Background and Objectives: Fertility preservation in young patients with hematological malignancies is often constrained by the need for urgent life-saving chemotherapy, leaving limited evidence to guide counseling once treatment has already begun. Reliable predictors of ovarian response after chemotherapy are therefore clinically important. Materials and Methods: This retrospective single-center study included 37 hematological patients aged ≤35 years who underwent urgent controlled ovarian stimulation after initial chemotherapy. Only the first cycle per patient was analyzed. Patients were grouped by metaphase II oocyte yield as high-yield group (≥8 metaphase II oocytes) or low-yield group (<8). Post-chemotherapy ovarian reserve markers and chemotherapy-related variables were assessed. Parsimoniously adjusted logistic regression and ROC analyses were performed, and LOESS regression was used to explore relationships with mature oocyte number. Results: The median number of chemotherapy cycles before stimulation was three (IQR: 2–4), and the median interval from last chemotherapy to retrieval was 33 days (IQR: 27–39). The high-yield group had higher post-chemotherapy anti-Müllerian hormone (AMH) and antral follicle count (AFC) than the low-yield group (both p < 0.05). In adjusted analyses, AMH (OR 2.58, 95% CI 1.17–5.70) and AFC (OR 1.24, 95% CI 1.04–1.48) were associated with achieving ≥8 mature oocytes. No association was detected between oocyte yield and chemotherapy cycle number, chemotherapy-free interval, alkylating agent exposure, or stimulation-related factors. LOESS showed positive, non-linear associations for AMH and AFC with mature oocyte number. In this exploratory analysis, ROC curves suggested moderate discrimination for predicting high oocyte yield, with areas under the curve of 0.78 for AMH, 0.73 for AFC, and 0.80 for the combined model. Conclusions: Post-chemotherapy AMH and AFC were associated with ovarian response in urgent fertility preservation after initial chemotherapy for young hematological malignancies. Larger studies are needed to validate these exploratory findings.
Ding et al. (Wed,) studied this question.
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