本系统评价和荟萃分析的目的是量化随机启动卵巢刺激 (RSOS) 与常规启动卵巢刺激 (CSOS) 相比，在性腺毒性治疗前癌症患者中的效果。最终的分析队列包含性腺毒性治疗前癌症患者的 688 个 RSOS 和 1076 个 CSOS 周期。通过 MEDLINE、Cochrane 图书馆和引用的参考文献的数据库检索确定了 11 项研究。感兴趣的主要结果是收集的卵母细胞和成熟卵母细胞的数量、冷冻保存的胚胎数量以及中期 II (MII)-窦卵泡计数 (AFC) 比率。根据纽卡斯尔-渥太华质量评估量表，这些研究被评为中等到高质量（从 6 到 9）。这两种方案收集的卵母细胞、MII 卵母细胞、可用于冷冻保存的胚胎数量相似，并且 MII-AFC 和受精率相当。与 RSOS 相比，RSOS 的卵巢刺激持续时间较长（标准化平均差 [S​​MD] 0.35，95% CI 0.09 至 0.61；P=0.009），促性腺激素消耗量较高（SMD 0.23，95% CI 0.06 至 0.40；P=0.009）。与CSOS。本系统回顾和荟萃分析表明，与接受 CSOS 的癌症患者相比，接受 RSOS 的癌症患者刺激持续时间更长，促性腺激素消耗总量更高，但对成熟卵母细胞产量没有显着影响。版权所有 © 2023 Reproductive Healthcare Ltd.由爱思唯尔有限公司出版。保留所有权利。

The aim of this systematic review and meta-analysis was to quantify the effect of random start ovarian stimulation (RSOS) compared with conventional start ovarian stimulation (CSOS) in cancer patients before gonadotoxic treatment. The final analytical cohort encompassed 688 RSOS and 1076 CSOS cycles of cancer patients before gonadotoxic treatment. Eleven studies were identified by database searches of MEDLINE, Cochrane Library and cited references. The primary outcomes of interest were the number of oocytes and mature oocytes collected, the number of embryos cryopreserved and the metaphase II (MII)-antral follicle count (AFC) ratio. The studies were rated from medium to high quality (from 6 to 9) according to the Newcastle-Ottawa Quality Assessment Scale. The two protocols resulted in similar numbers of oocytes collected, MII oocytes, embryos available for cryopreservation and comparable MII-AFC and fertilization rates. The duration of ovarian stimulation was longer (standardized mean difference [SMD] 0.35, 95% CI 0.09 to 0.61; P = 0.009) and gonadotrophin consumption was higher (SMD 0.23, 95% CI 0.06 to 0.40; P = 0.009) in RSOS compared with CSOS. This systematic review and meta-analysis show that the duration of stimulation is longer, and the total gonadotrophin consumption is higher in cancer patients undergoing RSOS compared with those undergoing CSOS, with no significant effect on mature oocyte yield.Copyright © 2023 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.