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Kutluk Oktay - One of the best experts on this subject based on the ideXlab platform.
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current approach to fertility preservation by Embryo Cryopreservation
Fertility and Sterility, 2013Co-Authors: Giuliano Bedoschi, Kutluk OktayAbstract:The ovaries are susceptible to damage following treatment with gonadotoxic chemotherapy, pelvic radiotherapy, and/or ovarian surgery. Gonadotoxic treatments have also been used in patients with various nonmalignant systemic diseases. Any women of reproductive age with a sufficiently high risk of developing future ovarian failure due to those medical interventions may benefit from Embryo Cryopreservation though the tools of assessment of such a risk are still not very precise. Furthermore, the risk assessment can be influenced by many other factors such as the delay expected after chemotherapy and the number of children desired in the future. Embryo Cryopreservation is an established and most successful method of fertility preservation when there is sufficient time available to perform ovarian stimulation. This publication will review the current state, approach, and indications of Embryo Cryopreservation for fertility preservation.
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In vitro maturation improves oocyte or Embryo Cryopreservation outcome in breast cancer patients undergoing ovarian stimulation for fertility preservation
Reproductive biomedicine online, 2010Co-Authors: Kutluk Oktay, Erkan Buyuk, Kenny A. Rodriguez-wallberg, G. SahinAbstract:This study tested in-vitro maturation (IVM) as a complementary strategy to improve the mature oocyte yield of breast cancer patients undergoing ovarian stimulation for fertility preservation. Secondary analysis of prospectively collected data is performed for 32 breast cancer patients undergoing oocyte or Embryo Cryopreservation before chemotherapy. Total number of oocytes and/or Embryos cryopreserved following IVM is compared with the total number cryopreserved before IVM. Overall, 464 oocytes were retrieved, of which 274 were mature. Following IVM, the number of total mature oocytes increased to 399 (45% increase in mature oocyte yield, P < 0.0001). Fertilization rate after IVM was statistically significantly higher than the fertilization of already mature oocytes at retrieval (86% versus 73%, respectively, P < 0.05). The total number of oocytes and Embryos frozen before IVM was 207 (45% of all oocytes retrieved). This number increased to 320 (69% of all oocytes retrieved) following IVM (P < 0.0001). IVM is a useful strategy to improve the mature oocyte yield of fertility preservation cycles. Immature oocytes retrieved during oocyte/Embryo Cryopreservation cycles should not be discarded to improve the future potential of fertility.
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fertility preservation in breast cancer patients a prospective controlled comparison of ovarian stimulation with tamoxifen and letrozole for Embryo Cryopreservation
Journal of Clinical Oncology, 2005Co-Authors: Kutluk Oktay, Erkan Buyuk, N. Libertella, Munire Erman Akar, Zev RosenwaksAbstract:Purpose To develop safe ovarian stimulation methods to perform in vitro fertilization (IVF) in breast cancer patients who wish to preserve their fertility via Embryo Cryopreservation before chemotherapy. Patients and Methods Sixty women (age range, 24 to 43 years) with breast cancer were prospectively studied. Twenty-nine patients underwent 33 ovarian stimulation cycles with either tamoxifen 60 mg/d alone (Tam-IVF) or in combination with low-dose follicle-stimulating hormone (TamFSH-IVF) or letrozole 5 mg in combination with FSH (Letrozole-IVF). After IVF, all resultant Embryos were cryopreserved to preserve fertility. Recurrence rates were compared with controls (n 31) who elected not to undergo IVF. Results Compared with Tam-IVF, both TamFSH-IVF and Letrozole-IVF patients had greater numbers of follicles (2 0.3 v 6 1 and 7.8 0.9, respectively; P .0001), mature oocytes (1.5 0.3 v 5.1 1.1 and 8.5 1.6, respectively; P .001), and Embryos (1.3 0.2 v 3.8 0.8 and 5.3 0.8, respectively; P .001). Peak estradiol (E2) levels were lower with Letrozole-IVF and Tam-IVF compared with TamFSH-IVF. After 554 31 days (range, 153 to 1,441 days) of follow-up, cancer recurrence rate was similar between IVF and control patients (three of 29 v three of 31 patients, respectively; hazard ratio, 1.5; 95% CI, 0.29 to 7.4), and this estimate was not affected by cancer stage. Conclusion The combination of low-dose FSH with tamoxifen (TamFSH-IVF) or letrozole (Letrozole-IVF) results in higher Embryo yield compared with Tam-IVF. Recurrence rates do not seem to be increased, but the letrozole protocol may be preferred because it results in lower peak E2 levels.
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Letrozole and tamoxifen as safer ovarian stimulants in women undergoing Embryo Cryopreservation for fertility preservation before breast cancer chemotherapy: A prospective controlled trial
Journal of Clinical Oncology, 2005Co-Authors: Kutluk Oktay, Erkan Buyuk, N. Libertella, K. Lostritto, Andrew J. Vickers, Munire Erman AkarAbstract:539 Background: Chemotherapy results in amenorrhea in up to 80% of breast cancer patients 1. Embryos can be cryopreserved for fertility preservation but safety of standard fertility drugs are questioned in patients with breast cancer. Our aim was to test the efficacy and safety of tamoxifen and letrozole as ovarian stimulants in breast cancer patients undergoing in vitro fertilization (IVF) to preserve their fertility via Embryo Cryopreservation prior to treatment. Methods: 72 (age 24–43) nonmetastatic breast cancer patients were studied prospectively. 36 patients underwent ovarian stimulation with either tamoxifen alone (Tam-IVF) or in combination with folicle stimulating hormone (TamFSH-IVF), or letrozole with FSH (Letrozole-IVF). All Embryos were cryopreserved to preserve fertility. Recurrence rates were compared to a prospective control group (N=36). Results: Compared to Tam-IVF, both TamFSH-IVF and Letrozole-IVF patients had greater number of mature oocytes (1.5 ± 0.3 vs. 5.1 ± 1.1 and 8.4 ± 1.2, p
C.d. Matthews - One of the best experts on this subject based on the ideXlab platform.
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The contribution of Embryo Cryopreservation to in-vitro fertilization/gamete intra-Fallopian transfer: 8 years experience
Human reproduction (Oxford England), 1994Co-Authors: X. Wang, W. Ledger, Dianna Payne, Regan Jeffrey, C.d. MatthewsAbstract:In this paper, the authors summarized their experience with Embryo Cryopreservation over an 8-year period. The results, therefore, reflect the long-term benefit of Embryo Cryopreservation to the overall in-vitro fertilization/gamete intra-Fallopian transfer (IVF/GIFT) programme and to the women who had Embryos cryopreserved. The stable survival rate of thawed Embryos and pregnancy rate, especially over the past 4 years, suggests that the results can reliably be used to evaluate the efficacy of the Embryo Cryopreservation programme. The ongoing pregnancy rate of frozen/thawed Embryo transfer is 10.9%, comparable with the ongoing pregnancy rate of fresh IVF/Embryo transfer in our unit over the same period. In addition to those factors known to affect the pregnancy rate in fresh IVF/GIFT cycles, such as age of the recipients and number of Embryos transferred, the major factor affecting the efficacy of the Cryopreservation programme is the number of oocytes retrieved in the initial stimulation cycle, and the number of Embryos available for Cryopreservation. The storage time of cryopreserved Embryos will also have a significant effect on the realization of the total potential of Embryo Cryopreservation. Overall the contribution of Cryopreservation to our IVF/GIFT programme is substantial, increasing pregnancy rate by 4%, while the greater net benefit, of course, is for the women who had Embryos cryopreserved (pregnancy rate increased by 7%), especially for those who returned for frozen/thawed Embryo transfer cycles (pregnancy rate increased by 11%).
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the contribution of Embryo Cryopreservation to in vitro fertilization gamete intra fallopian transfer 8 years experience
Human Reproduction, 1994Co-Authors: X. Wang, W. Ledger, Dianna Payne, Regan Jeffrey, C.d. MatthewsAbstract:In this paper, the authors summarized their experience with Embryo Cryopreservation over an 8-year period. The results, therefore, reflect the long-term benefit of Embryo Cryopreservation to the overall in-vitro fertilization/gamete intra-Fallopian transfer (IVF/GIFT) programme and to the women who had Embryos cryopreserved. The stable survival rate of thawed Embryos and pregnancy rate, especially over the past 4 years, suggests that the results can reliably be used to evaluate the efficacy of the Embryo Cryopreservation programme. The ongoing pregnancy rate of frozen/thawed Embryo transfer is 10.9%, comparable with the ongoing pregnancy rate of fresh IVF/Embryo transfer in our unit over the same period. In addition to those factors known to affect the pregnancy rate in fresh IVF/GIFT cycles, such as age of the recipients and number of Embryos transferred, the major factor affecting the efficacy of the Cryopreservation programme is the number of oocytes retrieved in the initial stimulation cycle, and the number of Embryos available for Cryopreservation. The storage time of cryopreserved Embryos will also have a significant effect on the realization of the total potential of Embryo Cryopreservation. Overall the contribution of Cryopreservation to our IVF/GIFT programme is substantial, increasing pregnancy rate by 4%, while the greater net benefit, of course, is for the women who had Embryos cryopreserved (pregnancy rate increased by 7%), especially for those who returned for frozen/thawed Embryo transfer cycles (pregnancy rate increased by 11%).
Mariette Goddijn - One of the best experts on this subject based on the ideXlab platform.
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tamoxifen or letrozole versus standard methods for women with estrogen receptor positive breast cancer undergoing oocyte or Embryo Cryopreservation in assisted reproduction
Cochrane Database of Systematic Reviews, 2013Co-Authors: T Dahhan, Eva M E Balkenende, Madelon Van Wely, Sabine C Linn, Mariette GoddijnAbstract:BACKGROUND Cryopreservation of oocytes or Embryos preceded by controlled ovarian stimulation (COS) can increase the chance of future pregnancy in women with breast cancer who risk therapy-induced ovarian failure. In women with estrogen-receptor (ER) positive breast cancer, alternative COS protocols with tamoxifen or letrozole are being used to theoretically inhibit breast cancer growth during COS. OBJECTIVES To assess the effects of tamoxifen or letrozole, in addition to standard COS protocols, on the breast cancer-free interval in premenopausal women with ER positive breast cancer who undergo COS for Embryo or oocyte Cryopreservation. SEARCH METHODS We searched the Ovid Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, and EBSCOhost CINAHL. We applied no limitations in year of publication or language. In addition, we searched trial registers for ongoing and registered trials, conference abstracts, and sources of grey literature. The search was conducted in January 2013. SELECTION CRITERIA Randomised trials comparing different COS protocols in women with breast cancer were eligible for inclusion. DATA COLLECTION AND ANALYSIS Two review authors independently scanned the titles, abstracts, or both sections according to Cochrane guidelines. If data to include were provided, data extraction would have been independently performed by two review authors by using forms designed according to Cochrane guidelines. MAIN RESULTS No randomised controlled trials were found that met the inclusion criteria. AUTHORS' CONCLUSIONS COS schedules with the additional use of tamoxifen or letrozole are commonly chosen as an alternative regimen in young women with ER positive breast cancer who undergo COS for oocyte or Embryo Cryopreservation. No randomised controlled trials support the idea that these alternative COS schedules are superior to standard COS.
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The Cochrane Library - Tamoxifen or letrozole versus standard methods for women with estrogen-receptor positive breast cancer undergoing oocyte or Embryo Cryopreservation in assisted reproduction.
The Cochrane database of systematic reviews, 2013Co-Authors: T Dahhan, Eva M E Balkenende, Madelon Van Wely, Sabine C Linn, Mariette GoddijnAbstract:BACKGROUND Cryopreservation of oocytes or Embryos preceded by controlled ovarian stimulation (COS) can increase the chance of future pregnancy in women with breast cancer who risk therapy-induced ovarian failure. In women with estrogen-receptor (ER) positive breast cancer, alternative COS protocols with tamoxifen or letrozole are being used to theoretically inhibit breast cancer growth during COS. OBJECTIVES To assess the effects of tamoxifen or letrozole, in addition to standard COS protocols, on the breast cancer-free interval in premenopausal women with ER positive breast cancer who undergo COS for Embryo or oocyte Cryopreservation. SEARCH METHODS We searched the Ovid Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, and EBSCOhost CINAHL. We applied no limitations in year of publication or language. In addition, we searched trial registers for ongoing and registered trials, conference abstracts, and sources of grey literature. The search was conducted in January 2013. SELECTION CRITERIA Randomised trials comparing different COS protocols in women with breast cancer were eligible for inclusion. DATA COLLECTION AND ANALYSIS Two review authors independently scanned the titles, abstracts, or both sections according to Cochrane guidelines. If data to include were provided, data extraction would have been independently performed by two review authors by using forms designed according to Cochrane guidelines. MAIN RESULTS No randomised controlled trials were found that met the inclusion criteria. AUTHORS' CONCLUSIONS COS schedules with the additional use of tamoxifen or letrozole are commonly chosen as an alternative regimen in young women with ER positive breast cancer who undergo COS for oocyte or Embryo Cryopreservation. No randomised controlled trials support the idea that these alternative COS schedules are superior to standard COS.
X. Wang - One of the best experts on this subject based on the ideXlab platform.
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The contribution of Embryo Cryopreservation to in-vitro fertilization/gamete intra-Fallopian transfer: 8 years experience
Human reproduction (Oxford England), 1994Co-Authors: X. Wang, W. Ledger, Dianna Payne, Regan Jeffrey, C.d. MatthewsAbstract:In this paper, the authors summarized their experience with Embryo Cryopreservation over an 8-year period. The results, therefore, reflect the long-term benefit of Embryo Cryopreservation to the overall in-vitro fertilization/gamete intra-Fallopian transfer (IVF/GIFT) programme and to the women who had Embryos cryopreserved. The stable survival rate of thawed Embryos and pregnancy rate, especially over the past 4 years, suggests that the results can reliably be used to evaluate the efficacy of the Embryo Cryopreservation programme. The ongoing pregnancy rate of frozen/thawed Embryo transfer is 10.9%, comparable with the ongoing pregnancy rate of fresh IVF/Embryo transfer in our unit over the same period. In addition to those factors known to affect the pregnancy rate in fresh IVF/GIFT cycles, such as age of the recipients and number of Embryos transferred, the major factor affecting the efficacy of the Cryopreservation programme is the number of oocytes retrieved in the initial stimulation cycle, and the number of Embryos available for Cryopreservation. The storage time of cryopreserved Embryos will also have a significant effect on the realization of the total potential of Embryo Cryopreservation. Overall the contribution of Cryopreservation to our IVF/GIFT programme is substantial, increasing pregnancy rate by 4%, while the greater net benefit, of course, is for the women who had Embryos cryopreserved (pregnancy rate increased by 7%), especially for those who returned for frozen/thawed Embryo transfer cycles (pregnancy rate increased by 11%).
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the contribution of Embryo Cryopreservation to in vitro fertilization gamete intra fallopian transfer 8 years experience
Human Reproduction, 1994Co-Authors: X. Wang, W. Ledger, Dianna Payne, Regan Jeffrey, C.d. MatthewsAbstract:In this paper, the authors summarized their experience with Embryo Cryopreservation over an 8-year period. The results, therefore, reflect the long-term benefit of Embryo Cryopreservation to the overall in-vitro fertilization/gamete intra-Fallopian transfer (IVF/GIFT) programme and to the women who had Embryos cryopreserved. The stable survival rate of thawed Embryos and pregnancy rate, especially over the past 4 years, suggests that the results can reliably be used to evaluate the efficacy of the Embryo Cryopreservation programme. The ongoing pregnancy rate of frozen/thawed Embryo transfer is 10.9%, comparable with the ongoing pregnancy rate of fresh IVF/Embryo transfer in our unit over the same period. In addition to those factors known to affect the pregnancy rate in fresh IVF/GIFT cycles, such as age of the recipients and number of Embryos transferred, the major factor affecting the efficacy of the Cryopreservation programme is the number of oocytes retrieved in the initial stimulation cycle, and the number of Embryos available for Cryopreservation. The storage time of cryopreserved Embryos will also have a significant effect on the realization of the total potential of Embryo Cryopreservation. Overall the contribution of Cryopreservation to our IVF/GIFT programme is substantial, increasing pregnancy rate by 4%, while the greater net benefit, of course, is for the women who had Embryos cryopreserved (pregnancy rate increased by 7%), especially for those who returned for frozen/thawed Embryo transfer cycles (pregnancy rate increased by 11%).
T Dahhan - One of the best experts on this subject based on the ideXlab platform.
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tamoxifen or letrozole versus standard methods for women with estrogen receptor positive breast cancer undergoing oocyte or Embryo Cryopreservation in assisted reproduction
Cochrane Database of Systematic Reviews, 2013Co-Authors: T Dahhan, Eva M E Balkenende, Madelon Van Wely, Sabine C Linn, Mariette GoddijnAbstract:BACKGROUND Cryopreservation of oocytes or Embryos preceded by controlled ovarian stimulation (COS) can increase the chance of future pregnancy in women with breast cancer who risk therapy-induced ovarian failure. In women with estrogen-receptor (ER) positive breast cancer, alternative COS protocols with tamoxifen or letrozole are being used to theoretically inhibit breast cancer growth during COS. OBJECTIVES To assess the effects of tamoxifen or letrozole, in addition to standard COS protocols, on the breast cancer-free interval in premenopausal women with ER positive breast cancer who undergo COS for Embryo or oocyte Cryopreservation. SEARCH METHODS We searched the Ovid Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, and EBSCOhost CINAHL. We applied no limitations in year of publication or language. In addition, we searched trial registers for ongoing and registered trials, conference abstracts, and sources of grey literature. The search was conducted in January 2013. SELECTION CRITERIA Randomised trials comparing different COS protocols in women with breast cancer were eligible for inclusion. DATA COLLECTION AND ANALYSIS Two review authors independently scanned the titles, abstracts, or both sections according to Cochrane guidelines. If data to include were provided, data extraction would have been independently performed by two review authors by using forms designed according to Cochrane guidelines. MAIN RESULTS No randomised controlled trials were found that met the inclusion criteria. AUTHORS' CONCLUSIONS COS schedules with the additional use of tamoxifen or letrozole are commonly chosen as an alternative regimen in young women with ER positive breast cancer who undergo COS for oocyte or Embryo Cryopreservation. No randomised controlled trials support the idea that these alternative COS schedules are superior to standard COS.
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The Cochrane Library - Tamoxifen or letrozole versus standard methods for women with estrogen-receptor positive breast cancer undergoing oocyte or Embryo Cryopreservation in assisted reproduction.
The Cochrane database of systematic reviews, 2013Co-Authors: T Dahhan, Eva M E Balkenende, Madelon Van Wely, Sabine C Linn, Mariette GoddijnAbstract:BACKGROUND Cryopreservation of oocytes or Embryos preceded by controlled ovarian stimulation (COS) can increase the chance of future pregnancy in women with breast cancer who risk therapy-induced ovarian failure. In women with estrogen-receptor (ER) positive breast cancer, alternative COS protocols with tamoxifen or letrozole are being used to theoretically inhibit breast cancer growth during COS. OBJECTIVES To assess the effects of tamoxifen or letrozole, in addition to standard COS protocols, on the breast cancer-free interval in premenopausal women with ER positive breast cancer who undergo COS for Embryo or oocyte Cryopreservation. SEARCH METHODS We searched the Ovid Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, and EBSCOhost CINAHL. We applied no limitations in year of publication or language. In addition, we searched trial registers for ongoing and registered trials, conference abstracts, and sources of grey literature. The search was conducted in January 2013. SELECTION CRITERIA Randomised trials comparing different COS protocols in women with breast cancer were eligible for inclusion. DATA COLLECTION AND ANALYSIS Two review authors independently scanned the titles, abstracts, or both sections according to Cochrane guidelines. If data to include were provided, data extraction would have been independently performed by two review authors by using forms designed according to Cochrane guidelines. MAIN RESULTS No randomised controlled trials were found that met the inclusion criteria. AUTHORS' CONCLUSIONS COS schedules with the additional use of tamoxifen or letrozole are commonly chosen as an alternative regimen in young women with ER positive breast cancer who undergo COS for oocyte or Embryo Cryopreservation. No randomised controlled trials support the idea that these alternative COS schedules are superior to standard COS.