Fertility in Breast Cancer Survivors in the Middle East: A Retrospective Study

Abstract

Introduction By the time they complete breast cancer therapy, many young patients are still of childbearing age. We aim to estimate the incidence of pregnancies in women who completed treatment and examine the percentage of patients who received fertility counseling before initiation of therapy. Material and methods Electronic health records of breast cancer patients between 2008 and 2014 at AUBMC were screened for exclusion criteria of having metastatic disease or known infertility, still receiving therapy, and being above 42 years at diagnosis. Data about therapy and tumor characteristics was obtained for the included survivors who were interviewed as well via telephone for information about fertility preservation counseling, pregnancy occurrence, and delivery. Results 451 breast cancer patients were identified. 39 patients remained after application of exclusion criteria. 30.76% (n = 12) wanted more children at the time of diagnosis. 10.25% (n = 4) of all 39 patients treated for breast cancer achieved one or more pregnancy after a median time of 3.83 years after completion of therapy. 25% (n = 3) of women who wanted more children at diagnosis (n = 12) were able to conceive. 23.07% (n = 9) of patients discussed fertility with their primary oncologist prior to treatment initiation. 35.89% (n = 14) of patients were aware of fertility preservation technique availability, but none of these patients used one. Conclusions The observed rate of pregnancy is comparable to the literature. There is a lack in fertility counseling of breast cancer patients, and the rate of use of fertility preservation techniques is very low despite prior knowledge about their availability.

The stake of informing patients of the risk of hypofertility after chemotherapy for breast cancer

“…These choices are obviously influenced by the patient's overall plans for parenthood. In a study conducted between 2018 and 2014 in a population similar to ours, Assi et al ( 15 ) reported that 30% of the 39 women in their small sample intended to become a parent at the time of diagnosis. We were not able to take this fundamental psychosocial factor into account, which constitutes a limitation.…”

“…However, other proxies of the intention of women with breast cancer to become a parent have been used elsewhere, such as marital status. For example, in a study published in 2014 by Ruddy et al ( 15 ) concerning women < 45 years of age with breast cancer, 37% of those younger than 40 years of age intended before their diagnosis to give birth to a child. They also reported that married women were more concerned about the risk of post-treatment hypofertility than other women ( 16 ).…”

Demographic and Socio-cultural Determinants of Intended and Unintended Pregnancies Among Women Under Cancer Treatment in Sistan and Baluchestan Province, Iran

“…The findings of a study by Kopeika et al (29) in the UK also found that 41% of young breast cancer survivors showed tendency to have children. Similarly, a study by in Beirut, Lebanon, revealed that 30.76% of women wanted more children at the time of diagnosis (38).…”

Fertilidade e contracepção em mulheres com câncer em tratamento quimioterápico

“…Data corroborated by an American study with 211 women with breast cancer undergoing chemotherapy, where 52% did not receive advice on preserving fertility. 4 Also observed in a study conducted in Lebanon 20 with 39 women with breast cancer and 76.9% did not discuss with the oncologist the possibility of infertility.…”