Is there a relationship between tumour aggressiveness and ovarian stimulation outcomes in adolescent and young adult patients with lymphoma?
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RESEARCH QUESTION: Does the aggressiveness of Hodgkin lymphoma impact the oocyte cohort after ovarian stimulation for fertility preservation? DESIGN: A retrospective analysis of prospectively collected data was undertaken. Seventy-seven chemo-naive women with newly diagnosed Hodgkin lymphoma were enrolled prospectively at the Observatory and Fertility Preservation Centre, Lille University Hospital, France between 2012 and 2021. Seventy-eight ovarian stimulation cycles were performed. Oocyte cohort characteristics were compared between patients with early and intermediate stage disease [German Hodgkin Study Group (GHSG) I + II] and patients with advanced stage disease (GHSG III). Among the GHSG III patients, the influence of the Hasenclever score on fertility preservation outcomes was analysed. The primary endpoint was the number of metaphase II oocytes (MII) retrieved. RESULTS: The groups were comparable except for body mass index (BMI). Overall, a median of seven (interquartile range 4-11) MII oocytes were retrieved. Before and after adjustment for BMI, age, pre-treatment anti-Müllerian hormone concentration, and total dose of gonadotrophin, GHSG status did not have a significant impact on the number of MII oocytes retrieved [relative risk 0.96, 95% confidence interval 0.68-1.34; P = 0.79] or the other ovarian stimulation outcomes. The Hasenclever score was not significantly associated with the number of MII oocytes retrieved. CONCLUSION: Tumour aggressiveness was not found to have a significant influence on the number of MII oocytes retrieved in young women with Hodgkin lymphoma. These results suggest that fertility preservation should be proposed systematically, regardless of the stage of Hodgkin disease, in young women.