Priming Before In Vitro Maturation Cycles in Cancer Patients Undergoing Urgent Fertility Preservation: a Randomized Cont
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REPRODUCTIVE ENDOCRINOLOGY: ORIGINAL ARTICLE
Priming Before In Vitro Maturation Cycles in Cancer Patients Undergoing Urgent Fertility Preservation: a Randomized Controlled Study Charlotte Sonigo 1,2 & Grégoire Le Conte 1 & Marouane Boubaya 3 & Haykanush Ohanyan 3 & Marion Pressé 1 & Hady El Hachem 4 & Isabelle Cedrin-Durnerin 5 & Alexandra Benoit 1 & Christophe Sifer 6 & Nathalie Sermondade 6 & Michaël Grynberg 1,4,7 Received: 24 March 2020 / Revised: 9 May 2020 / Accepted: 22 June 2020 # Society for Reproductive Investigation 2020
Abstract In vitro maturation (IVM) of oocytes retrieved at germinal vesicle stage, followed by vitrification of mature oocytes, has emerged as a fertility preservation (FP) option. This technique was first developed for patients with polycystic ovarian syndrome. In this population, providing LH activity prior to oocyte collection has been associated with better IVM outcomes. However, the benefit of this treatment in normo-ovulatory breast cancer (BC) patients undergoing IVM for FP purpose has never been investigated. To assess if the absence of therapeutic intervention prior to oocyte retrieval for IVM modifies IVM outcomes in BC patients undergoing urgent FP, we performed a noninferiority, randomized controlled trial. The main outcome was the total number of mature oocytes obtained and cryopreserved after IVM. A total of 172 normo-ovulatory women, suffering from BC, 18 to 39 years of age received no injection or a subcutaneous injection of hCG or GnRH agonist (GnRHa) 36 h before oocytes retrieval according to randomized allocation. The total number of cryopreserved oocytes were 5.1 ± 3.8, 5.4 ± 3.8, and 6.0 ± 4.2 oocytes, respectively in the without, hCG and GnRHa groups. Mean differences were not significant between the three groups (− 0.5; CI 97.5% [− 2.03:1.02] and − 0.22; CI 97.5% [− 1.75:1.32], respectively). Intention to treat analyses failed to show non-inferiority in the “without injection group” in comparison with hCG or GnRHa groups. Our results are not conclusive enough to modify our practices and to stop administering hCG or GnRHa before IVM cycles for FP. The study was retrospectively registered to clinical trial (ID NCT03954197) in May 2019. Keywords Fertility preservation . In vitro maturation . Priming . GnRH agonists . hCG
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s43032-020-00244-0) contains supplementary material, which is available to authorized users. * Michaël Grynberg [email protected] 1
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Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Université Paris saclay, Assistance Publique - Hôpitaux de Paris, 92140 Clamart, France Inserm, UMR-S 1185 physiologie et physiopathologie endocrienne, Université Paris Saclay, Le Kremlin Bicêtre, France Clinical Research Unit and Clinical Research Center, Avicenne Hospital, APHP, Bobigny, France
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Department of Reproductive Medicine, Ovo Clinic, Montreal, Quebec, Canada; Department of Obstetrics and Gynecology, University
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