The effect of aromatase inhibitor on controlled ovarian stimulation for oocyte cryopreservation in adolescent and young cancer patients

J Obstet Gynaecol Res. 2023 Mar;49(3):973-979. doi: 10.1111/jog.15535. Epub 2023 Jan 6.

Abstract

Aim: To determine the impact of aromatase inhibitor (AI) use in oocyte cryopreservation among Japanese adolescent and young adult (AYA) cancer patients for fertility preservation, we evaluated the oocyte cryopreservation outcomes following AI therapy in combination with the follicular phase start (FPS) and random start (RS) protocols.

Methods: This retrospective study included 81 cycles of controlled ovarian stimulation (COS) among 73 AYA patients with cancer who underwent oocyte cryopreservation to maintain fertility. The outcome measures were the total number of matured oocytes that were retrieved and cryopreserved, as well as their maturation rates. The AI (+) and AI (-) groups were compared using the RS and FPS protocols.

Results: Our results showed that the combined use of AI and COS decreases serum E2 levels and maintains the number of retrieved and cryopreserved mature oocytes. We also confirmed the efficacy of the RS protocol, which was found to have comparable outcomes to that of the FPS protocol in both AI (+) and AI (-) groups.

Conclusion: The combined use of AI and COS is beneficial for oocyte cryopreservation in patients with estrogen-sensitive cancer, regardless of the menstrual cycle phase of COS initiation.

Keywords: aromatase inhibitors; cryopreservation; fertility preservation; oocytes; random start ovarian stimulation.

MeSH terms

  • Aromatase Inhibitors
  • Cryopreservation
  • Female
  • Fertility Preservation* / methods
  • Humans
  • Neoplasms*
  • Oocyte Retrieval / methods
  • Oocytes
  • Ovulation Induction / methods
  • Retrospective Studies

Substances

  • Aromatase Inhibitors