Fertility preservation in patients with BRCA mutation

Ghunaim, Suleiman; Ghazeeri, Ghina; Khalife, Dalia; Azim, Hatem A.

doi:10.3332/ecancer.2020.1033

Cited by 7 publications

(8 citation statements)

References 48 publications

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“…An increased risk of BC was seen in BRCA1 (20%) and BRCA2 (10%). Implementing these gene screenings has become an excellent strategy (17). However, they are still not widely available due to cost.…”

Section: Discussionmentioning

confidence: 99%

“…The choice of FP should be carefully discussed as OTC may have the risk of reintroducing ovarian cancer (OC) following OTT. The risk of OC is 40% for BRCA1 compared to that for BRCA2 at 15% (17). Therefore, a lengthy discussion should be offered before OTC.…”

Section: Discussionmentioning

confidence: 99%

“…The use of COS-AI is also recommended to reduce the risk of breast tissue stimulation (7,9). However, the risk of transferring to the offspring needs to be highlighted as an autosomal dominant (AD) link (17,18). It could be carried in cryopreserved oocytes or embryos.…”

Section: Discussionmentioning

confidence: 99%

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Case Report: Young Adults With Breast Cancer: A Case Series of Fertility Preservation Management and Literature Review

et al. 2021

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Breast cancer comprised at least 21.8% of the overall cancer among young adult (YA) women and became the leading cancer in this group in Japan, with 50% adolescent and YAs being diagnosed and 15–44-year-old women showing excellent 5-year survival. Surgical-chemoradiation therapy often results in excellent survivorship with an increased incidence of treatment-induced subfertility. Therefore, adding fertility preservation (FP) to the primary cancer treatment is necessary. Herein, we reported a series of cases of YA women with breast cancer who opted for FP, where their option was tailored accordingly. To date, the selection of oocytes, embryos and ovarian tissue is widely available as an FP treatment. PGT could reduce the risk of BRCA mutation transmission amongst BRCA carriers before pregnancy planning. Otherwise, gonadotropin-releasing hormone analog has no gonadoprotective effect and thus should not be considered as an FP option.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Case Report: Young Adults With Breast Cancer: A Case Series of Fertility Preservation Management and Literature Review

et al. 2021

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“…In addition, the cryopreservation of oocytes/embryos at a younger age may be favorable as the depletion of their ovarian reserve is suspected to be accelerated [ 124 ]. Yet, these techniques remain suitable for BRCA -mutated patients [ 92 , 122 , 125 ]. Initially, COS was not recommended for patients with estrogen-sensitive cancers, but it is now performed with the introduction of aromatase inhibitors in the stimulation protocol used for fertility preservation at diagnosis [ 126 , 127 ].…”

Section: Brca Mutations and Fertilitymentioning

confidence: 99%

BRCA Mutations and Fertility Preservation

Dias Nunes,

Demeestere,

Devos

2023

IJMS

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Hereditary cancers mostly affect the adolescent and young adult population (AYA) at reproductive age. Mutations in BReast CAncer (BRCA) genes are responsible for the majority of cases of hereditary breast and ovarian cancer. BRCA1 and BRCA2 act as tumor suppressor genes as they are key regulators of DNA repair through homologous recombination. Evidence of the accumulation of DNA double-strand break has been reported in aging oocytes, while BRCA expression decreases, leading to the hypothesis that BRCA mutation may impact fertility. Moreover, patients exposed to anticancer treatments are at higher risk of fertility-related issues, and BRCA mutations could exacerbate the treatment-induced depletion of the ovarian reserve. In this review, we summarized the functions of both genes and reported the current knowledge on the impact of BRCA mutations on ovarian ageing, premature ovarian insufficiency, female fertility preservation strategies and insights about male infertility. Altogether, this review provides relevant up-to-date information on the impact of BRCA1/2 mutations on fertility. Notably, BRCA-mutated patients should be adequately counselled for fertility preservation strategies, considering their higher sensitivity to chemotherapy gonadotoxic effects.

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“…Immature oocytes can be retrieved simultaneously with the mature oocyte, and subsequently cultured in vitro for 24–48 h to mature into metaphase II oocytes, maximizing the number of obtained fertilizable oocytes [ 99 , 100 ]. In another aspect, oocyte and embryo cryopreservation provides a chance for preimplantation genetic testing during IVF procedure, which helps to eliminate the possibility of malignancy transmission to their offspring in genetic-related cancer patients [ 101 , 102 , 103 ]. Otherwise, the IVF procedure using a donor oocyte and subsequent embryo cryopreservation is an alternative option, which prevents occurrence of genetically based tumors in these patients’ offspring [ 104 ].…”

Section: The Therapeutic Options For Fpmentioning

confidence: 99%

Female Oncofertility: Current Understandings, Therapeutic Approaches, Controversies, and Future Perspectives

Kawamura

2021

JCM

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Recent advances in early detection and oncological therapies have ameliorated the survival rate of young cancer patients. Yet, ovarian impairment induced by chemotherapy and radiotherapy is still a challenging issue. This review, based on clinical and lab-based studies, summarizes the evidence of gonadotoxicity of chemoradiotherapy, the recent approaches, ongoing controversies, and future perspectives of fertility preservation (FP) in female patients who have experienced chemo- or radio-therapy. Existing data indicate that chemotherapeutic agents induce DNA alterations and massive follicle activation via the phosphoinositide 3-kinase (PI3K)/Akt signaling pathway. Meanwhile, the radiation causes ionizing damage, leading to germ cell loss. In addition to the well-established methods, numerous therapeutic approaches have been suggested, including minimizing the follicle loss in cryopreserved ovarian grafts after transplantation, in vitro activation or in vitro growing of follicles, artificial ovarian development, or fertoprotective adjuvant to prevent ovarian damage from chemotherapy. Some reports have revealed positive outcomes from these therapies, whereas others have demonstrated conflictions. Future perspectives are improving the live birth rate of FP, especially in patients with adverse ovarian reserve, eliminating the risk of malignancy reintroducing, and increasing society’s awareness of FP importance.

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Fertility preservation in patients with BRCA mutation

Cited by 7 publications

References 48 publications

Case Report: Young Adults With Breast Cancer: A Case Series of Fertility Preservation Management and Literature Review

Case Report: Young Adults With Breast Cancer: A Case Series of Fertility Preservation Management and Literature Review

BRCA Mutations and Fertility Preservation

Female Oncofertility: Current Understandings, Therapeutic Approaches, Controversies, and Future Perspectives

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