2022 Volume 71 Issue 2 Pages 245-249
Recently, cancer treatment has made dramatic progress, and patients’ prognoses have improved significantly. On the other hand, the cancer incidence in the reproductive age has been increasing, and more professional attention is being paid to preserving female fertility that could be threatened by cancer treatment. Women generally grow a single follicle per menstrual cycle. To cryopreserve multiple embryos per cycle, women are administered hormones for ovarian stimulation for approximately two weeks. There are mainly two types of controlled ovarian stimulation (COS) protocol for fertility preservation: standard COS (GnRH antagonist protocol) and random-start COS, in which a patient is stimulated on presentation regardless of her menstrual-cycle phase. Here, we aimed to clarify the difference in embryo quality between random-start COS and standard COS. Embryos (cleavage stage) obtained from 17 women each in the two COS protocols were classified into four grades in accordance with the Nagoya University Hospital classification. Grades 3 and 4 embryos were considered high-quality embryos. The percentages of high-quality embryos in the two COS protocols were compared. The percentages of high-quality embryos were 54.2% and 69.0% in the standard COS and random-start COS, respectively, which were not significantly different as determined by Fisher’s exact test (p < 0.05). This result indicates that there were no significant differences in embryo quality between standard COS and random-start COS. We consider random-start COS to be useful for fertility preservation in cancer patients who require early cancer therapy.
