The preservation of fertility in women of childbearing age with breast cancer is challenging because the time for ovarian stimulation is restricted and only a limited number of oocytes can be retrieved before gonadotoxic therapies. The aim of this meta-analysis was to evaluate the fertility preservation outcomes after ovarian stimulation with various protocols in women with breast cancer. PubMed, Embase and the Cochrane Library were searched. Twenty-two studies comparing the outcomes of women with breast cancer receiving random-start ovarian stimulation or conventional protocol; single or double ovarian stimulation cycles; and coadministration of aromatase inhibitors or tamoxifen were included. Random-start ovarian stimulation resulted in a comparable number of retrieved oocytes to the conventional protocol. Two ovarian stimulation cycles had significantly higher numbers of total retrieved oocytes than one cycle (mean difference 7.91, 95% confidence interval [CI] 3.42 to 12.40). Coadministration of letrozole and tamoxifen showed similar results for retrieved oocytes to those without. A significantly lower peak serum oestradiol concentration was observed in letrozole-based groups than in letrozole-free groups (mean difference −1.22; 95% CI −1.42 to −1.02). In conclusion, this study indicated that implementing random-start protocols to shorten the duration of waiting for ovarian stimulation, applying two ovarian stimulation cycles, and coadministration of letrozole can lead to more desirable outcomes.

由于卵巢刺激的时间受到限制，而且在进行性腺毒性治疗之前只能取出有限数量的卵母细胞，因此患有乳腺癌的育龄妇女保持生育能力具有挑战性。这项荟萃分析的目的是评估对患有乳腺癌的女性使用各种方案进行卵巢刺激后的生育力保留结果。检索了 PubMed、Embase 和 Cochrane 图书馆。22 项研究比较了乳腺癌女性接受随机开始卵巢刺激或常规方案的结果；单次或双次卵巢刺激周期；包括芳香酶抑制剂或他莫昔芬的共同给药。随机开始的卵巢刺激导致与传统方案相当数量的取回卵母细胞。两个卵巢刺激周期的总回收卵母细胞数量显着高于一个周期（平均差 7.91，95% 置信区间 [CI] 3.42 至 12.40）。来曲唑和他莫昔芬的共同给药对取回的卵母细胞与没有的卵母细胞的结果相似。在以来曲唑为基础的组中观察到血清雌二醇峰值浓度显着低于无来曲唑组（平均差 -1.22；95% CI -1.42 至 -1.02）。总之，本研究表明，实施随机启动方案以缩短等待卵巢刺激的持续时间、应用两个卵巢刺激周期以及联合使用来曲唑可以产生更理想的结果。来曲唑和他莫昔芬的共同给药对取回的卵母细胞与没有的卵母细胞的结果相似。在以来曲唑为基础的组中观察到血清雌二醇峰值浓度显着低于无来曲唑组（平均差 -1.22；95% CI -1.42 至 -1.02）。总之，本研究表明，实施随机启动方案以缩短等待卵巢刺激的持续时间、应用两个卵巢刺激周期以及联合使用来曲唑可以产生更理想的结果。来曲唑和他莫昔芬的共同给药对取回的卵母细胞与没有的卵母细胞的结果相似。在以来曲唑为基础的组中观察到血清雌二醇峰值浓度显着低于无来曲唑组（平均差 -1.22；95% CI -1.42 至 -1.02）。总之，本研究表明，实施随机启动方案以缩短等待卵巢刺激的持续时间、应用两个卵巢刺激周期以及联合使用来曲唑可以产生更理想的结果。