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Priming Before In Vitro Maturation Cycles in Cancer Patients Undergoing Urgent Fertility Preservation: a Randomized Controlled Study.
Reprod Sci. 2020 Jul 02 [Online ahead of print]RS

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 non-inferiority, 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.

Authors+Show Affiliations

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.Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Université Paris saclay, Assistance Publique - Hôpitaux de Paris, 92140, Clamart, France.Clinical Research Unit and Clinical Research Center, Avicenne Hospital, APHP, Bobigny, France.Clinical Research Unit and Clinical Research Center, Avicenne Hospital, APHP, Bobigny, France.Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Université Paris saclay, Assistance Publique - Hôpitaux de Paris, 92140, Clamart, France.Department of Reproductive Medicine, Ovo Clinic, Montreal, Quebec, Canada; Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada.Department of Reproductive Medicine & Fertility Preservation, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140, Bondy, France.Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Université Paris saclay, Assistance Publique - Hôpitaux de Paris, 92140, Clamart, France.Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140, Bondy, France.Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140, Bondy, France.Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Université Paris saclay, Assistance Publique - Hôpitaux de Paris, 92140, Clamart, France. michael.grynberg@aphp.fr. Department of Reproductive Medicine, Ovo Clinic, Montreal, Quebec, Canada; Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada. michael.grynberg@aphp.fr. Unité Inserm U1133, Université Paris-Diderot, 75013, Paris, France. michael.grynberg@aphp.fr.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32617881

Citation

Sonigo, Charlotte, et al. "Priming Before in Vitro Maturation Cycles in Cancer Patients Undergoing Urgent Fertility Preservation: a Randomized Controlled Study." Reproductive Sciences (Thousand Oaks, Calif.), 2020.
Sonigo C, Le Conte G, Boubaya M, et al. Priming Before In Vitro Maturation Cycles in Cancer Patients Undergoing Urgent Fertility Preservation: a Randomized Controlled Study. Reprod Sci. 2020.
Sonigo, C., Le Conte, G., Boubaya, M., Ohanyan, H., Pressé, M., El Hachem, H., Cedrin-Durnerin, I., Benoit, A., Sifer, C., Sermondade, N., & Grynberg, M. (2020). Priming Before In Vitro Maturation Cycles in Cancer Patients Undergoing Urgent Fertility Preservation: a Randomized Controlled Study. Reproductive Sciences (Thousand Oaks, Calif.). https://doi.org/10.1007/s43032-020-00244-0
Sonigo C, et al. Priming Before in Vitro Maturation Cycles in Cancer Patients Undergoing Urgent Fertility Preservation: a Randomized Controlled Study. Reprod Sci. 2020 Jul 2; PubMed PMID: 32617881.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Priming Before In Vitro Maturation Cycles in Cancer Patients Undergoing Urgent Fertility Preservation: a Randomized Controlled Study. AU - Sonigo,Charlotte, AU - Le Conte,Grégoire, AU - Boubaya,Marouane, AU - Ohanyan,Haykanush, AU - Pressé,Marion, AU - El Hachem,Hady, AU - Cedrin-Durnerin,Isabelle, AU - Benoit,Alexandra, AU - Sifer,Christophe, AU - Sermondade,Nathalie, AU - Grynberg,Michaël, Y1 - 2020/07/02/ PY - 2020/03/24/received PY - 2020/06/22/accepted PY - 2020/05/09/revised PY - 2020/7/4/entrez PY - 2020/7/4/pubmed PY - 2020/7/4/medline KW - Fertility preservation KW - GnRH agonists KW - In vitro maturation KW - Priming KW - hCG JF - Reproductive sciences (Thousand Oaks, Calif.) JO - Reprod Sci N2 - 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 non-inferiority, 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. SN - 1933-7205 UR - https://www.unboundmedicine.com/medline/citation/32617881/Priming_Before_In_Vitro_Maturation_Cycles_in_Cancer_Patients_Undergoing_Urgent_Fertility_Preservation:_a_Randomized_Controlled_Study L2 - https://journals.sagepub.com/doi/10.1007/s43032-020-00244-0?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -
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