Effects of Follicular Testosterone on Cumulus and Granulosa Cells during Ovarian Stimulation with Aromatase Inhibitors in Patients with Breast Cancer

For patients with estrogen-sensitive tumors, there is a concern that the high estrogen state induced by controlled ovarian stimulation (COS) for oocyte retrieval may stimulate the growth of cancer cells. Protocols using aromatase inhibitors (AIs) have been developed to suppress the elevated estrogen levels during ovarian stimulation. However, studies have shown that COS with AI may induce apoptosis in cumulus and granulosa cells due to an increase in the androgen/estrogen ratio, which is associated with decreased oocyte quality. In the present study, we examined the hormonal dynamics in follicular fluid collected from patients with breast cancers who underwent COS with AI for fertility preservation (n = 11). In addition, we examined the relative gene expressions of several oocyte quality predictor genes in the cumulus and granulosa cells. The control samples were collected from patients with general infertility who underwent COS without AI (n = 17).