Effects of fertility preservation in patients with breast cancer: A retrospective two‐centers study

Abstract

PurposeTo assess the efficacy of fertility preservation (FP) and the impact of chemotherapy on the reproductive potential of Japanese patients with breast cancer.MethodsSixty‐two patients with breast cancer visited the authors’ centers from October, 2003 to June, 2015. They were divided into two groups according to the treatment: oocyte or embryo vitrification for FP before cancer treatment (group A) or infertility treatment after cancer treatment (group B). Group B was divided into two subgroups, B1 (no chemotherapy) and B2 (postchemotherapy), in order to analyze the effect of anticancer drugs on ovarian reserves and assisted reproductive technology outcomes. The number of retrieved oocytes, vitrified oocytes or embryos, and pregnancy rates were analyzed and compared: group A compared to group B1 compared to group B2.ResultsThe patients in groups A and B1 underwent egg collection without any chemotherapy. The numbers of collected oocytes and vitrified embryos were significantly higher in groups A and B1 than in group B2. Nearly 50% of the in vitro fertilization patients who underwent an embryo transfer (ET) became pregnant, including two patients in group A who underwent a vitrified‐warmed ET. Among the pregnant women, 70% did not have chemotherapy.ConclusionFor patients with breast cancer, FP with unfertilized oocytes or embryos before chemotherapy seems to be promising for achieving higher pregnancy rates, with no risk of minimal residual disease.

Preserving fertility in young women undergoing chemotherapy for early breast cancer; the Maastricht experience

“…To date, the available data on the transfer of cryopreserved oocytes or embryos after breast cancer therapy are limited [18,25,[27][28][29]. Embryo or oocyte transfer rates of 6-25% are reported [18,25,[27][28][29].…”

Nationwide survey of Japanese breast oncology and reproductive endocrinology departments about the impact of breast cancer treatment on fertility

“…Recently, freezing of embryos and/or unfertilized eggs is considered to be an option for improving pregnancy rates with no risk of minimal residual disease for breast cancer patients. 34,41 We found that 56.7% of responding departments used TAM for a minimum of 2 years before permitting patients to try for pregnancy. This may have come from the protocol of the ongoing clinical trial (Pregnancy Outcome and Safety of Interrupting Therapy for Women with Endocrine Responsive Breast Cancer [POSITIVE]), which permits pregnancy 2 years after initiation of TAM, but there is no established evidence for this approach.…”

“…9,32 In this context, fertility preservation is a key issue for young breast cancer patients. [33][34][35] The breast oncology departments responding to our survey noted that the most common method of achieving pregnancy was natural insemination (69.6%) after completing treatment for breast cancer (Fig. 4c).…”

“…The freezing of embryos, unfertilized eggs and/or ovarian tissue is sometimes performed before initiating breast cancer treatment. Recently, freezing of embryos and/or unfertilized eggs is considered to be an option for improving pregnancy rates with no risk of minimal residual disease for breast cancer patients 34,41 …”

Ovarian Metastasis of Breast Cancer Found During Ovarian Tissue Cryopreservation for Fertility Preservation: A Case Report

“…Evidence indicate that post cancer fertility is markedly decreased as a consequence of both the direct gonadal toxicity of chemotherapy regimens and the time needed before pregnancy (Bedoschi et al, 2016). In this context, oncofertility counselling is now integral part of the management of young breast cancer patients (Hashimoto et al, 2017). Recommendations state that this consultation should be organized as soon as possible following the diagnosis of malignancy (Oktay et al, 2018).…”