• fertility preservation
• oocyte cryopreservation
• random ovarian stimulation
• University of of Pisa

The study is a retrospective analysis about 21 cancer patients occur to our center, Department of Reproductive Medicine of The University of Pisa, in order to preserve their fertility before cancer treatment. We investigate the use of different stimulation protocol, according to different phases of menstrual cycle and according to cancer disease.
Patients were divided into two group depending on the phase of menstrual cycle, follicular or luteal phase, at the moment of first examination. Standard stimulation protocol with gonadotropins is admistered in the follicular group, whereas in the second group we use GnRH-anatgonist before gonadotropins somministration in order to have a rapid luteolysis. Among the 21 cancer patients, two are affected by breast cancer. These patients receive a controlled ovarian stimulation with a combined letrozole-gonadotropins protocol after GnRH-antagonist induced luteolysis.
The outcome measures are number of days needed before starting procedure, duration of stimulation, cumulative dosage of gonadotropins number of oocyte retrieved and percentage of mature oocytes. We focus our attention also on estradiol levels during ovarian stimulation.
The results don’t show any differences between two groups if we consider days of stimulation, total amount of gonadotropins administered and the number of good mature quality oocytes retrieved. Moreover estradiol levels in letrozole group are lower than those in other patients.
This study suggests that oocytes can be obtained before cancer treatment irrespective of menstrual cycle phase without compromising the efficacy of procedure. Moreover starting ovarian stimulation anytime during menstrual cycle allows to patients to not postpone the beginning of cancer treatment.
Different stimulation protocols, according to different kinf of diasese, are available in order to obtain the maximum results without any complication for patients.