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A retrospective study evaluating the impact of scattering radiation from imaging procedures on oocyte quality during ovarian stimulation for fertility preservation in young breast cancer patients

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Abstract

Purpose

Ovarian stimulation for oocyte and embryo cryopreservation is the standard of care for fertility preservation in young breast cancer patients before gonadotoxic chemotherapy. The procedure should be started as soon as possible to avoid delay of treatment; thus, it is often performed concomitantly with tumor staging assessments. However, questions remain regarding the potential negative impact on oocyte quality that may occur due to exposure to scattered ionizing radiation from imaging techniques when staging assessment is conducted at the same time as ovarian stimulation.

Methods

We conducted a retrospective study on all breast cancer patients who performed ovarian stimulation for fertility preservation at our center between November 2012 and May 2020.

Results

Gynecologic and oncological characteristics were similar between patients exposed (n = 14) or not (n = 60) to ionizing radiation. Exposed patients started the ovarian stimulation sooner after diagnosis than non-exposed patients (11.5 vs 28 days, respectively, P < 0.01). Cycle parameters, including the median number of oocytes collected (10.5 vs 7, P = 0.16), maturation rates (92.5% vs 85.7%, P = 0.54), and fertilization rates (62.2% vs 65.4%, P = 0.70), were similar between groups.

Conclusion

This study shows that scattered ionizing radiation due to staging assessment appears to be safe without compromising follicular growth and maturation. Larger studies on fertility and obstetrical outcomes are needed to confirm these preliminary data.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Acknowledgements

The authors would like to acknowledge the contribution of a medical writer, Sandy Field, PhD, for English language editing of this manuscript.

Funding

Margherita Condorelli and Isabelle Demeestere acknowledge Télévie-FNRS and Fonds Erasme for their financial support. This work was supported by Télévie-FNRS (Grant Number: 7.6508.20) and Fonds Erasme (Grant Number: not applicable). Matteo Lambertini acknowledges the support from the Italian Association for Cancer Research (“Associazione Italiana per la Ricerca sul Cancro,” AIRC; MFAG 2020 ID 24698) and the Italian Ministry of Health (5 x 1000 funds 2017).

Author information

Author notes

  1. Matteo Lambertini and Isabelle Demeestere are Co-last authors.

Authors and Affiliations

  1. Fertility Clinic, Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium

    Margherita Condorelli, Oranite Goldrat, Anne Delbaere & Isabelle Demeestere

  2. Research Laboratory on Human Reproduction, Université Libre de Bruxelles, Brussels, Belgium

    Margherita Condorelli, Maëlle Sens & Isabelle Demeestere

  3. Chair in Health and Precarity, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium

    Judith Racapé

  4. Research Center in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium

    Judith Racapé

  5. Medical Oncology Department, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy

    Matteo Lambertini

  6. Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy

    Matteo Lambertini

Authors
  1. Margherita Condorelli
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  2. Maëlle Sens
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  3. Oranite Goldrat
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  4. Anne Delbaere
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  6. Matteo Lambertini
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  7. Isabelle Demeestere
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Contributions

MC, ML, and ID conceived and designed the study, OG, MS, AD, and MC acquired the data. JR, ML, MS, and MC analyzed the data. MC and ID wrote the manuscript and all other authors revised it critically and finally approved it.

Corresponding author

Correspondence to Isabelle Demeestere.

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Conflict of interest

Matteo Lambertini acted as a consultant for Roche, Lilly, AstraZeneca, and Novartis and has received honoraria from Sandoz, Roche, Lilly, Pfizer, Novartis, and Takeda, outside the submitted work. Anne Delbaere received grants from Ferring Pharmaceuticals and consultancy or lecture fees from Merck, Gedeon-Richter Ferring Pharmaceuticals, and OVVI Diagnostics, outside the submitted work. Isabelle Demeestere received research grants from Ferring and Roche, consultancy or lecture fees from Roche, Novartis and support for attending meetings from Ferring and Theramex, outside the submitted work. The remaining authors have no conflicts of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the ethics committee of CUB-Hôpital Erasme (P2020.328).

Informed consent

The need for obtaining informed consent was waived by the Hôpital Erasme ethical committee, given that this study was retrospective and non-interventional. Patients have the right to refuse to participate in any clinical trial by informing the hospital which keeps a record of their choice. We hereby confirm that we took into account patient preference and consequently excluded all patients that refused their participation in clinical trials.

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Supplementary Information

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Supplementary file1 (DOCX 14 kb)

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Supplementary file4 (JPG 113 kb)

Figure S1: Correlation between radiation doses and total number of oocytes collected (pink) and total number of mature oocytes (blue) in the exposure group.

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Condorelli, M., Sens, M., Goldrat, O. et al. A retrospective study evaluating the impact of scattering radiation from imaging procedures on oocyte quality during ovarian stimulation for fertility preservation in young breast cancer patients. Breast Cancer Res Treat 192, 123–130 (2022). https://doi.org/10.1007/s10549-021-06489-w

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  • DOI: https://doi.org/10.1007/s10549-021-06489-w

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