Abstract
PurposeTo determine the factors that affect oocyte extraction efficiency when using the “combined procedure”. In the present “combined procedure” ovarian tissue cryopreservation and oocyte extraction from an isolated ovary, later used in In Vitro Maturation (IVM), are performed concurrently.MethodsData were analyzed retrospectively and obtained from the clinical records of 27 young breast cancer patients referred for fertility preservation.ResultsThe patients’ mean age was 33.7 (±3.8) years, mean serum anti-Müllerian hormone (AMH) concentration was 3.5 (±2.1) ng/ml, and mean number of extracted oocytes was 8.3 (±6.1). The phase of menstruation (follicular or luteal) did not affect either the number of oocytes extracted (P = 0.99) nor oocyte survival or maturation rates. Likewise, the number of oocytes that could be extracted was not affected by the type of laparoscopic procedure (multiple-port or single-incision laparoscopy; P = 0.94) or the molecular subtype of breast cancer (either Luminal A or B; P = 0.52). Analysis revealed that the number of extracted oocytes was well-correlated with the patient’s AMH serum level and age (coefficient of correlation: 0.60 and −0.48, respectively).ConclusionWe conclude that the outcome of the “combined procedure” primarily depends upon the patient’s serum AMH level and age. Importantly, the “combined procedure” may be used during any phase of the menstrual cycle to preserve the fertility of breast cancer patients.
Highlights
The number of young breast cancer patients who desire to bear children has increased in Japan [1]
We conclude that the outcome of the “combined procedure” primarily depends upon the patient’s serum anti-Müllerian hormone (AMH) level and age
The “combined procedure” may be used during any phase of the menstrual cycle to preserve the fertility of breast cancer patients
Summary
The number of young breast cancer patients who desire to bear children has increased in Japan [1]. Chemotherapy for the treatment of breast cancer may induce amenorrhea or premature ovarian failure (POF) [2]. In breast cancer patients aged >40 years, the front line chemotherapy regimen AC or AC-T (anthracycline and cyclophosphamide, and taxane) could decrease ovarian reserve. CMF (cyclophosphamide and methotrexate and 5-FU) is not first line treatment, it could induce POF for more than half of breast cancer patients aged 30–39 years. Of the 242 breast cancer patients who were administered AC or trastuzumab and paclitaxel, paclitaxel did not increase the risk of amenorrhea [3]. The increased risk of POF caused by taxane has been considered [4]
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