Comparison between Random Start and Follicular Start Outcomes in Fertility Preservation According to Type of Malignancy

Introduction:
Oocyte and embryo freezing is considered a utile fertility preservation method for oncologic patients. However, conventional stimulation protocols might take 2-4 weeks to be completed, which might not be feasible in patients in need for urgent cancer treatment. Recent studies have highlighted that random start ovarian stimulation can be initiated irrespective of the phase of the menstruation, supported by the occurrence of several follicular waves during the menstruation cycle.

Aim of Study:
Comparison of the number of eggs extracted during fertility preservation cycles by starting time of ovarian stimulation in patients with different types of cancer.

Method:
Retrospective study, collecting data from digital files of female oncologic patients who went through oocyte and embryo cryopreservation cycles, aged 18-41 years, between 2013-2020.Results: We collected data of 189 cycles of 149 oncologic patients. In 90 cycles stimulation start was in the follicular phase and in 99 cycles start was random. We defined the type of cancer and found the following: breast cancer (43.92%), lymphoma (15.87%), brain (0.074%), and others (40.136 %.). We compared number of retrieved oocytes, number of MII and maturation rate, and found no difference according to type of malignancy (Breast, lymphoma and brain malignancy) and timing of stimulation start.

Conclusion:
We found comparable results of retrieved oocytes MII and maturation rate in random start and early follicular start cycle in different types of malignancy, this finding might reassure the clinician to start stimulation as early as possible and save valuable time for oncologic patients despite of malignancy type