Safety and feasibility of performing two consecutive ovarian stimulation cycles with the use of letrozole-gonadotropin protocol for fertility preservation in breast cancer patients

Objective: To investigate the safety and feasibility of performing two consecutive ovarian stimulation cycles with the use of letrozole protocol for fertility preservation in breast cancer patients. Design: Retrospective cohort study. Setting: Academic fertility preservation center. Patient(s): Seventy-eight women <= 45 years, diagnosed with stage <= 3 breast cancer, who desired fertility preservation. Intervention(s): Two consecutive cycles versus a single ovarian stimulation cycle with a letrozole-follicle-stimulating hormone (FSH) protocol. Main Outcome Measure(s): Embryo or oocyte cryopreservation outcomes, time interval from surgery to chemotherapy, and breast cancer recurrence rates. Result(s): Sixty-one patients underwent single-cycle stimulation and 17 received two stimulation cycles. The mean total number of oocytes harvested (16.1 +/- 13.2 vs. 9.1 +/- 5.2) and embryos generated (6.4 +/- 2.9 vs. 3.7 +/- 3.1) were statistically significantly higher in patients who underwent two cycles versus one cycle. The time interval from surgery to chemotherapy was similar between the two-cycle and single-cycle groups (63.7 +/- 7.7 vs. 58.0 +/- 12.1 days). After a mean follow-up interval of 58.5 +/- 13.6 months, the recurrence rates were similar between the two-cycle (0 of 17) and single-cycle (2 of 49) patients. Conclusion(s): It appears to be safe and feasible to perform two consecutive ovarian stimulation cycles to increase the oocyte/embryo yield for fertility preservation. (Fertil Steril (R) 2013;100:1681-5. (C)2013 by American Society for Reproductive Medicine.)