在保留生育能力的情况下，乳腺癌预后因素会影响卵巢储备功能和对卵巢刺激的反应吗？对 352 名乳腺癌女性进行观察性双中心回顾性研究，她们在 2015 年 11 月期间使用随机启动促性腺激素释放激素拮抗剂方案和玻璃化卵母细胞接受了卵巢刺激2022 年 8 月。测量血清抗苗勒氏管激素 (AMH) 水平和窦卵泡计数 (AFC)。根据患者特征和乳腺癌预后因素，分析回收的卵母细胞数量、成熟率和卵泡输出率（FORT）。中位年龄为34岁（31.1-37.1）。中位 AFC 和血清 AMH 水平分别为 17 (12-26) 个卵泡和 2 (1.2-3.4) ng/ml。卵巢刺激后，回收了 10.5 (6.0-16.0) 个卵母细胞，其中 8 个 (4-13) 已成熟。平均卵母细胞成熟率为 79% (62-92)。窦卵泡计数 (>12) 显着影响回收少于 8 个成熟卵母细胞的风险（P < 0.0001，多变量分析）。通过卵泡输出率（FORT指数）和回收的卵母细胞数量评估卵泡对FSH的反应性，分别为31%（21-50）和10.5%（6.0-16.0）。 FORT指数和卵巢刺激结果不受乳腺癌预后因素的影响。乳腺癌预后因素不影响卵巢储备标志物或生育力保存中对卵巢刺激的反应。因此，在考虑卵巢刺激进行卵母细胞玻璃化冷冻时，肿瘤分级、三阴性状态、HER2 过表达和高 Ki67 不应改变生育力保存策略。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Do breast cancer prognostic factors influence ovarian reserve and response to ovarian stimulation in the context of fertility preservation?Observational, bicentric retrospective study of 352 women with breast cancer who underwent ovarian stimulation using a random start gonadotrophin releasing hormone antagonist protocol and vitrified oocytes between November 2015 and August 2022. Serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) were measured. The number of oocytes recovered, maturation rate and follicular output rate (FORT) were analysed according to patients' characteristics and breast cancer prognostic factors.Median age was 34 years (31.1-37.1). Median AFC and serum AMH level were 17 (12-26) follicles and 2 (1.2-3.4) ng/ml, respectively. After ovarian stimulation, 10.5 (6.0-16.0) oocytes were recovered, with eight (4-13) being mature. Mean oocyte maturation rate was 79% (62-92). Antral follicle count (>12) significantly affected the risk of recovering fewer than eight mature oocytes (P < 0.0001, multivariate analysis). Follicular responsiveness to FSH, assessed by the follicular output rate (FORT index) and number of oocytes recovered, were 31% (21-50) and 10.5% (6.0-16.0), respectively. FORT index and ovarian stimulation outcomes were not influenced by breast cancer prognostic factors.Breast cancer prognostic factors do not influence ovarian reserve markers or response to ovarian stimulation in fertility preservation. Therefore, tumour grade, triple-negative status, HER2 overexpression and high Ki67 should not alter the fertility-preservation strategy when considering ovarian stimulation for oocyte vitrification.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.