Critical appraisal:Azim AA, Costantini-Ferrando M, Oktay K 2008

Critical Appraisal

Article being appraised

Azim AA, Costantini-Ferrando M, Oktay K. Safety of fertility preservation by ovarian stimulation with letrozole and gonadotropins in patients with breast cancer: a prospective controlled study. J Clin Oncol 2008 Jun 1;26(16):2630-5 Available from: http://www.ncbi.nlm.nih.gov/pubmed/18509175.

Applicable clinical question

In female cancer patients does the use of ovarian stimulation for oocyte retrieval increase the risk of cancer recurrence? In breast cancer patients does the hormone receptor status of the tumor influence this outcome?

Key Facts

Study Design

cohort study, risk factors

Study aims:

prospective non-randomised controlled study

Number of Patients:

215

women with breast cancer

Results of outcome(s):

Time between surgery and chemotherapy was longer for patients undergoing IVF (45.08�31.64 v 33.46�27.3 days; P�.01).
There was no significant difference in relapse-free survival between the groups.
In conclusion, our study suggests that the use of letrozole and
gonadotropins for controlled ovarian stimulation before embryo or
oocyte cryopreservation is unlikely to result in a significant increase in
recurrence of breast cancer compared with those who did not undergo
ovarian stimulation, at least in the short term. Because of the relatively
short-term follow-up and small number of patients, however, a definitive
judgment on the safety of our approach cannot yet be rendered.