Random start ovarian stimulation before gonadotoxic therapies in women with cancer: a systematic review and meta-analysis
The aim of this systematic review and meta-analysis was to quantify the effect of random start ovarian stimulation (RSOS) compared with conventional start ovarian stimulation (CSOS) in cancer patients before gonadotoxic treatment. The final analytical cohort encompassed 688 RSOS and 1076 CSOS cycles...
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| Veröffentlicht in: | Reproductive biomedicine online 2023-12, Vol.47 (6), p.103337, Article 103337 |
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| creator | Sönmezer, Murat Şükür, Yavuz Emre Ateş, Can Saçıntı, Koray Görkem Sönmezer, Meltem Aslan, Batuhan Atabekoğlu, Cem Somer Özmen, Batuhan Oktay, Kutluk H. |
| description | The aim of this systematic review and meta-analysis was to quantify the effect of random start ovarian stimulation (RSOS) compared with conventional start ovarian stimulation (CSOS) in cancer patients before gonadotoxic treatment. The final analytical cohort encompassed 688 RSOS and 1076 CSOS cycles of cancer patients before gonadotoxic treatment. Eleven studies were identified by database searches of MEDLINE, Cochrane Library and cited references. The primary outcomes of interest were the number of oocytes and mature oocytes collected, the number of embryos cryopreserved and the metaphase II (MII)–antral follicle count (AFC) ratio. The studies were rated from medium to high quality (from 6 to 9) according to the Newcastle–Ottawa Quality Assessment Scale. The two protocols resulted in similar numbers of oocytes collected, MII oocytes, embryos available for cryopreservation and comparable MII–AFC and fertilization rates. The duration of ovarian stimulation was longer (standardized mean difference [SMD] 0.35, 95% CI 0.09 to 0.61; P = 0.009) and gonadotrophin consumption was higher (SMD 0.23, 95% CI 0.06 to 0.40; P = 0.009) in RSOS compared with CSOS. This systematic review and meta-analysis show that the duration of stimulation is longer, and the total gonadotrophin consumption is higher in cancer patients undergoing RSOS compared with those undergoing CSOS, with no significant effect on mature oocyte yield. |
| doi_str_mv | 10.1016/j.rbmo.2023.103337 |
| format | Article |
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The final analytical cohort encompassed 688 RSOS and 1076 CSOS cycles of cancer patients before gonadotoxic treatment. Eleven studies were identified by database searches of MEDLINE, Cochrane Library and cited references. The primary outcomes of interest were the number of oocytes and mature oocytes collected, the number of embryos cryopreserved and the metaphase II (MII)–antral follicle count (AFC) ratio. The studies were rated from medium to high quality (from 6 to 9) according to the Newcastle–Ottawa Quality Assessment Scale. The two protocols resulted in similar numbers of oocytes collected, MII oocytes, embryos available for cryopreservation and comparable MII–AFC and fertilization rates. The duration of ovarian stimulation was longer (standardized mean difference [SMD] 0.35, 95% CI 0.09 to 0.61; P = 0.009) and gonadotrophin consumption was higher (SMD 0.23, 95% CI 0.06 to 0.40; P = 0.009) in RSOS compared with CSOS. This systematic review and meta-analysis show that the duration of stimulation is longer, and the total gonadotrophin consumption is higher in cancer patients undergoing RSOS compared with those undergoing CSOS, with no significant effect on mature oocyte yield.</description><identifier>ISSN: 1472-6483</identifier><identifier>ISSN: 1472-6491</identifier><identifier>EISSN: 1472-6491</identifier><identifier>DOI: 10.1016/j.rbmo.2023.103337</identifier><identifier>PMID: 37857156</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Chemotherapy ; Cryopreservation - methods ; Female ; Fertility preservation ; Fertility Preservation - methods ; Gonadotoxic therapies ; Gonadotropins ; Humans ; Neoplasms - therapy ; Oocyte Retrieval - methods ; Oocytes - physiology ; Ovarian stimulation ; Ovulation Induction - methods ; Random start ovarian stimulation ; Retrospective Studies</subject><ispartof>Reproductive biomedicine online, 2023-12, Vol.47 (6), p.103337, Article 103337</ispartof><rights>2023 Reproductive Healthcare Ltd.</rights><rights>Copyright © 2023 Reproductive Healthcare Ltd. 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The final analytical cohort encompassed 688 RSOS and 1076 CSOS cycles of cancer patients before gonadotoxic treatment. Eleven studies were identified by database searches of MEDLINE, Cochrane Library and cited references. The primary outcomes of interest were the number of oocytes and mature oocytes collected, the number of embryos cryopreserved and the metaphase II (MII)–antral follicle count (AFC) ratio. The studies were rated from medium to high quality (from 6 to 9) according to the Newcastle–Ottawa Quality Assessment Scale. The two protocols resulted in similar numbers of oocytes collected, MII oocytes, embryos available for cryopreservation and comparable MII–AFC and fertilization rates. The duration of ovarian stimulation was longer (standardized mean difference [SMD] 0.35, 95% CI 0.09 to 0.61; P = 0.009) and gonadotrophin consumption was higher (SMD 0.23, 95% CI 0.06 to 0.40; P = 0.009) in RSOS compared with CSOS. This systematic review and meta-analysis show that the duration of stimulation is longer, and the total gonadotrophin consumption is higher in cancer patients undergoing RSOS compared with those undergoing CSOS, with no significant effect on mature oocyte yield.</description><subject>Chemotherapy</subject><subject>Cryopreservation - methods</subject><subject>Female</subject><subject>Fertility preservation</subject><subject>Fertility Preservation - methods</subject><subject>Gonadotoxic therapies</subject><subject>Gonadotropins</subject><subject>Humans</subject><subject>Neoplasms - therapy</subject><subject>Oocyte Retrieval - methods</subject><subject>Oocytes - physiology</subject><subject>Ovarian stimulation</subject><subject>Ovulation Induction - methods</subject><subject>Random start ovarian stimulation</subject><subject>Retrospective Studies</subject><issn>1472-6483</issn><issn>1472-6491</issn><issn>1472-6491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1P3DAQhq2qqHy0f6CHykcuWezYibOoF4RaQEJCQnC2Jva4eBXHi-0F9t_Xq6Uce5kvvfOO5iHkO2cLznh_tlqkMcRFy1pRB0II9YkccanappdL_vmjHsQhOc55xRgf2CC-kEOhhk7xrj8i23uYbQw0F0iFxhdIHuba-bCZoPg40xFdTEj_xBlsLPHNG1qeMMHaY6Z-pq8xYI2-PFEDs8F0ToHmbS4YqoGhCV88vtJ6hgYs0MAM0zb7_JUcOJgyfnvPJ-Tx96-Hy-vm9u7q5vLitjGSsdJw6MzIe6W4aZetta6FbpCdcYCi48aybmmEUUxK5qRzchwNk90A0CvHpe3FCTnd-65TfN5gLjr4bHCaYMa4ybodBsYZE0pVabuXmhRzTuj0OvkAaas50zvkeqV3yPUOud4jr0s_3v03Y0D7sfKPcRX83AuwfllZJJ2Nx0rK-oSmaBv9__z_Aj6BlOo</recordid><startdate>202312</startdate><enddate>202312</enddate><creator>Sönmezer, Murat</creator><creator>Şükür, Yavuz Emre</creator><creator>Ateş, Can</creator><creator>Saçıntı, Koray Görkem</creator><creator>Sönmezer, Meltem</creator><creator>Aslan, Batuhan</creator><creator>Atabekoğlu, Cem Somer</creator><creator>Özmen, Batuhan</creator><creator>Oktay, Kutluk H.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202312</creationdate><title>Random start ovarian stimulation before gonadotoxic therapies in women with cancer: a systematic review and meta-analysis</title><author>Sönmezer, Murat ; 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| ispartof | Reproductive biomedicine online, 2023-12, Vol.47 (6), p.103337, Article 103337 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Chemotherapy Cryopreservation - methods Female Fertility preservation Fertility Preservation - methods Gonadotoxic therapies Gonadotropins Humans Neoplasms - therapy Oocyte Retrieval - methods Oocytes - physiology Ovarian stimulation Ovulation Induction - methods Random start ovarian stimulation Retrospective Studies |
| title | Random start ovarian stimulation before gonadotoxic therapies in women with cancer: a systematic review and meta-analysis |
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