The following is a summary of “Random start ovarian stimulation before gonadotoxic therapies in women with cancer: a systematic review and meta-analysis,” published in the December 2023 issue of Obstetrics and Gynecology by Sönmezer, et al.
For a systematic review and meta-analysis, researchers sought to find out how different types of random start ovarian stimulation (RSOS) compared with conventional start ovarian stimulation (CSOS) affected cancer patients before they started gonadotoxic treatment. The last group that was analyzed had 688 RSOS cycles and 1,076 CSOS cycles of cancer patients who had not yet started gonadotoxic treatment.
11 studies were found by searching MEDLINE, the Cochrane Library, and the sources given. The main results that were looked at were the number of oocytes and mature oocytes that were collected, the number of eggs that were frozen, and the ratio of metaphase II (MII) to antral follicle count (AFC). Using the Newcastle–Ottawa Quality Assessment Scale, the works were given scores between 6 and 9, which means they were of medium to high quality.
The 2 methods produced about the same number of oocytes, MII oocytes, embryos that could be frozen, and equal rates of MII–AFC and fertilization. There was a longer stimulation of the ovaries (standardized mean difference [SMD] 0.35, 95% CI 0.09 to 0.61; P = 0.009), and more gonadotrophin was used (SMD 0.23, 95% CI 0.06 to 0.40; P = 0.009) in RSOS compared to CSOS. The systematic review and meta-analysis showed that in cancer patients undergoing RSOS compared to those undergoing CSOS, the stimulation lasted longer and more gonadotrophin was used. Still, there was no significant difference in the number of developed oocytes produced.
Source: sciencedirect.com/science/article/abs/pii/S1472648323004376