Experience in random-start ovarian stimulation for preserving reproductive material of cancer patients


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Abstract

Aim. To compare the effectiveness of ovarian stimulation during the luteal and follicular phases in patients referred by an oncologist for retrieval and cryopreservation of reproductive material. Materials and methods. Patients requiring gonadotoxic treatment for cancer underwent ovarian stimulation according to the standard protocol with the gonadotrophin-releasing hormone (GnRH) antagonist in the follicular phase (FF) and random-start protocol in the luteal phase (LF). The comparative analysis included daily and total gonadotropin doses, duration of stimulation, outcomes of stimulation (number of mature oocytes), and features of steroidogenesis dynamics. Results. All patients included in the study were comparable in age and serum levels of anti-Mtillerian hormone (AMH). The mean age of women in groups 1 and 2 was 33.38 (3.73) and 33.3 (5.47) years, respectively. There was no statistically significant difference in the daily and total gonadotropin doses between the two groups. The findings of this study demonstrated that the administration of exogenous gonadotropins in LF induced follicular growth leading to comparable results in the number of obtained and mature oocytes. Conclusion. The findings of the present study showed the feasibility of ovarian stimulation in any phase of the menstrual cycle. This opportunity is essentialfor cancer patients given the limited time frame in which reproductive material must be obtained before gonadotoxic therapy can begin. Further, more extensive studies are needed to investigate folliculogenesis providing ovarian stimulation in any phase of the menstrual cycle.

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About the authors

T. A Nazarenko

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: t.nazarenko@mail.ru
Dr.Med.Sci., Professor, Head of the Institute of Reproductive Medicine 4, Oparina str., Moscow, 117997, Russian Federation

Ya. O Martirosyan

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia; I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia

Email: marti-yana@index.ru
Clinical Resident at the Department of Obstetrics, Gynecology, Perinatology and Reproductive Medicine of the Medical Faculty 4, Oparina str., Moscow, 117997, Russian Federation

A. M Biryukova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: alma21@list.ru
Ph.D., Clinical Care Supervisor at the F. Paulsen Research and Educational Center for ART with the Clinical Department 4, Oparina str., Moscow, 117997, Russian Federation

L. G Dzhanashvili

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: lana.janashvili@gmail.com
Ph.D. Student Oparina str., Moscow, 117997, Russian Federation

T. Yu Ivanets

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: t_ivanets@oparina4.ru
Dr.Med.Sci., Head of the Clinical Diagnostic Laboratory 4, Oparina str., Moscow, 117997, Russian Federation

Yu. V Sukhova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: jbezzubenko@mail.ru
MD, Clinical Pathologist at the Clinical Diagnostic Laboratory 4, Oparina str., Moscow, 117997, Russian Federation

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