Is letrozole during ovarian stimulation useful in breast cancer patients undergoing fertility preservation to reduce early luteal progesterone levels following GnRH-agonist trigger?

Background: In absence of contraindication, breast cancer patients of reproductive age can undergo fertility preservation with controlled ovarian stimulation for oocyte/embryo cryopreservation before the administration of potentially gonadotoxic treatments. High hormonal levels induced by ovarian stimulation might have an adverse impact on hormone-positive breast cancer. Whether letrozole supplementation during ovarian stimulation (COSTLES) reduces serum progesterone levels after GnRHa trigger remains unknown.

Double-in vitro maturation increases the number of vitrified oocytes available for fertility preservation when ovarian stimulation is unfeasible.

When ovarian stimulation is unfeasible, in vitro maturation (IVM) represents an alternative option for fertility preservation (FP). This retrospective study aims to evaluate the feasibility of performing within a short time frame two IVM cycles for FP. Seventeen women with breast cancer, 18-40 years of age, having undergone 2 cycles of IVM followed by oocyte vitrification were included.

[Dual trigger with gonadotropin-releasing hormone agonist and hCG to improve oocyte maturation rate].

Objective: This study investigates dual trigger with GnRHa and hCG as a potential treatment in patients with a history of ≥25 % immature oocytes retrieved in IVF/ICSI cycles.

Methods: This is a retrospective case-control study performed between October 2008 and December 2017. Forty-seven patients who experienced high oocyte immaturity rate (≥25 %) during their first IVF/ICSI cycle (analyzed as control group) and received a dual trigger for their subsequent cycle, were involved.

Serum progesterone concentration and live birth rate in frozen-thawed embryo transfers with hormonally prepared endometrium.

Research Question: Is serum progesterone measurement on the day of embryo transfer associated with outcome of frozen-thawed embryo transfer (FET) in cycles using hormonal replacement therapy (HRT) for endometrium preparation?

Design: This single-centre retrospective study assessed the relationship between serum progesterone on embryo transfer day and live birth rates in 227 FET cycles. Endometrial preparation was performed by sequential administration of vaginal oestradiol until endometrial thickness was >7 mm, followed by transdermal oestradiol combined with 600 mg vaginal micronized progesterone.

Results: Mean serum embryo transfer day progesterone was 11.

Anti Müllerian Hormone: More than a biomarker of female reproductive function.

Anti-Müllerian hormone (AMH), known for its role during sexual differentiation, is a dimeric glycoprotein that belongs to the transforming growth factor-β (TGF-β) family. AMH has recently been identified as a reliable marker of ovarian reserve that can help predict early ovarian follicle loss and menopause onset. AMH levels also reflect the effects of damaging gynecologic surgeries or gonadotoxic treatments such as chemotherapy on ovarian reserve.