EP410 Reduced response to controlled ovarian stimulation after radical trachelectomy

Introduction/Background In vitro fertilization is often needed after radical trachelectomy because of difficult spontaneous pregnancy or cervical factor infertility, such as cervical stenosis. At the time of in vitro fertilization, patients who have undergone radical trachelectomy usually experience resistance to controlled ovarian stimulation. We aimed to clarify the decrease in response to controlled ovarian stimulation after radical trachelectomy in patients who received in vitro fertilization treatment at our hospital. Methodology The outcomes of ovarian stimulation were retrospectively evaluated and compared between patients who have undergone radical trachelectomy and control patients who had male factor infertility or unexplained infertility. Patients with ovarian factor infertility, such as those with a history of ovarian endometriotic cyst or ovarian surgery, were excluded. The data obtained were age at ovarian stimulation, body mass index, total dose of gonadotropin, duration of stimulation, peak estradiol concentration, number of retrieved oocytes, and number of fertile ova. Results A total of 22 ovarian stimulation cycles in 11 radical trachelectomy patients and 51 cycles in 28 control patients were reviewed. The median age at ovarian stimulation was 35.1 years (range 29.0–41.2 years) in the radical trachelectomy group and 38.2 years (range 22.9–44.8 years) in the control group (p=0.034). Compared with the control group, the radical trachelectomy group had significantly lower mean peak estradiol concentration [1,418 pg/mL (SD 727) vs. 1,845 pg/mL (SD 787), p=0.03] and smaller median number of mature oocytes [5 (range 1–14) vs. 8 (range 1–19), p=0.014], despite the higher use of gonadotropin [3,456 IU (SD 1,406) vs. 2,654 IU (SD 908), p=0.005]. Conclusion The response to controlled ovarian stimulation decreased after radical trachelectomy. For better reproductive outcome, cryopreservation of eggs before radical trachelectomy should be considered. Disclosure Nothing to disclose.