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. 2019 Dec;36(12):2593-2604.
doi: 10.1007/s10815-019-01615-6. Epub 2019 Nov 23.

Counseling young women with early breast cancer on fertility preservation

M E Elena Ter Welle-Butalid  1   2 , I J H Ingeborg Vriens  2   3 , J G Josien Derhaag  1   2 , E M Edward Leter  2   4 , C E Christine de Die-Smulders  2   4 , M Marjolein Smidt  2   5 , R J T Ron van Golde  1   2 , V C G Vivianne Tjan-Heijnen  6   7
Affiliations

Counseling young women with early breast cancer on fertility preservation

M E Elena Ter Welle-Butalid et al. J Assist Reprod Genet. 2019 Dec.

Abstract

Purpose: Women with early-stage breast cancer may still have a future child wish, while chemotherapy may impair fertility. To pursue on fertility preservation shortly after breast cancer diagnosis is complex. This review holds a critical reflection on all topics that need to be counseled to give them the opportunity to make a well-informed decision before starting any oncological treatment.

Methods: A comprehensive literature review was performed on papers published in English language on breast cancer in young women, risk of chemotherapy-induced infertility, fertility preservation techniques, impact of possible mutation carriership, and future pregnancy outcome.

Results: Below 40 years of age, the risk of permanent chemotherapy-induced ovarian function failure is approximately 20%, where taxanes do not significantly add to this risk. Overall, 23% of reported women who performed fertility preservation by cryopreserving oocytes or embryos returned for embryo transfer. Of these, 40% gave live birth. Both fertility preservation in women diagnosed with breast cancer and pregnancy after treatment seem safe with respect to breast cancer survival. Women who have a genetic predisposition for breast cancer like BRCA gene mutation should also be informed about the possibility of pre-implantation genetic diagnosis.

Conclusions: Women with an early stage of breast cancer and a possible future child wish should be referred to an expertise center in breast cancer, fertility preservation, and genetics in this complex decision-making process, shortly after diagnosis.

Keywords: Breast cancer; Chemotherapy; Cryopreservation; Fertility preservation; Young women.

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Conflict of interest statement

Author M.S. has received a research grant (microbiome research) from Servier Pharma. The other authors state that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Topics that need to be discussed when counseling young women with early-stage breast cancer and (possible) indication for (neo)adjuvant chemotherapy with respect to fertility
See this image and copyright information in PMC

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