PONE-D-22-23405Optimizing ovarian hyperstimulation for fertility preservation in women with cancer a ‘before and after’ studyPLOS ONE

Dear Dr. Francesca Filippi,

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Gulzhanat Aimagambetova

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The title of the manuscript sounds confusing. It will benefit if rephrased for more clarity.

The abstract provides some understanding of the study, however, should be improved to represent the study in a clearer way. In the methods section of the abstract, the study design should be explained. It is not clear what does "before and after '' mean?

The manuscript draft is landscape oriented. Is there any practical need for it? Please follow the PLOS ONE journal requirements at https://journals.plos.org/plosone/s/submission-guidelines.

The introduction part provides a clear rationale for the study. However, it is too narrow and the text will benefit if reworked. In particular, more updated references are suggested. For example for the sentences in lines 39-41 and 42-46 the following more updated sources could be used - doi: 10.3332/ecancer.2020.1030; doi: 10.3390/jcm11010196; doi: 10.3390/ijms222111825; doi: 10.1007/s00404-018-5006-z.

Moreover, information on the epidemiology of GYN cancers in general and among young women and the current situation in your country with the fertility preservation approach could improve the introduction part.

The methods section is detailed. However, poorly structured. Please provide the following items (better to highlight with the relevant subheadings, which will make the text more comprehensible for a potential audience): Study Design, study participants/subjects, Study instruments, variables, study protocol, ethical considerations, and statistical analyses.

The text in lines 107-114 of the methods section looks confusing. It might sound better if moved to the results section. However, it is up to the authors to decide.

The results are promising and presented clearly, supported by tables and figures.

The discussion part is interesting but will improve if restructured according to the suggested outline (the following items should be mentioned): Rationale of the study (why it was done); Main findings of the study; What makes your study unique; What it adds to what we already know; Subject of the discussion, Comparison with previous studies, agreement and disagreement with the studies compared; study strengths and limitations; Clinical implication.

Reviewer #2: I read with great interest the manuscript, which falls within the aim of this Journal. In my honest opinion, the topic is interesting enough to attract the readers’ attention. Nevertheless, the authors should clarify some points and improve the discussion, as suggested below.

Authors should consider the following recommendations:

- I recommend to discuss, at least briefly, novel pieces of evidence about fertility-preservation in case of early-stage endometrial cancer, since it is one of the most common gynecological malignancies in women of reproductive age (authors may refer to: PMID: 36143933).

- Authors may consider to add further details about the psychological impact of cancer in women wishing to preserve their fertility (PMID: 28275393).

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Reviewer #1: No

Reviewer #2: No

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Progestin-primed ovarian stimulation for fertility preservation in women with cancer: a comparative study

PONE-D-22-23405R1

Dear Dr. Francesca Filippi,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Gulzhanat Aimagambetova

Academic Editor

PLOS ONE

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Authors responded to comments.

Manuscript can be accepted for publication in this revised version.

Reviewer #2: I carefully evaluated the revised version of this manuscript.

Authors have performed the required changes, improving significantly the quality of the paper.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Professor Dr. Milan Terzic

Reviewer #2: No

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