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Fertility preservation for women with breast cancer before chemotherapy: a systematic review and meta-analysis
- Source :
- Reproductive BioMedicine Online. 44:357-369
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
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.
- Subjects :
- Oncology
medicine.medical_specialty
medicine.drug_class
media_common.quotation_subject
Breast Neoplasms
Fertility
Stimulation
Breast cancer
Ovulation Induction
Internal medicine
Humans
Medicine
Fertility preservation
Aromatase
media_common
Cryopreservation
Aromatase inhibitor
biology
business.industry
Letrozole
Fertility Preservation
Obstetrics and Gynecology
medicine.disease
Tamoxifen
Reproductive Medicine
Oocytes
biology.protein
Female
business
Developmental Biology
medicine.drug
Subjects
Details
- ISSN :
- 14726483
- Volume :
- 44
- Database :
- OpenAIRE
- Journal :
- Reproductive BioMedicine Online
- Accession number :
- edsair.doi.dedup.....68b9ca3a83fcfafd2665f85768d7e8fc