Skip to main content

Advertisement

Log in

Oocyte Donation, Gestational Carriers, and Adoption for Breast Cancer Survivors

  • Fertility Issues and Breast Cancer (J Jeruss, Section Editor)
  • Published:
Current Breast Cancer Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The purpose of this review is to describe and compare the use of oocyte donation, gestational carriers, and adoption for family building specifically in women with a history of breast cancer.

Recent Findings

Oocyte donation is an effective and safe option for women whose exposure to gonadotoxic cancer therapy has resulted in primary ovarian insufficiency, or for women with a familial cancer syndrome who are concerned about genetic risk to their offspring. A gestational carrier may also be considered—with or without oocyte donation—depending on the patient’s acceptance of ovarian stimulation and pregnancy in the context of prior breast cancer or ongoing endocrine therapy. Lastly, adoption is a frequently considered option for family building by many breast cancer survivors.

Summary

Assisted reproductive technology and adoption offer breast cancer survivors the opportunity to expand their families despite the challenges that the diagnosis may pose.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. DeSantis CE, Ma J, Sauer AG, Newman LA, Jemal A. Breast cancer statistics, 2017, racial disparity in mortality by state. CA Cancer J Clin. 2017;67:439–48.

    Article  Google Scholar 

  2. Masciello MC, Bartholomew AJ, Haslinger M, Bozzuto LM, Tung SS, Thibodeau R, et al. Physician perspectives on fertility preservation discussions with premenopausal breast cancer patients: results from a multihospital health care system. Ann Surg Oncol. 2019;26:3210–5.

    Article  Google Scholar 

  3. •• Partridge AH, Gelber S, Peppercorn J, Sampson E, Knudsen K, Laufer M, et al. Web-based survey of fertility issues in young women with breast cancer. J Clin Oncol. 2004;22:4174–83 This web-based survey study highlights the fact that many patients are concerned with inability to have children and that these concerns may affect treatment decisions. Many also feel that their fertility needs are not adequately addressed by healthcare providers.

    Article  Google Scholar 

  4. Gunning MN, Troìa L, Janse FJ, Luisi S, Fauser BCJM. Premature ovarian insufficiency. In: Petraglia F, Fauser BC, editors. Female reproductive dysfunction. Cham: Springer International Publishing; 2020 [cited 2020 Apr 18]. p. 1–21. Available from: https://doi.org/10.1007/978-3-030-03594-5_15-1

  5. Kim SS, Klemp J, Fabian C. Breast cancer and fertility preservation. Fertil Steril. 2011;95:1535–43.

    Article  Google Scholar 

  6. Henry NL, Xia R, Banerjee M, Gersch C, McConnell D, Giacherio D, et al. Predictors of recovery of ovarian function during aromatase inhibitor therapy. Ann Oncol. 2013;24:2011–6.

    Article  CAS  Google Scholar 

  7. Burstein HJ, Temin S, Anderson H, Buchholz TA, Davidson NE, Gelmon KE, et al. Adjuvant endocrine therapy for women with hormone receptor–positive breast cancer: American Society of Clinical Oncology clinical practice guideline focused update. J Clin Oncol. 2014;32:2255–69.

    Article  Google Scholar 

  8. ESO-ESMO 4rd international consensus guidelines for breast cancer in young women (BCY4) | Elsevier enhanced reader. Available from: https://reader.elsevier.com/reader/sd/pii/S0923753420363638?token=8CD9755E6363D90A38B46949F6277094D891A79E3F7B32DFA47BFED807587323146E419E1211493BA390C2E3DCF57A33. Accessed 16 Apr 2020.

  9. Derks-Smeets IAP, Gietel-Habets JJG, Tibben A, Tjan-Heijnen VCG, Meijer-Hoogeveen M, Geraedts JPM, et al. Decision-making on preimplantation genetic diagnosis and prenatal diagnosis: a challenge for couples with hereditary breast and ovarian cancer. Hum Reprod. 2014;29:1103–12.

    Article  CAS  Google Scholar 

  10. National summary report. [cited 2020 May 28]. Available from: https://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx?reportingYear=2018#donor-fresh-egg. Accessed 28 May 2020

  11. Męczekalski B, Maciejewska-Jeske M, Podfigurna A. Reproduction in premature ovarian insufficiency patients – from latest studies to therapeutic approach. Prz Menopauzalny. 2018;17:117–9.

    PubMed  PubMed Central  Google Scholar 

  12. Muñoz E, Fernandez I, Martinez M, Tocino A, Portela S, Pellicer A, et al. Oocyte donation outcome after oncological treatment in cancer survivors. Fertil Steril. 2015;103:205–13.

    Article  Google Scholar 

  13. • Luke B, Brown MB, Missmer SA, Spector LG, Leach RE, Williams M, et al. Assisted reproductive technology use and outcomes among women with a history of cancer. Hum Reprod. 2016;31:183–9 This cohort study evaluated women with cancer either undergoing autologous IVF or using donor oocytes when compared to women without cancer. While the live birth rate was significantly lower for cancer survivors undergoing autologous IVF, use of donor oocytes results in similar live birth rates between groups.

    Article  Google Scholar 

  14. Guidelines for oocyte donation. Fertil Steril. 2004;82:13–5.

  15. Reh A, Amarosa A, Licciardi F, Krey L, Berkeley AS, Kump L. Evaluating the necessity for universal screening of prospective oocyte donors using enhanced genetic and psychological testing. Hum Reprod. 2010;25:2298–304.

    Article  Google Scholar 

  16. Cahill DJ, Wardle PG, Harlow CR, Hunt LP, Hull MGR. Expected contribution to serum oestradiol from individual ovarian follicles in unstimulated cycles. Hum Reprod. 2000;15:1909–12.

    Article  CAS  Google Scholar 

  17. Azim AA, Costantini-Ferrando M, Oktay K. Safety of fertility preservation by ovarian stimulation with letrozole and gonadotropins in patients with breast cancer: a prospective controlled study. J Clin Oncol. 2008;26:2630–5.

    Article  CAS  Google Scholar 

  18. Oktay K, Buyuk E, Libertella N, Akar M, Rosenwaks Z. Fertility preservation in breast cancer patients: a prospective controlled comparison of ovarian stimulation with tamoxifen and letrozole for embryo cryopreservation. J Clin Oncol. 2005;23:4347–53.

    Article  CAS  Google Scholar 

  19. Marklund A, Nasiell J, Berger A-S, Fagerberg A, Rodriguez-Wallberg KA. Pregnancy achieved using donor eggs in cancer survivors with treatment-induced ovarian failure: obstetric and perinatal outcome. J Women's Health (Larchmt). 2018;27:939–45.

    Article  Google Scholar 

  20. • Perkins KM, Boulet SL, Jamieson DJ, Kissin DM, National Assisted Reproductive Technology Surveillance System (NASS) Group. Trends and outcomes of gestational surrogacy in the United States. Fertil Steril. 2016;106:435–442.e2 This study identified national trends in use of gestational carriers, with significant increase over time. Though gestational carrier cycles had higher rates of success than nongestational carrier cycles, the rates of multiple gestational and preterm births were higher.

    Article  Google Scholar 

  21. 2016 Assisted reproductive technology national summary report figures | 2013 ART Report | Division of Reproductive Health | CDC. 2019. Available from: https://www.cdc.gov/art/reports/2016/national-summary-figures.html. Accessed 21 May 2020.

  22. Söderström-Anttila V, Wennerholm U-B, Loft A, Pinborg A, Aittomäki K, Romundstad LB, et al. Surrogacy: outcomes for surrogate mothers, children and the resulting families-a systematic review. Hum Reprod Update. 2016;22:260–76.

    PubMed  Google Scholar 

  23. Perkins KM, Boulet SL, Levine AD, Jamieson DJ, Kissin DM. Differences in the utilization of gestational surrogacy between states in the U.S. Reprod Biomed Soc Online. 2017;5:1–4.

    Article  Google Scholar 

  24. Segal TR, Kim K, Mumford SL, Goldfarb JM, Weinerman RS. How much does the uterus matter? Perinatal outcomes are improved when donor oocyte embryos are transferred to gestational carriers compared to intended parent recipients. Fertil Steril. 2018;110:888–95.

    Article  Google Scholar 

  25. Moravek MB, Confino R, Smith KN, Kazer RR, Klock SC, Lawson AK, et al. Long-term outcomes in cancer patients who did or did not pursue fertility preservation. Fertil Steril. 2018;109:349–55.

    Article  Google Scholar 

  26. Oktay K, Harvey BE, Partridge AH, Quinn GP, Reinecke J, Taylor HS, et al. Fertility preservation in patients with cancer: ASCO clinical practice guideline update. J Clin Oncol. 2018;36:1994–2001.

    Article  Google Scholar 

  27. Robertson AD, Missmer SA, Ginsburg ES. Embryo yield after in vitro fertilization in women undergoing embryo banking for fertility preservation before chemotherapy. Fertil Steril. 2011;95:588–91.

    Article  Google Scholar 

  28. Druckenmiller S, Goldman KN, Labella PA, Fino ME, Bazzocchi A, Noyes N. Successful oocyte cryopreservation in reproductive-aged cancer survivors. Obstet Gynecol. 2016;127:474–80.

    Article  CAS  Google Scholar 

  29. Anchan RM, Missmer SA, Correia KF, Ginsburg ES. Gestational carriers: a viable alternative for women with medical contraindications to pregnancy. Open J Obstet Gynecol. 2013;3:24–31.

    Article  Google Scholar 

  30. Oktay K, Turan V, Bedoschi G, Pacheco FS, Moy F. Fertility preservation success subsequent to concurrent aromatase inhibitor treatment and ovarian stimulation in women with breast cancer. J Clin Oncol. 2015;33:2424–9.

    Article  Google Scholar 

  31. Pagani O, Azim H. Pregnancy after breast cancer: myths and facts. Breast Care (Basel). 2012;7:210–4.

    Article  Google Scholar 

  32. Carneiro MM, Cota AM, Amaral MC, Pedrosa ML, Martins BO, Furtado MH, et al. Motherhood after breast cancer: can we balance fertility preservation and cancer treatment? A narrative review of the literature. JBRA Assist Reprod. 2018;22:244–52.

    PubMed  PubMed Central  Google Scholar 

  33. Azim HA, Santoro L, Pavlidis N, Gelber S, Kroman N, Azim H, et al. Safety of pregnancy following breast cancer diagnosis: a meta-analysis of 14 studies. Eur J Cancer. 2011;47:74–83.

    Article  Google Scholar 

  34. Valachis A, Tsali L, Pesce LL, Polyzos NP, Dimitriadis C, Tsalis K, et al. Safety of pregnancy after primary breast carcinoma in young women: a meta-analysis to overcome bias of healthy mother effect studies. Obstet Gynecol Surv. 2010;65:786–93.

    Article  Google Scholar 

  35. Durrani S, Akbar S, Heena H. Breast cancer during pregnancy. Cureus. 2018;10:e2941.

    PubMed  PubMed Central  Google Scholar 

  36. Davies C, Pan H, Godwin J, Gray R, Arriagada R, Raina V, et al. Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Lancet. 2013;381:805–16.

    Article  CAS  Google Scholar 

  37. Pagani O, Partridge AH, Peccatori F, Azim HA, Colleoni M, Saura C, et al. Abstract OT1-01-06: POSITIVE: a study evaluating pregnancy, disease outcome and safety of interrupting endocrine therapy for premenopausal women with endocrine responsIVE breast cancer who desire pregnancy (IBCSG 48-14/BIG 8-13). Cancer Res. 2019;79:OT1–01-06-OT1–01–6.

    Google Scholar 

  38. • Gorman JR, Whitcomb BW, Standridge D, Malcarne VL, Romero SAD, Roberts SA, et al. Adoption consideration and concerns among young adult female cancer survivors. J Cancer Surviv. 2017;11:149–57 This study compared attitudes toward adoption in women with and without a history of cancer. Though there was a twofold higher interest in adoption among women with cancer, they also expressed reservations such as the desire for a biological child.

    Article  Google Scholar 

  39. Rosen A. Third-party reproduction and adoption in cancer patients. J Natl Cancer Inst Monogr. 2005;2005:91–3.

    Article  Google Scholar 

  40. Quinn GP, Zebrack B, Sehovic I, Bowman M, Vadaparampil ST. Adoption and cancer survivors: findings from a learning activity for oncology nurses. Cancer. 2015;121:2993–3000.

    Article  Google Scholar 

  41. Loren AW, Mangu PB, Beck LN, Brennan L, Magdalinski AJ, Partridge AH, et al. Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31:2500–10.

    Article  Google Scholar 

  42. Canada AL, Schover LR. The psychosocial impact of interrupted childbearing in long-term female cancer survivors. Psychooncology. 2012;21:134–43.

    Article  Google Scholar 

  43. Finger R, Sommerfelt C, Freeman M, Wilson CK, Wade A, Daly D. A cost-effectiveness comparison of embryo donation with oocyte donation. Fertil Steril. 2010;93:379–81.

    Article  Google Scholar 

  44. How much does surrogacy cost? | Surrogate.com. Available from: https://surrogate.com/intended-parents/the-surrogacy-process/how-much-does-surrogacy-cost/. Accessed 21 May 2020.

  45. Home study - child welfare information gateway. Available from: https://www.childwelfare.gov/topics/adoption/adoptive/home-study/. Accessed 21 May 2020.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Divya K. Shah.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Fertility Issues and Breast Cancer

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, I.T., Humphries, L.A. & Shah, D.K. Oocyte Donation, Gestational Carriers, and Adoption for Breast Cancer Survivors. Curr Breast Cancer Rep 12, 361–366 (2020). https://doi.org/10.1007/s12609-020-00391-y

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12609-020-00391-y

Keywords

Navigation