Objective: To evaluate the impact of lymphoma aggressiveness on ovarian response during fertility preservation treatment.
Design: Retrospective cohort study.
Setting: University-affiliated tertiary hospital.
Patient(s): Women with lymphoma who underwent ovarian stimulation for fertility preservation in the period from 2009 to 2018.
Intervention(s): None.
Main outcome measure(s): Primary outcome: the number of mature oocytes; secondary outcomes: the number of retrieved oocytes, estradiol level, and number of follicles >14 mm on the day of oocyte maturation trigger.
Result(s): Patients with stage I-II lymphoid neoplasms (localized disease) were compared with those with stage III-IV lymphomas (advanced disease). Women with favorable levels of biochemical prognostic markers were also compared with those with unfavorable levels. Women with favorable levels of biochemical prognostic markers (n = 74) had a higher number of mature oocytes compared with patients with unfavorable serum levels (n = 67): 11 (7.8-16) versus 9 (5-11), respectively. The number of mature oocytes was similar between patients with localized (n = 75) and advanced (n = 66) lymphomas. Women with unfavorable combination of stage and biochemical factors had lower number of mature oocytes compared to patients with favorable combination: 8 (5-10) versus 11 (7-16), respectively. Multivariate logistic regression showed that favorable levels of biochemical markers as well as a combination of extent and biochemical parameters were statistically significantly associated with the result of over 10 mature oocytes.
Conclusion(s): Highly-aggressive lymphoid neoplasms have a negative impact on ovarian function and response during fertility preservation treatment.
Keywords: Fertility preservation; lymphoma; number of oocytes; prognostic factors; stage of cancer.
Copyright © 2019 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.