COH outcomes in breast cancer patients for fertility preservation: a comparison with the expected response by age

Abstract

Purpose

Breast cancer is the most common cancer diagnosed during childbearing age, and fertility preservation is becoming increasingly more essential. However, recent studies indicate a possible poorer response to controlled ovarian hyperstimulation (COH) in cancer patients than in non-cancer controls and a negative impact of BRCA mutations on female fertility. This study aims to evaluate ovarian response and the number of mature oocytes (MII) vitrified in women with breast cancer, with or without BRCA mutation, comparing them to the expected response according to an age-related nomogram.

Methods

This is a retrospective observational study involving sixty-one breast cancer patients who underwent COH for oocyte cryopreservation. The age-specific nomogram was built using 3871 patients who underwent COH due to oocyte donation, fertility preservation for non-medical reasons, or FIVET for male factor exclusively.

Results

The mean number of oocytes retrieved was 13.03, whereas the mean number of MII oocytes was 10.00. After the application of the z-score, no statistically significant differences were found compared with the expected response in the general population, neither by dividing patients according to the presence or absence of BRCA mutation nor according to the phase in which they initiated stimulation.

Conclusion

The results obtained do not support the notion of a negative impact of the BRCA mutation on the ovarian response of women with breast cancer. Women with breast cancer undergoing COH for fertility preservation can expect the ovarian response predicted for their age.

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Author information

Affiliations

Authors

Contributions

Elisa Malacarne, Marta Devesa, and Francisca Martinez have designed and developed the study and participated in the literature review and manuscript drafting; Ignacio Rodriguez has contributed to the design and statistics and critically revised the manuscript; and Buenaventura Coroleu has contributed with the critical review of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Elisa Malacarne.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Institutional Review Board (CIOG 1020190522/01).

Additional information

This work was performed under the auspices of the Càtedra d’Investigació en Obstetrícia I Ginecologia of the Department of Obstetrics and Gynecology, Hospital Universitari Dexeus, Universitat Autònoma de Barcelona.

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Malacarne, E., Devesa, M., Martinez, F. et al. COH outcomes in breast cancer patients for fertility preservation: a comparison with the expected response by age. J Assist Reprod Genet 37, 3069–3076 (2020). https://doi.org/10.1007/s10815-020-01944-x

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Keywords

  • Fertility preservation
  • Breast Cancer
  • BRCA
  • Ovarian response
  • Controlled ovarian hyperstimulation
  • Nomogram