P-222: Ovarian Stimulation for Fertility Preservation in Cancer Patients: A Prospective Study

Background: To determine whether random-start controlled ovarian stimulation (COS), in which a stimulation is performed regardless to day of patient’s menstrual cycle, has similar outcomes in comparison to conventional early follicular phase-start COS for cryopreservation of fertilized oocytes in cancer patients. Materials and Methods: This prospective study was performed at two infertility centesr; Vali-e-Asr reproductive health research center (a tertiary referral university hospital) and Shayanmehr private clinic from January 2011 to February 2014. The Institutional Review Board and Ethical Committee of Tehran medical sciences university approved this study. All patients were recently diagnosed with cancer and were chosen for chemotherapy/radiotherapy or bilateral oopherectomy. All the patients were evaluated for fertility preservation within 48 hours. Time frame until the initiation of cancer treatment was at least 2 weeks. All participants received COS cycles using GnRh antagonist for pituitary suppression. The decision to perform with a conventional- versus a random-start COS was elected by the patients’ menstrual cycle on presentation. Primary outcome was total number of Metaphase II (MII) oocytes. Secondary outcomes were dosage of gonadotropins, number of days for ovarian stimulation, oocyte maturity rate (MII oocytes/total oocytes), and fertilization rate. Results: During the study, 10 patients with ovarian tumor, 3 patients with uterine and one with breast cancer referred to study centers for fertility preservation. Seven patients underwent conventionalstart and seven with random-start COS. The number of total and MII oocytes retrieved, and fertilization rates were similar between groups. No differences were observed in total dose of gonadotropins (P=0.9) and the duration of stimilation (p=0.3) between two groups Conclusion: This pilot study presented that oocytes can be obtained before cancer therapy efficiently by random-start COS and this method could reduce delays and provide this opportunity for more patients to perform fertility preservation and still continue with cancer treatment within 2-3.