Reproductive potential and performance of fertility preservation strategies in BRCA-mutated breast cancer patients

Lambertini, Matteo; Goldrat, Oranite; Ferreira, Arlindo R.; Dechene, Julie; Azim, Hatem A.; Désir, Julie; Delbaere, Anne; Roodenbeke, Marie Daphne t’Kint de; Azambuja, Evandro de; Ignatiadis, Michail; Demeestere, Isabelle

doi:10.1093/annonc/mdx639

Cited by 103 publications

(111 citation statements)

References 15 publications

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“…Moreover, as 30% of women wish to perform a preimplantation genetic diagnosis to select healthy embryos before transfer, oocyte retrieval will be mandatory for this technique and could be offered at a young age before childbearing is desired . Finally, the genetic disorder itself might impact reproductive potential and the performance of fertility preservation …”

Section: Genetic Disordersmentioning

confidence: 99%

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Challenges of fertility preservation in non‐oncological diseases

Condorelli

Demeestere

2019

Acta Obstet Gynecol Scand

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Clinicians should provide fertility counseling to all patients receiving gonadotoxic treatment. International scientific societies have mainly focused on oncological patients, and fewer efforts have been made to apply these recommendations to women diagnosed with benign disease (eg benign hematological diseases, autoimmune diseases, and gynecological or genetic disorders). However, these indications account for 8%‐13% of the demand for fertility preservation. The risk of premature ovarian failure due to treatment, or to the disease itself, can be considered fairly high for many young women. Counseling and adequate management of these women require particular attention due to the severe health conditions that are associated with some of these diseases. In this review, we address specific issues related to providing adequate fertility counseling and management for women who have been diagnosed with the major non‐oncological indications, based on the literature and on our clinical experience.

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Section: Genetic Disordersmentioning

confidence: 99%

“…72 Finally, the genetic disorder itself might impact reproductive potential 73 and the performance of fertility preservation. 74 Finally, rare genetic disorders such as Hurler syndrome (mucopolysaccharidosis type 1) might need a conditioning treatment for HSCT. In those cases, ovarian tissue cryopreservation can also be proposed.…”

Section: G Ene Ti C D Isorder Smentioning

confidence: 99%

Challenges of fertility preservation in non‐oncological diseases

Condorelli

Demeestere

2019

Acta Obstet Gynecol Scand

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“…It would be of particular interest to assess which is the relevance of these oncologic events as confounding factors in BRCA1/2 women reduced fertility. [13,[15][16][17] The previous six studies related to this topic, addressing ovarian stimulation in BRCA 1/2 subjects, did not analyze in detail the potential role of oncologic history itself, independent of BRCA mutations, as fertility performance determinant [16,[18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Impact of BRCA1 and BRCA2 mutations on ovarian reserve and fertility preservation outcomes in young women with breast cancer

Porcu

Cillo

Cipriani

et al. 2019

J Assist Reprod Genet

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Purpose To determine the impact of BRCA1 and BRCA2 mutations on ovarian reserve and fertility preservation outcome. The main purpose and research question of the study is to determine the impact of BRCA1 and BRCA2 mutations on ovarian reserve and fertility preservation outcomes. Methods Prospective study: 67 breast cancer patients between 18 and 40 years old, undergoing a fertility preservation by means of oocyte storage were considered. Inclusions criteria for the study were age between 18 and 40 years old, BMI between 18 and 28, breast cancer neoplasm stage I and II according to American Joint Committee on Cancer classification (2017) and no metastasis. Exclusion criteria: age over 40 years old, BMI < 18 and > 28, breast cancer neoplasm stage III and IV and do not performed the BRCA test. A total of 21 patients had not performed the test and were excluded. Patients were divided into four groups: Group A was composed by 11 breast cancer patients with BRCA 1 mutations, Group B was composed by 11 breast cancer patients with BRCA 2 mutations, Group C was composed by 24 women with breast cancer without BRCA mutations, and Group D (control) was composed by 181 normal women. Results Group A showed significant lower AMH levels compared to Group C and D (1.2 ± 1.1 vs 4.5 ± 4.1 p < 0.05 and 1.2 ± 1.1 vs 3.8 ± 2.5 p < 0.05). BRCA1 mutated patients showed a significant lower rate of mature oocytes (MII) compared to Group C (3.1 ± 2.3 vs 7.2 ± 4.4 p < 0,05) and Group D (3.1 ± 2.3 vs 7.3 ± 3.4; p < 0,05). Breast cancer patients needed a higher dose of gonadotropins compared to controls (Group A 2206 ± 1392 Group B2047.5 ± 829.9 Group C 2106 ± 1336 Group D 1597 ± 709 p < 0,05). No significant differences were found among the groups considering basal FSH levels, duration of stimulation, number of developed follicles, and number of total retrieved oocytes. Regarding BRCA2 mutation, no effect on fertility was shown in this study. Conclusions The study showed that BRCA1 patients had a higher risk of premature ovarian insufficiency (POI) confirmed by a diminished ovarian reserve and a lower number of mature oocytes suitable for cryopreservation.

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“…Cancer patients were younger (32.3 AE 3.5 vs. 37.2 AE 4.9 years) and obtained a significantly higher number of vitrified MII oocytes per cycle (8.7 AE 6.9 vs. 7.3 AE 5.6). As shown in the prior study, a significant lower number of cancer patients returned to the fertility clinic for trying to attempt pregnancy ( [28,29].…”

Section: Fertility and Cancer In Young Adult Womenmentioning

confidence: 86%

Fertility, sexuality and cancer in young adult women

Condorelli

Lambertini

Mastro

et al. 2019

Current Opinion in Oncology

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Purpose of review To provide an up-to-date overview on indications, efficacy and safety of the existing fertility preservation strategies as well as on the features and management of sexual dysfunction in young adult women with newly diagnosed cancer. Recent findings Because of the improved life expectancy of cancer survivors, a growing attention should be given to the side effects of anticancer treatments. Among young cancer patients, risk of infertility and sexual dysfunction are of great concern.

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Reproductive potential and performance of fertility preservation strategies in BRCA-mutated breast cancer patients

Abstract: A consistent trend for reduced reproductive potential and performance of cryopreservation strategies was observed in BRCA-mutated breast cancer patients. Independent validation of these results is needed.

Cited by 103 publications

References 15 publications

Challenges of fertility preservation in non‐oncological diseases

Challenges of fertility preservation in non‐oncological diseases

Impact of BRCA1 and BRCA2 mutations on ovarian reserve and fertility preservation outcomes in young women with breast cancer

Fertility, sexuality and cancer in young adult women

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