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Controlled Ovarian Stimulation Protocols in Cancer Patients

  • Hakan CakmakEmail author
  • Mitchell P. Rosen
Chapter
  • 579 Downloads

Abstract

Embryo/oocyte cryopreservation is an effective method for fertility preservation in cancer patients. Determination of the controlled ovarian stimulation protocol and gonadotropin dose for oocyte/embryo cryopreservation requires an individualized assessment. Maximizing the number of embryos and oocytes cryopreserved during a fertility preservation cycle without causing ovarian hyperstimulation syndrome is extremely important, because the most of the patients have a single cycle opportunity due to time constraints before starting their oncologic treatment. In emergent settings, random-start ovarian stimulation is emerging as a new technique for the purpose of fertility preservation without compromising oocyte yield and maturity. Ovarian stimulation with tamoxifen or letrozole is highly recommended in patients with estrogen-sensitive cancers undergoing fertility preservation. While only a minority of the cancer patients has undergone thawing and embryo transfer, recent data of these modified protocols in egg donors and infertile patients have suggested that pregnancy outcomes are similar to those of conventional protocols.

Keywords

Cancer Controlled ovarian stimulation Random-start ovarian stimulation Fertility preservation Oocyte/embryo cryopreservation 

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Copyright information

© Springer Japan 2016

Authors and Affiliations

  1. 1.Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology, and Reproductive SciencesUniversity of California San FranciscoSan FranciscoUSA

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