Abstract
The preservation of fertility in women of childbearing age with breast cancer is challenging because the time for ovarian stimulation is restricted and only a limited number of oocytes can be retrieved before gonadotoxic therapies. The aim of this meta-analysis was to evaluate the fertility preservation outcomes after ovarian stimulation with various protocols in women with breast cancer. PubMed, Embase and the Cochrane Library were searched. Twenty-two studies comparing the outcomes of women with breast cancer receiving random-start ovarian stimulation or conventional protocol; single or double ovarian stimulation cycles; and coadministration of aromatase inhibitors or tamoxifen were included. Random-start ovarian stimulation resulted in a comparable number of retrieved oocytes to the conventional protocol. Two ovarian stimulation cycles had significantly higher numbers of total retrieved oocytes than one cycle (mean difference 7.91, 95% confidence interval [CI] 3.42 to 12.40). Coadministration of letrozole and tamoxifen showed similar results for retrieved oocytes to those without. A significantly lower peak serum oestradiol concentration was observed in letrozole-based groups than in letrozole-free groups (mean difference −1.22; 95% CI −1.42 to −1.02). In conclusion, this study indicated that implementing random-start protocols to shorten the duration of waiting for ovarian stimulation, applying two ovarian stimulation cycles, and coadministration of letrozole can lead to more desirable outcomes.
Original language | English |
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Pages (from-to) | 357-369 |
Number of pages | 13 |
Journal | Reproductive BioMedicine Online |
Volume | 44 |
Issue number | 2 |
DOIs | |
Publication status | Published - Feb 2022 |
Keywords
- Aromatase inhibitor
- Breast cancer
- Fertility preservation
- Meta-analysis
- Ovarian stimulation
ASJC Scopus subject areas
- Reproductive Medicine
- Obstetrics and Gynaecology
- Developmental Biology