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.

Original languageEnglish
Pages (from-to)2593-2604
Number of pages12
JournalJournal of Assisted Reproduction and Genetics
Volume36
Issue number12
Early online date23 Nov 2019
DOIs
Publication statusPublished - Dec 2019

Keywords

  • Breast cancer
  • Chemotherapy
  • Young women
  • Fertility preservation
  • Cryopreservation
  • IN-VITRO FERTILIZATION
  • CONTROLLED OVARIAN HYPERSTIMULATION
  • CHEMOTHERAPY-INDUCED AMENORRHEA
  • ANTI-MULLERIAN HORMONE
  • PREMENOPAUSAL WOMEN
  • OOCYTE VITRIFICATION
  • ANTIMULLERIAN HORMONE
  • TIME-COURSE
  • FOLLOW-UP
  • STIMULATION

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