Preservation of reproductive material in oncology patients: the role of anti-Müllerian hormone and possibilities of Random Start protocols using corifollitropin alfa
Nazarenko T.A., Dzhanashvili L.G., Biryukova A.M., Krylova E.I.
Objective: To perform retrospective assessment of the effectiveness of using corifollitropin alfa according to Random Start protocol for ovarian stimulation regardless of the day or both follicular and luteal phases of the menstrual cycle taking into account anti-Müllerian hormone (AMH) levels in oncology patients.
Materials and methods: Retrospective analysis of medical records of 190 patients with oncologic diseases was performed. The patients were referred by oncologist to the IVF clinic for fertility preservation, where they underwent examination and treatment from 2024 to 2025.
Results: Analysis of clinical data of 160 patients showed that the AMH level is a key factor determining ovarian response to controlled ovarian stimulation. The groups with AMH levels >1.5 ng/ml demonstrated significantly higher number of oocytes 12.7 (5.9) and 11.8 (3.1) versus. 2.9 (1.6) and 3.0 (1.2); (p<001) and blastocysts 3.2 (1.7) and 3.4 (1.8) versus 0.9 (0.4) and 0.9 (0.4); (p<0.01) compared with the groups with AMH levels <1.5 ng ml. The initiation of stimulation in a phase of the cycle did not influence significantly these indicators.
A positive correlation was found between AMH level and the number of antral follicles (r=0.85–0.91), oocytes (r=0.84–0.94), and blastocysts (r=0.76–0.94). The need for additional gonadotropin stimulation and its duration directly depended on the initial ovarian reserve.
Conclusion: Thus, patient stratification based on AMH level helps to optimize the stimulation protocol, whereas the choice of follicular or luteal phase of the cycle for initiation of ovarian stimulation does not significantly influence treatment effectiveness. The use of long-acting gonadotropin (corifollitropin alfa) in ovarian stimulation protocols for oncology patients is of significant practical interest due to the possibility of a single injection against the backdrop of psychological stress related to diagnosis and treatment. However, the effectiveness of this approach, especially in Random Start protocols is understudied. Based on the obtained data, p corifollitropin alfa can be recommended for patients with preserved ovarian reserve during the follicular phase of the cycle. With diminished ovarian reserve, particularly in the luteal phase, the conventional protocol with daily gonadotropin administration can be preferable, since it is more predictable. Our study provides the physicians with substantiated criteria for selection of the optimal stimulation protocol for oncology patients.
Authors' contributions: Nazarenko T.A. – the study concept and design, manuscript editing and final approval; Dzhanashvili L.G., Birukova A.M., Krylova E.I. – material collection, statistical data analysis and processing, manuscript writing.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare
Funding: The study was carried out without any sponsorship.
Ethical Approval: The study was approved by the local Ethics Committee of Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.
Patient Consent for Publication: The patients have signed informed consent for publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Nazarenko T.A., Dzhanashvili L.G., Birukova A.M., Krylova E.I. Preservation of reproductive material in oncology patients: the role of anti-Müllerian hormone and possibilities of Random Start protocols using corifollitropin alfa.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (4): 149-158 (in Russian)
https://dx.doi.org/10.18565/aig.2025.363
Keywords
corifollitropin alfa
Random Start protocol
oncofertility
ovarian stimulation
anti-Müllerian hormone (AMH)
ovarian reserve
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Received 09.12.2025
Accepted 09.04.2026
About the Authors
Tatyana A. Nazarenko, Dr. Med. Sci., Professor, Head of the Institute of Reproductive Medicine, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation, 117997, Russia, Moscow, Ac. Oparin str., 4, t_nazarenko@oparina4.ru,https://orcid.org/0000-0002-5823-1667
Lana G. Dzhanashvili, PhD, obstetrician-gynecologist at the Scientific and Clinical Department of ART named after F. Paulsen, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation, l_dzhanashvili@oparina4.ru, 117997, Russia, Moscow,
Ac. Oparin str., 4, https://orcid.org/0000-0002-2891-3974
Almina M. Birukova, PhD, Head on Clinical Work at the Scientific and Clinical Department of ART named after F. Paulsen, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation, a_birukova@oparina4.ru, 117997, Russia, Moscow,
Ac. Oparin str., 4, https://orcid.org/0009-0004-5113-6239
Ekaterina I. Krylova, obstetrician-gynecologist at the Scientific and Clinical Department of ART named after F. Paulsen, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation, kr.katrin00@gmail.com, 117997, Russia, Moscow, Ac. Oparin str., 4. https://orcid.org/0000-0002-0220-0474
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