Random-start controlled ovarian hyperstimulation with letrozole for fertility preservation in cancer patients: Case series and review of literature

The aim of this case series was to describe our experience with random-start controlled ovarian hyperstimulation (rs-coh) with the use of letrozole for fertility preservation. gnrh antagonist and letrozole cycles were started in three patients with a diagnosis of cancer and had a limited time window for fertility preservation for coh before initiating cancer therapy. cycles were started in the late follicular or luteal phase, and the duration of coh ranged between 7-8 days. a total of 4-14 oocytes were retrieved, the peak e2 levels were 252-354 pg/ml and the saved time for start of the cancer treatment were 16-26 days for each patient. in conclusion, rs-coh with letrozole cycle is a reasonable option for fertility preservation in cancer patients for whom the treatment window may be narrow. also, the use of a letrozole for coh may decrease the potential risk of ovarian hyperstimulation syndrome.