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Reduced response to controlled ovarian stimulation after radical trachelectomy: A pitfall of fertility‐sparing surgery for cervical cancer
Author(s) -
Tamauchi Satoshi,
Kajiyama Hiroaki,
Osuka Satoko,
Moriyama Yoshinori,
Yoshihara Masato,
Kikkawa Fumitaka
Publication year - 2021
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13529
Subject(s) - trachelectomy , stimulation , medicine , urology , infertility , radical surgery , fertility preservation , gynecology , fertility , andrology , cervical cancer , cancer , pregnancy , biology , population , environmental health , genetics
Objective To clarify the decrease in response to controlled ovarian stimulation in patients who receive in vitro fertilization treatment after radical trachelectomy. Methods The outcomes of ovarian stimulation were retrospectively evaluated and compared between patients who have undergone radical trachelectomy and control patients who had male factor infertility or unexplained infertility. Results A total of 30 ovarian stimulation cycles in 14 radical trachelectomy patients and 54 cycles in 30 control patients were reviewed. The median age at ovarian stimulation was 34.8 years in the radical trachelectomy group and 36.5 years in the control group. Compared with the control group, the radical trachelectomy group had significantly lower mean estradiol concentration (1461.7 pg/ml, SD 775.0 vs. 1950.9 pg/ml, SD 1057.3, P = 0.029) during controlled ovarian stimulation cycle and smaller median number of retrieved oocytes (5, range 1–14 vs. 8, range 1–19, P = 0.007), despite the higher use of gonadotropin (3527.5 IU, SD 1313.4 vs. 2670.8 IU, SD 905.1, P = 0.001). Conclusion The response to controlled ovarian stimulation decreased after radical trachelectomy.