Volodarsky-Perel A, Tulandi T, Son WY, Khojah M, Buckett W. Impact of extent and biochemical parameters of lymphoma on fertility preservation outcome.
Fertil Steril 2020;
113:400-407.e1. [PMID:
32106993 DOI:
10.1016/j.fertnstert.2019.09.033]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/09/2019] [Accepted: 09/21/2019] [Indexed: 10/24/2022]
Abstract
OBJECTIVE
To evaluate the impact of lymphoma aggressiveness on ovarian response during fertility preservation treatment.
DESIGN
Retrospective cohort study.
SETTING
University-affiliated tertiary hospital.
PATIENT(S)
Women with lymphoma who underwent ovarian stimulation for fertility preservation in the period from 2009 to 2018.
INTERVENTION(S)
None.
MAIN OUTCOME MEASURE(S)
Primary outcome: the number of mature oocytes; secondary outcomes: the number of retrieved oocytes, estradiol level, and number of follicles >14 mm on the day of oocyte maturation trigger.
RESULT(S)
Patients with stage I-II lymphoid neoplasms (localized disease) were compared with those with stage III-IV lymphomas (advanced disease). Women with favorable levels of biochemical prognostic markers were also compared with those with unfavorable levels. Women with favorable levels of biochemical prognostic markers (n = 74) had a higher number of mature oocytes compared with patients with unfavorable serum levels (n = 67): 11 (7.8-16) versus 9 (5-11), respectively. The number of mature oocytes was similar between patients with localized (n = 75) and advanced (n = 66) lymphomas. Women with unfavorable combination of stage and biochemical factors had lower number of mature oocytes compared to patients with favorable combination: 8 (5-10) versus 11 (7-16), respectively. Multivariate logistic regression showed that favorable levels of biochemical markers as well as a combination of extent and biochemical parameters were statistically significantly associated with the result of over 10 mature oocytes.
CONCLUSION(S)
Highly-aggressive lymphoid neoplasms have a negative impact on ovarian function and response during fertility preservation treatment.
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