Reproductive biomedicine online · 2024
Do aromatase inhibitors and tamoxifen affect oocyte numbers retrieved in oocyte or embryo banking cycles?
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Sauerbrun-Cutler May-Tal, Klein Elizabeth J, Scarpaci Matthew M, Eaton Jennifer L
Аннотация
RESEARCH QUESTION: Does the number of oocytes retrieved differ in oocyte and embryo banking cycles using tamoxifen versus aromatase inhibitors versus no adjuvant medications?
DESIGN: Observational cohort study of patients (n = 42,854) aged 18-43 years undergoing oocyte or embryo banking cycles between 2016 and 2018 recorded in SART CORS.
RESULTS: The following fresh banking cycles were analysed: oocyte and embryo banking cycles using, as part of the ovarian stimulation protocol, aromatase inhibitors (n = 2096); tamoxifen (n = 58) and no adjuvant medications (n = 40,700). Mean age at cycle initiation was 35 years; most patients were nulligravid (77.31%) and nulliparous (91.76%). Mean numbers of oocytes retrieved and cryopreserved in all banking cycles were higher in the no adjuvant medication group compared with the aromatase inhibitor group (oocytes retrieved: 14.2 versus 12.6; P < 0.001; oocytes cryopreserved: 11.4 versus 10.3; P < 0.001); no difference was observed in oocyte yield between the aromatase inhibitors and adjuvant medication groups in banking cycles before gonadotoxic treatment, nor in the number of oocytes retrieved or cryopreserved between the tamoxifen and no adjuvant medication groups in all banking cycles. In the generalized linear model, the adjusted mean difference of oocytes retrieved was significantly lower in the aromatase inhibitor group compared with the no adjuvant medication group (-1.25, 95% CI -1.7 to -0.80; P < 0.001) in combined oocyte and embryo banking cycles.
CONCLUSION: Banking cycles using aromatase inhibitors may compromise oocyte yield when used for cycles without a pre-gonadotoxic treatment indication. Our data support the continued use of aromatase inhibitors for pre-gonadotoxic treatment banking cycles as IVF cycle outcomes and live birth rates are comparable to those for cycles with no adjuvant medication.
DESIGN: Observational cohort study of patients (n = 42,854) aged 18-43 years undergoing oocyte or embryo banking cycles between 2016 and 2018 recorded in SART CORS.
RESULTS: The following fresh banking cycles were analysed: oocyte and embryo banking cycles using, as part of the ovarian stimulation protocol, aromatase inhibitors (n = 2096); tamoxifen (n = 58) and no adjuvant medications (n = 40,700). Mean age at cycle initiation was 35 years; most patients were nulligravid (77.31%) and nulliparous (91.76%). Mean numbers of oocytes retrieved and cryopreserved in all banking cycles were higher in the no adjuvant medication group compared with the aromatase inhibitor group (oocytes retrieved: 14.2 versus 12.6; P < 0.001; oocytes cryopreserved: 11.4 versus 10.3; P < 0.001); no difference was observed in oocyte yield between the aromatase inhibitors and adjuvant medication groups in banking cycles before gonadotoxic treatment, nor in the number of oocytes retrieved or cryopreserved between the tamoxifen and no adjuvant medication groups in all banking cycles. In the generalized linear model, the adjusted mean difference of oocytes retrieved was significantly lower in the aromatase inhibitor group compared with the no adjuvant medication group (-1.25, 95% CI -1.7 to -0.80; P < 0.001) in combined oocyte and embryo banking cycles.
CONCLUSION: Banking cycles using aromatase inhibitors may compromise oocyte yield when used for cycles without a pre-gonadotoxic treatment indication. Our data support the continued use of aromatase inhibitors for pre-gonadotoxic treatment banking cycles as IVF cycle outcomes and live birth rates are comparable to those for cycles with no adjuvant medication.