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. 2022 Jun 1;150(11):1850-1860.
doi: 10.1002/ijc.33933. Epub 2022 Feb 7.

Is ovarian recovery after chemotherapy in young patients with early breast cancer influenced by controlled ovarian hyperstimulation for fertility preservation or tumor characteristics? Results of a prospective study in 126 patients

Audrey Mailliez  1 , Pascal Pigny  2   3 , Emilie Bogart  4 , Laura Keller  5 , Emmanuelle D'Orazio  6 , Marie Vanseymortier  4 , Marie-Cécile Le Deley  4 , Christine Decanter  6   7
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Is ovarian recovery after chemotherapy in young patients with early breast cancer influenced by controlled ovarian hyperstimulation for fertility preservation or tumor characteristics? Results of a prospective study in 126 patients

Audrey Mailliez et al. Int J Cancer. .

Abstract

Young individuals, aged <40 years, represent 7% of all patients with early breast cancer (EBC), most of whom receive chemotherapy. Preserving future fertility in these patients has become a major concern. This prospective study assessed ovarian function during and after chemotherapy according to patient and tumor characteristics and evaluated the outcome of controlled ovarian hyperstimulation (COH). Ovarian reserve was evaluated in terms of amenorrhea duration and by longitudinal serum anti-Müllerian hormone (AMH) level variations measured at study entry, during treatment and until 24 months thereafter. COH has been proposed for patients receiving adjuvant chemotherapy. We studied the association between clinical factors and ovarian function using Cox models and logistic regression. In this young population (age < 38 years, median = 32), 85 of 90 evaluable patients (94%) experienced chemo-induced amenorrhea, including six persistent amenorrhea and one chemotherapy-induced definitive ovarian failure. Overall, 33% of patients still had undetectable AMH values 12 months after the end of chemotherapy, although most had recovered spontaneous and regular menstrual function. No specific factor was associated with clinical or biological late ovarian dysfunction, except for age and baseline AMH value. Overall, 58 patients underwent COH. The mean number of total retrieved oocytes and metaphase II oocytes were of 11.7 and 6.9, respectively. Thus, our study confirms the importance of fertility preservation in young patients with EBC. Our findings indicate that sequential chemotherapy is associated with a higher risk of persistent amenorrhea. There was no significant association between tumor characteristics, fertility preservation or recovery of ovarian reserve.

Keywords: AMH; breast cancer; chemotherapy; fertility preservation; oocyte cryopreservation.

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References

REFERENCES

    1. McCray DKS, Simpson AB, Flyckt R, et al. Fertility in women of reproductive age after breast cancer treatment: practice patterns and outcomes. Ann Surg Oncol. 2016;23(10):3175-3181.
    1. Freedman RA, Partridge AH. Management of breast cancer in very young women. Breast. 2013;22:S176-S179.
    1. Azim HA, Santoro L, Pavlidis N, et al. Safety of pregnancy following breast cancer diagnosis: a meta-analysis of 14 studies. Eur J Cancer. 2011;47(1):74-83.
    1. Lambertini M, del Mastro L, Pescio MC, et al. Cancer and fertility preservation: international recommendations from an expert meeting. BMC Med. 2016;14(1):1-6.
    1. Dewailly D, Andersen CY, Balen A, et al. The physiology and clinical utility of anti-Mullerian hormone in women. Hum Reprod Update. 2014;20(3):370-385.

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