The impact of malignancy on response to ovarian stimulation for fertility preservation: a meta-analysis

Objective: To evaluate the impact of cancer diagnosis on response to ovarian stimulation for fertility preservation. Design: Meta-analysis. Setting: Not applicable. Patient(s): An electronic-based search was performed with the use of PubMed until May 2018 limited to English-language articles. In the final analysis, 10 case-controlled retrospective cohort studies were included, comparing ovarian response to stimulation between women with cancer and age-matched healthy women (control group). Intervention(s): None. Main outcome measure(s): Number of total oocytes retrieved, number of mature oocytes, fertilization rate and two pronuclei embryos obtained. Result(s): Ten studies that included a total of 713 women with cancer were analyzed in the cancer group (722 cycles), and 1,830 healthy women (1,835 cycles) qualified as controls for the meta-analysis. The pooled results showed no impact of cancer diagnosis on the mean number of total oocytes (P=.517; 95% CI -0.23 to 0.12), mature oocytes (P=.104; 95% CI -0.23 to 0.01), and two pronuclei embryos (P=.136; 95% CI -0.32 to 0.04) and fertilization rates (P=.273; 95% CI -0.29 to 0.183). When the analysis was limited to women with breast cancer diagnosis, there was also no difference in the mean number of total oocytes (P=.812; 95% CI -0.28 to 0.36) and mature oocytes (P=.993; 95% CI -0.16 to 0.16) between the two groups. Conclusion(s): This meta-analysis indicates that cancer diagnosis is not associated with reduced response to ovarian stimulation. (C) 2018 by American Society for Reproductive Medicine. El resumen esta disponible en Espanol al final del articulo.