Critical appraisal:Hashimoto T, Nakamura Y, Obata R, Doshida M, Toya M, Takeuchi T, et al 2017 2

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Critical Appraisal

Article being appraised

Hashimoto T, Nakamura Y, Obata R, Doshida M, Toya M, Takeuchi T, et al. Effects of fertility preservation in patients with breast cancer: A retrospective two-centers study. Reprod Med Biol 2017 Oct;16(4):374-379 Available from: http://www.ncbi.nlm.nih.gov/pubmed/29259491.


Applicable clinical question

Key Facts

Study Design

case series

Study aims:

to assess the efficacy of fertility preservation and the impact of chemotherapy on the reproductive potential of Japanese patients with breast cancer.

Number of Patients:

62

Reported outcome(s):

Pateints were divided into two groups according to the treatment: oocyte or embryo vitrification for FP before cancer treatment (group A) or infertility treatment after cancer treatment (group B). Group B was further divided , B1 (no chemotherapy) and B2 (postchemotherapy), in order to analyze the effect of anticancer drugs on ovarian reserves and assisted reproductive technology outcomes. The number of retrieved oocytes, vitrified oocytes or embryos, and pregnancy rates were analyzed and compared: group A compared to group B1 compared to group B2.

Results of outcome(s):

The patients in groups A and B1 underwent egg collection without any chemotherapy. The numbers of collected oocytes and vitrified embryos were significantly higher in groups A and B1 than in group B2. Nearly 50% of the in vitro fertilization patients who underwent an embryo transfer (ET) became pregnant, including two patients in group A who underwent a vitrified-warmed ET. Among the pregnant women, 70% did not have chemotherapy.

Includes an economic evaluation

no

Evidence ratings

Level of evidence

IV

Risk of bias
Moderate risk of bias Comments:


Size of effect
5 Reason for decision:
Relevance of evidence
2 Additional comments: Demonstrates benefit of freezing before chemotherpay, but no QOL or economic measures
Result of appraisal

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Article
Hashimoto T, Nakamura Y, Obata R, Doshida M, Toya M, Takeuchi T, et al. Effects of fertility preservation in patients with breast cancer: A retrospective two-centers study. Reprod Med Biol 2017 Oct;16(4):374-379 Available from: http://www.ncbi.nlm.nih.gov/pubmed/29259491.
Assigned to
User:Roger.hart
Topic area
Guidelines:COSA:Cancer fertility preservation guidelines/Options for treatment
Clinical question
Form
Form:Critical appraisal


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