Letrozole for ovulation induction and fertility preservation by embryo cryopreservation in young women with endometrial carcinoma.

Abstract:

OBJECTIVE:To reduce estrogen exposure in women with endometrial cancer undergoing in vitro fertilization using an aromatase inhibitor. DESIGN:Prospective case series. SETTING:Academic center for reproductive medicine. PATIENT(S):Endometrial carcinoma patients presenting for fertility preservation or fresh embryo transfer to gestational carrier. INTERVENTION(S):Four patients with endometroid carcinoma underwent five IVF cycles for immediate or delayed embryo transfer to gestational carriers before or after staging and definitive surgery. To prevent surge in E(2) levels, letrozole was started 2 days before gonadotropin administration and then given concomitantly. Embryos were either cryopreserved for fertility preservation or transferred freshly to a surrogate. MAIN OUTCOME MEASURE(S):Peak E(2) level during stimulation, pregnancy in a gestational carrier. RESULT(S):Peak E(2) level during stimulation was 386.67 +/- 102.93 pg/mL. A mean of 7 +/- 2.85 oocytes were retrieved, resulting in 4.8 +/- 1.76 embryos per cycle. In one patient, two embryos were transferred to a surrogate, resulting in a triplet pregnancy. The delivery occurred at 31 weeks and the infants did not show any congenital or developmental abnormalities. Three patients had their embryos cryopreserved for future use. CONCLUSION(S):The use of letrozole and gonadotropins is associated with lower E(2) levels compared with standard stimulation cycles in endometrial carcinoma patients. Combination of this approach with surrogacy may enable these young women to preserve their fertility.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Azim A,Oktay K

doi

10.1016/j.fertnstert.2006.12.068

subject

Has Abstract

pub_date

2007-09-01 00:00:00

pages

657-64

issue

3

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(07)00101-X

journal_volume

88

pub_type

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