Until several years ago, the prevailing thought was that only one “wave” of follicles is available for growth per monthly menstrual cycle; therefore, controlled ovarian stimulation (COS) for fertility preservation would require waiting for a woman’s period to start prior to her starting fertility medications for COS leading up to oocyte retrieval for fertility preservation prior to cancer treatments such as chemotherapy. Because a female cancer patient would often need to start cancer treatments very soon after diagnosis, if she was in a phase of her menstrual cycle that was, for example, two weeks away from her upcoming period, there was not enough time to wait for the period and proceed with COS for fertility preservation because this wait time and process would delay cancer treatments and their outcomes. In some cases, such a scenario would preclude fertility preservation.
The dogma that only one wave of follicles is available for growth has been disproven as it has clearly been shown in studies and clinical private practice that there are several “waves” of follicles available for growth during a monthly menstrual cycle. Follicles can be grown at other times of the menstrual cycle with fertility medication, and this process is referred to as “random” COS (RCOS). Oocytes can be retrieved for oocyte and/or embryo cryopreservation, and there have been good fertility outcomes from such cases. Women of reproductive age who unfortunately are diagnosed with cancer can immediately start RCOS for fertility preservation without the delay in their upcoming cancer treatments that used to be a concern. Dr. Shahryar Kavoussi was interviewed by Nicole Villalpando of the Austin American Statesman regarding RCOS.
To read the article in the Austin American Statesman click here.