Search

Purpose: To investigate the interrelation between serum E2 level on hCG day, score of transferred embryos and pregnancy achievement. Methods: Records of 350 women aged 18-40 years who underwent ovarian hyperstimulation in fresh cycles down regulated either with GnRH agonist ( n = 70) or GnRH antagonist ( n = 280) followed by oocyte pick-up, ICSI and embryo transfer are retrospectively analyzed. Results: Median E2 levels on hCG day of cycles ending with and without pregnancy were similar ( p = 0.308). ROC curve for AUC of E2 on hCG day with dependent variable pregnancy rate also demonstrated that the E2 level on hCG day cannot be used to predict pregnancy in IVF/ICSI cycles (AUC 0.532, 95 % confidence interval: 0.471-0.593). Grouping cycles according to their E2 levels on hCG day also did not demonstrate any detrimental effect of either low or high E2 levels on hCG day both in agonist and antagonist cycles. Pregnancy rates are strongly correlated with mean and total score of transferred embryos. Interrelation of E2 on hCG day and pregnancy rate is independent from score of transferred embryos. Conclusions: E2 on hCG day is not correlated with pregnancy rates and cannot be used to predict pregnancy in neither agonist nor antagonist cycles, no matter its level or percentile is used. [ABSTRACT FROM AUTHOR]

Purpose(s): To evaluate results of neoadjuvant chemotherapy (NACT) following debulking surgery in patients with extensive metastatic disease and/or poor medical performance Method(s): Advanced stage epithelial ovarian cancer patients were treated with either NACT followed by debulking surgery or primary surgery followed by adjuvant chemotherapy after assessment of the extent of disease by laparoscopy or laparotomy. Results: Out of 297, 223 patients were in the primary surgery group, whereas 74 of them met NACT criteria. Optimal cytoreduction rates were 63.2 % in primary surgery group and 60.8 % in NACT group, respectively ( p: 0.709). In the primary surgery group, the overall survival was significantly higher ( p: 0.002). Mean patient age was more advanced ( p: 0.014) and the performance status of patients was poorer ( p < 0.001) in NACT group. Only patient group (primary surgery or neoadjuvant chemotherapy) ( p: 0.001) retained significance as predictors of survival in multivariate analyses. Conclusion(s): Improved rate of optimal cytoreduction with NACT in advanced ovarian cancer patients does not prolong survival. The extent of disease at diagnosis is the primary determinant of survival. Randomizing patients with equally extensive disease and performance status to either NACT or primary debulking surgery in a future study will better clarify benefits attributed to NACT. [ABSTRACT FROM AUTHOR]