ovarian stimulation without letrozole. These findings encourage the use of COSTLES in this context to decrease the potential deleterious effect of elevated hormonal levels on hormone-positive breast cancer. |
| first_indexed | 2024-12-12T16:33:31Z |
| format | Article |
| id | doaj.art-9bd752466eac47afa858bbcfc2173c93 |
| institution | Directory Open Access Journal |
| issn | 1477-7827 |
| language | English |
| last_indexed | 2024-12-12T16:33:31Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
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| series | Reproductive Biology and Endocrinology |
| spelling | doaj.art-9bd752466eac47afa858bbcfc2173c932022-12-22T00:18:44ZengBMCReproductive Biology and Endocrinology1477-78272022-06-012011810.1186/s12958-022-00958-7Is letrozole during ovarian stimulation useful in breast cancer patients undergoing fertility preservation to reduce early luteal progesterone levels following GnRH-agonist trigger?Imane Lalami0Julie Labrosse1Isabelle Cedrin-Durnerin2Marjorie Comtet3Claire Vinolas4Fabien Krief5Christophe Sifer6Maeliss Peigne7Michael Grynberg8Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean VerdierDepartment of Reproductive Medicine and Fertility Preservation, Hôpital Jean VerdierDepartment of Reproductive Medicine and Fertility Preservation, Hôpital Jean VerdierDepartment of Reproductive Medicine and Fertility Preservation, Hôpital Jean VerdierDepartment of Reproductive Medicine and Fertility Preservation, Hôpital Jean VerdierDepartment of Reproductive Medicine and Fertility Preservation, Hôpital Jean VerdierDepartment of Cytogenetic and Reproductive Biology, Hôpital Jean VerdierDepartment of Reproductive Medicine and Fertility Preservation, Hôpital Jean VerdierDepartment of Reproductive Medicine and Fertility Preservation, Hôpital Jean VerdierAbstract Background In absence of contraindication, breast cancer patients of reproductive age can undergo fertility preservation with controlled ovarian stimulation for oocyte/embryo cryopreservation before the administration of potentially gonadotoxic treatments. High hormonal levels induced by ovarian stimulation might have an adverse impact on hormone-positive breast cancer. Whether letrozole supplementation during ovarian stimulation (COSTLES) reduces serum progesterone levels after GnRHa trigger remains unknown. We aimed to determine whether COSTLES might be useful for breast cancer patients undergoing fertility preservation to reduce early luteal progesterone levels following GnRH-agonist (GnRHa)trigger. Methods All women who underwent COS with GnRH antagonist protocol with GnRHa trigger were included. Serum progesterone level measured 12 h after GnRHa trigger was compared between patients undergoing COS with letrozole supplementation (COSTLES group) and patients undergoing COS without letrozole (Control group) for fertility preservation purposes. Results A total of 246 patients were included, of which 84 patients (34.1%) in the COSTLES group and 162 patients (65.6%) in the Control group. All patients in the COSTLES group were BC patients (n = 84, 100%), while the Control group included 77 BC patients (47.5%). Patients in the two groups were comparable. The mean number of oocytes recovered and vitrified at metaphase 2 stage did not significantly differ between the two groups. Serum progesterone levels on the day after GnRHa trigger were significantly lower in the COSTLES group (8.6 ± 0.7 vs. 10.5 ± 0.5 ng/mL, respectively, p < 0.03), as well as serum E2 levels (650.3 ± 57.7 vs. 2451.4.0 ± 144.0 pg/mL, respectively, p < 0.01). However, the GnRHa-induced LH surge was significantly higher in in the COSTLES group (71.9 ± 4.6 vs. 51.2 ± 2.6 UI/L, respectively, p < 0.01). Conclusions Our results show that COSTLES for fertility preservation in breast cancer patients using GnRHa trigger reduces serum progesterone levels compared to ovarian stimulation without letrozole. These findings encourage the use of COSTLES in this context to decrease the potential deleterious effect of elevated hormonal levels on hormone-positive breast cancer.https://doi.org/10.1186/s12958-022-00958-7Ovarian stimulationProgesteroneCryopreservationEstrogenLuteal phaseLuteinizing hormone |
| spellingShingle | Imane Lalami Julie Labrosse Isabelle Cedrin-Durnerin Marjorie Comtet Claire Vinolas Fabien Krief Christophe Sifer Maeliss Peigne Michael Grynberg Is letrozole during ovarian stimulation useful in breast cancer patients undergoing fertility preservation to reduce early luteal progesterone levels following GnRH-agonist trigger? Reproductive Biology and Endocrinology Ovarian stimulation Progesterone Cryopreservation Estrogen Luteal phase Luteinizing hormone |
| title | Is letrozole during ovarian stimulation useful in breast cancer patients undergoing fertility preservation to reduce early luteal progesterone levels following GnRH-agonist trigger? |
| title_full | Is letrozole during ovarian stimulation useful in breast cancer patients undergoing fertility preservation to reduce early luteal progesterone levels following GnRH-agonist trigger? |
| title_fullStr | Is letrozole during ovarian stimulation useful in breast cancer patients undergoing fertility preservation to reduce early luteal progesterone levels following GnRH-agonist trigger? |
| title_full_unstemmed | Is letrozole during ovarian stimulation useful in breast cancer patients undergoing fertility preservation to reduce early luteal progesterone levels following GnRH-agonist trigger? |
| title_short | Is letrozole during ovarian stimulation useful in breast cancer patients undergoing fertility preservation to reduce early luteal progesterone levels following GnRH-agonist trigger? |
| title_sort | is letrozole during ovarian stimulation useful in breast cancer patients undergoing fertility preservation to reduce early luteal progesterone levels following gnrh agonist trigger |
| topic | Ovarian stimulation Progesterone Cryopreservation Estrogen Luteal phase Luteinizing hormone |
| url | https://doi.org/10.1186/s12958-022-00958-7 |
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