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Journal of Assisted Reproduction and Genetics

, Volume 27, Issue 8, pp 491–494 | Cite as

Ovarian stimulation during the luteal phase for fertility preservation of cancer patients: case reports and review of the literature

  • Giuliano M. Bedoschi
  • Felipe Oliveira de Albuquerque
  • Rui Alberto Ferriani
  • Paula Andrea Navarro
fertility preservation

Abstract

Purpose

To report the case of a patient with a diagnosis of infiltrative ductal carcinoma of the breast (case 1) and of a patient with Hodgkin’s lymphoma (case 2), both submitted to ovarian stimulation during the luteal phase of the menstrual cycle in order to cryopreserve embryos and oocytes, respectively, in view of the need to start chemotherapy within a maximum of three weeks.

Methods

Case reports

Results

Both patients were submitted to ovarian stimulation with recombinant follicle stimulating hormone together with pituitary blockade with a GnRH antagonist during the luteal phase of the cycle. Oocyte retrieval was performed nine days after the beginning of ovarian stimulation, with 12 mature oocytes being obtained in both cases. In case 1, all mature oocytes were submitted to ICSI, with fertilization and cleavage rates of 83.3% and 70%, respectively, and with the formation of seven good quality embryos. In case 2, all of mature oocytes were cryopreserved.

Conclusions

These cases demonstrate that it is possible to obtain mature oocytes when ovarian stimulation is started in the luteal phase in situations in which there is not sufficient time for conventional stimulation.

Keywords

Preservation of fertility Ovarian stimulation Luteal phase GnRH antagonist Mature oocytes 

References

  1. 1.
    Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA Cancer J Clin. 2009;59:225–49.CrossRefPubMedGoogle Scholar
  2. 2.
    Sonmezer M, Oktay K. Fertility preservation in female patients. Hum Reprod Update. 2004;10:251–66.CrossRefPubMedGoogle Scholar
  3. 3.
    Elizur SE, Chian RC. Fertility preservation treatment for young women with autoimmune diseases facing treatment with gonadotoxic agents. Rheumatology. 2008;47:1506–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Seli E, Tangir J. Fertility preservation options for female patients with malignancies. Curr Opin Obstet Gynecol. 2005;17:299–308.CrossRefPubMedGoogle Scholar
  5. 5.
    Partridge A, Gelber S. Age of menopause among women who remain premenopausal following treatment for early breast cancer: long-term results from International Breast Cancer Study Group Trials V and VI. Eur J Cancer. 2007;43:1646–53.CrossRefPubMedGoogle Scholar
  6. 6.
    Lee SJ, Schover LR. American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J Clin Oncol. 2006;24:2917–31.CrossRefPubMedGoogle Scholar
  7. 7.
    Oktay K, Tilly J. Livebirth after cryopreserved ovarian tissue autotransplantation. Lancet. 2004;364:2091–2. author reply 2092-3.CrossRefPubMedGoogle Scholar
  8. 8.
    Chian RC, Buckett WM. Prospective randomized study of human chorionic gonadotrophin priming before immature oocyte retrieval from unstimulated women with polycystic ovarian syndrome. Hum Reprod. 2000;15:165–70.CrossRefPubMedGoogle Scholar
  9. 9.
    Anderson RA, Kinniburgh D. Preliminary experience of the use of a gonadotrophin-releasing hormone antagonist in ovulation induction/in-vitro fertilization prior to cancer treatment. Hum Reprod. 1999;14:2665–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Sherman BM, Korenman SG. Hormonal characteristics of the human menstrual cycle throughout reproductive life. Int J Fertil. 1967;12:77.Google Scholar
  11. 11.
    Pache T, Wladimiroff J, DeJong F, Hop W, Fauser B. Growth patterns of nondominant ovarian follicles during the normal menstrual cycle. Fertil Steril. 1990;54:338–42.Google Scholar
  12. 12.
    Hodgen G. The dominant ovarian follicle. Fertil Steril. 1982;38:281–300.PubMedGoogle Scholar
  13. 13.
    Baerwald AR, Adams GP, Pierson RA. Characterization of ovarian follicular wave dynamics in women. Biol Reprod. 2003;69:1023–31.CrossRefPubMedGoogle Scholar
  14. 14.
    McNatty KP, Hillier SG, Boogaard AMVD, Trimbos-Kemper TC, Reichert LK, Hall EVV. Follicular development during the luteal phase of the human menstrual cycle. J Clin Endocrinol Metab. 1983;56:1022–31.CrossRefPubMedGoogle Scholar
  15. 15.
    Dolmans MM, Demylle D, Martinez-Madrid B, Donnez J. Efficacy of in vitro fertilization after chemotherapy. Fertil Steril. 2005; 883–897.Google Scholar
  16. 16.
    Grifo JA, Noyes N. Delivery rate using cryopreserved oocytes is comparable to conventional in vitro fertilization using fresh oocytes: potential fertility preservation for female cancer patients. Fertil Steril. 2010;93:391–6.CrossRefPubMedGoogle Scholar
  17. 17.
    Cobo A, Kuwayama M, Perez S, Ruiz A, Pellicer A, Remohi J. Comparison of concomitant outcome achieved with fresh and cryopreserved donor oocytes vitrified by the CryoTop method. Fertil Steril. 2008;89:1657–64.CrossRefPubMedGoogle Scholar
  18. 18.
    von Wolff M, Thaler CJ, Frambach T, Zeeb C, Lawrenz B, Popovici RM, et al. Ovarian stimulation to cryopreserve fertilized oocytes in cancer patients can be started in the luteal phase. Fertil Steril. 2009;92:1360–5.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Giuliano M. Bedoschi
    • 1
  • Felipe Oliveira de Albuquerque
    • 1
  • Rui Alberto Ferriani
    • 1
    • 2
  • Paula Andrea Navarro
    • 1
    • 2
  1. 1.Department of Gynecology and Obstetrics, University HospitalFaculty of Medicine of Ribeirão Preto, USPRibeirão PretoBrazil
  2. 2.National Institute of Hormones and Women’s Health, CNPqRibeirão PretoBrazil

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