Cancer, pregnancy and fertility: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Peccatori, Fedro Alessandro; Azim, Hatem A.; Orecchia, Roberto; Hoekstra, Harald J.; Pavlidis, Nicholas; Kesić, Vesna; Pentheroudakis, G.

doi:10.1093/annonc/mdt199

Cited by 653 publications

(739 citation statements)

References 70 publications

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“…If a partner is not available or where embryo cryopreservation is not permitted by law, oocytes cryopreservation is a valid alternative [16]. Oocyte cryopreservation is not considered experimental since 2013, by the American Society of Clinical Oncology (ASCO) and the European Society of Medical Oncology (ESMO) [22,23]. More than 1000 births have been reported worldwide from cryopreserved oocytes [22,24].…”

Section: Fertility Preservation Options For Female Patientsmentioning

confidence: 99%

Fertility preservation in cancer patients: The global framework

Linkeviciute

Boniolo

Chiavari

et al. 2014

Cancer Treatment Reviews

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Cancer treatment is the most frequent cause of reduced fertility in cancer patients, with up to 80% of survivors affected. None of the established or experimental fertility preservation methods can assure parenthood; instead it may provide a future opportunity to overcome treatment induced sterility. Previous research demonstrated that fertility counselling has clinical and psychological benefit. Therefore, such patient services are recommended by internationally recognized guidelines. Around 70-75% of young cancer survivors in retrospective studies are reported to desire parenthood but the numbers of patients who use fertility preservation services prior treatment are significantly lower. Moreover, despite existing guidelines healthcare professionals worldwide lack practical knowledge and have personal biases which prevent addressing fertility preservation issues adequately. Surveys of healthcare professionals report the following barriers: lack of time and knowledge about existing options, poor prognosis, and delay in treatment, patient's age, partnership status, existing children, sexual orientation and socioeconomic situation. Moreover, fertility preservation consultation is not limited to medical aspects. Patient's fears, expectations and priorities shaped by personal values have to be addressed in a light of medical necessities, realistic survival prognosis, socio-cultural environment and availability of resources. We call for a need of framework for patient centred fertility counselling with a proposal that such framework should include support in decision making which would help patients to understand medical aspects of their cancer, realistic fertility preservation options, identify their preferences based on personal values and goals. Optional support services could also include legal guidance, psychological and spiritual support and financial counselling.

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Section: Fertility Preservation Options For Female Patientsmentioning

confidence: 99%

Fertility preservation in cancer patients: The global framework

Linkeviciute

Boniolo

Chiavari

et al. 2014

Cancer Treatment Reviews

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“…Both the maternal prognosis and the risk for the fetus need to be taken into account. Chemotherapy should be avoided during the first trimester of gestation but selective agents can be administered with reasonable safety during the second and third trimester without an excessive increased risk for the fetus [13,14]. A three-week period should be allowed between the last chemotherapy dose and the expected date of delivery.…”

Section: Sexual Dysfunction Reproduction and Pregnancymentioning

confidence: 99%

Principles of chemotherapy

Lundqvist

2012

Intl J Gynecology & Obste

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“…Current guidelines recommend an elaborate discussion on family planning matters and early referral for fertility preservation on presentation [14][15][16]. To reduce ovarian damage, patients can be prescribed with a GnRH analogue during chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

IVF for fertility preservation in breast cancer patients—efficacy and safety issues

Shapira

Raanani

Meirow

2015

J Assist Reprod Genet

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Background Potential risks on future fertility have become a dominant issue in consultation and management of newly diagnosed young cancer patients. Several fertility preservation strategies are currently available. Of those, ovarian stimulation followed by IVF and embryo cryopreservation is the most established one and is especially applicable in reproductive aged breast cancer patients. Aim The aim of this study is to provide a comprehensive review on ovarian stimulation and IVF for fertility preservation in newly diagnosed breast cancer patients. Methods Review of relevant literature is available through PubMed and Google scholar. Results The use of IVF for fertility preservation in breast cancer patients raises dilemmas regarding efficacy and safety of controlled ovarian stimulation. Among these are the suggested role of malignancy and BRCA mutation in reducing ovarian response to stimulation, strategies designated to protect against hyper-estrogenic state associated with stimulation (co-treatment with tamoxifen or letrozole), and possible adjustments to accommodate oncologic-related time constraints. Conclusion Ovarian stimulation followed by IVF forms an important fertility preservation strategy for newly diagnosed young breast cancer patients, though live born rates following thawed embryo transfer in these patients are still lacking. Recent advances in controlled ovarian stimulation protocols provide practical options for some of the challenges that breast cancer patients present.

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Cancer, pregnancy and fertility: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Cited by 653 publications

References 70 publications

Fertility preservation in cancer patients: The global framework

Fertility preservation in cancer patients: The global framework

Principles of chemotherapy

IVF for fertility preservation in breast cancer patients—efficacy and safety issues

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