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Strategies to Maintain Fertility in Young Breast Cancer Patients

  • Elizabeth S. Constance
  • Molly B. Moravek
  • Jacqueline S. JerussEmail author
Chapter
Part of the Cancer Treatment and Research book series (CTAR, volume 173)

Abstract

Breast cancer is the most frequently occurring cancer in women of reproductive age. Treatments for breast cancer may eliminate or diminish fertility, making discussions about fertility preservation essential prior to initiation of gonadotoxic therapies. Additionally, even in patients who do not require chemotherapy, the use of adjuvant endocrine therapy will often push patients out of the reproductive window before treatment is completed. The only established methods for fertility preservation are oocyte or embryo cryopreservation, but experimental methods, such as ovarian suppression with GnRH agonists and ovarian tissue cryopreservation, show great promise. Early referral to a fertility specialist for interested patients affords patients the most fertility preservation options, with only minimal delay to cancer treatment.

Keywords

Fertility preservation Oncofertility Reproduction 

References

  1. 1.
    American Cancer Society (2015) Breast cancer facts & figures 2015-2016. American Cancer Society, Inc., AtlantaGoogle Scholar
  2. 2.
    Azim HA Jr, Kroman N, Paesmans M, Gelber S, Rotmensz N, Ameye L, De Mattos-Arruda L, Pistilli B, Pinto A, Jensen MB, Cordoba O, de Azambuja E, Goldhirsch A, Piccart MJ, Peccatori FA (2013) Prognostic impact of pregnancy after breast cancer according to estrogen receptor status: a multicenter retrospective study. J Clin Oncol 31(1):73–79CrossRefPubMedGoogle Scholar
  3. 3.
    Bedoschi G, Oktay K (2013) Current approach to fertility preservation by embryo cryopreservation. Fertil Steril 99(6):1496–1502CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Boukaidi SA, Cooley A, Hardy A, Matthews L, Zelivianski S, Jeruss JS (2012) Impact of infertility regimens on breast cancer cells: follicle-stimulating hormone and luteinizing hormone lack a direct effect on breast cell proliferation in vitro. Fertil Steril 97(2):440–444CrossRefPubMedGoogle Scholar
  5. 5.
    Cakmak H, Rosen MP (2015) Random-start ovarian stimulation in patients with cancer. Curr Opin Obstet Gynecol 27(3):215–221CrossRefPubMedGoogle Scholar
  6. 6.
    Diaz de la Noval B (2016) Potential implications on female fertility and reproductive lifespan in BRCA germline mutation women. Arch Gynecol Obstet 294(5):1099–1103CrossRefGoogle Scholar
  7. 7.
    Doyle JO, Richter KS, Lim J, Stillman RJ, Graham JR, Tucker MJ (2016) Successful elective and medically indicated oocyte vitrification and warming for autologous in vitro fertilization, with predicted birth probabilities for fertility preservation according to number of cryopreserved oocytes and age at retrieval. Fertil Steril 105(2):459–466 e452Google Scholar
  8. 8.
    Friedler S, Koc O, Gidoni Y, Raziel A, Ron-El R (2012) Ovarian response to stimulation for fertility preservation in women with malignant disease: a systematic review and meta-analysis. Fertil Steril 97(1):125–133CrossRefPubMedGoogle Scholar
  9. 9.
    Fritz M, Speroff L (2011) Clinical gynecologic endocrinology and infertility, 8th edn. Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar
  10. 10.
    Goldfarb SB, Kamer SA, Oppong BA, Eaton A, Patil S, Junqueira MJ, Olcese C, Kelvin JF, Gemignani ML (2016) Fertility preservation for the young breast cancer patient. Ann Surg Oncol 23(5):1530–1536CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Goncalves V, Quinn GP (2016) Review of fertility preservation issues for young women with breast cancer. Hum Fertil (Camb) 1–14Google Scholar
  12. 12.
    Jacobson MH, Mertens AC, Spencer JB, Manatunga AK, Howards PP (2016) Menses resumption after cancer treatment-induced amenorrhea occurs early or not at all. Fertil Steril 105(3):765–772 e764Google Scholar
  13. 13.
    Jeruss JS, Woodruff TK (2009) Preservation of fertility in patients with cancer. N Engl J Med 360(9):902–911. PMID: 19246362Google Scholar
  14. 14.
    Kasum M, von Wolff M, Franulic D, Cehic E, Klepac-Pulanic T, Oreskovic S, Juras J (2015) Fertility preservation options in breast cancer patients. Gynecol Endocrinol 31(11):846–851PubMedGoogle Scholar
  15. 15.
    Kim J, Oktay K, Gracia C, Lee S, Morse C, Mersereau JE (2012) Which patients pursue fertility preservation treatments? A multicenter analysis of the predictors of fertility preservation in women with breast cancer. Fertil Steril 97(3):671–676CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Lambertini M, Ginsburg ES, Partridge AH (2015) Update on fertility preservation in young women undergoing breast cancer and ovarian cancer therapy. Curr Opin Obstet Gynecol 27(1):98–107CrossRefPubMedGoogle Scholar
  17. 17.
    Lee SJ, Schover LR, Partridge AH, Patrizio A, Wallace LN, Hagerty LV, Beck LN, Brennan LV, Oktay K, American Society of Clinical (2006) American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J Clin Oncol 24(18):2917–2931Google Scholar
  18. 18.
    Llarena NC, Estevez SL, Tucker SL, Jeruss JS (2015) Impact of fertility concerns on tamoxifen initiation and persistence. JNCI J Natl Cancer Inst 107(10). PMID: 26307641Google Scholar
  19. 19.
    Loren AW, Mangu PB, Beck LN, Brennan L, Magdalinski AJ, Partridge AH, Quinn G, Wallace WH, Oktay K, American Society of Clinical (2013) Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 31(19):2500–2510Google Scholar
  20. 20.
    McCray DK, Simpson AB, Flyckt R, Liu Y, O’Rourke C, Crowe JP, Grobmyer SR, Moore HC, Valente SA (2016) Fertility in women of reproductive age after breast cancer treatment: practice patterns and outcomes. Ann Surg Oncol 23(10):3175–3181CrossRefPubMedGoogle Scholar
  21. 21.
    Oktay K, Kim JY, Barad D, Babayev SN (2009) Association of BRCA1 mutations with occult primary ovarian insufficiency: a possible explanation for the link between infertility and breast/ovarian cancer risks. J Clin Oncol 28(2):240–244CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Practice Committee of American Society for Reproductive (2013) Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion. Fertil Steril 100(5):1214–1223CrossRefGoogle Scholar
  23. 23.
    Practice Committee of American Society for Reproductive (2014) Ovarian tissue cryopreservation: a committee opinion. Fertil Steril 101(5):1237–1243CrossRefGoogle Scholar
  24. 24.
    Prasath EB, Chan ML, Wong WH, Lim CJ, Tharmalingam MD, Hendricks M, Loh SF, Chia YN (2014) First pregnancy and live birth resulting from cryopreserved embryos obtained from in vitro matured oocytes after oophorectomy in an ovarian cancer patient. Hum Reprod 29(2):276–278CrossRefPubMedGoogle Scholar
  25. 25.
    Reddy J, Oktay K (2012) Ovarian stimulation and fertility preservation with the use of aromatase inhibitors in women with breast cancer. Fertil Steril 98(6):1363–1369CrossRefPubMedGoogle Scholar
  26. 26.
    Scanlon M, Blaes A, Geller M, Majhail NS, Lindgren B, Haddad T (2012) Patient satisfaction with physician discussions of treatment impact on fertility, menopause and sexual health among pre-menopausal women with cancer. J Cancer 3:217–225CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Turan V, Bedoschi G, Moy F, Oktay K (2013) Safety and feasibility of performing two consecutive ovarian stimulation cycles with the use of letrozole-gonadotropin protocol for fertility preservation in breast cancer patients. Fertil Steril 100(6):1681–1685 e1681Google Scholar
  28. 28.
    Waks AG, Partridge AH (2016) Fertility preservation in patients with breast cancer: necessity, methods, and safety. JNCCN 14(3):355–363PubMedGoogle Scholar
  29. 29.
    Wallace WH, Thomson AB, Saran F, Kelsey TW (2005) Predicting age of ovarian failure after radiation to a field that includes the ovaries. Int J Radiat Oncol Biol Phys 62(3):738–744CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Elizabeth S. Constance
    • 1
  • Molly B. Moravek
    • 1
  • Jacqueline S. Jeruss
    • 2
    • 3
    Email author
  1. 1.Department of Obstetrics and GynecologyUniversity of Michigan Health SystemsAnn ArborUSA
  2. 2.Department of SurgeryUniversity of MichiganAnn ArborUSA
  3. 3.Division of Surgical Oncology3303 Cancer CenterAnn ArborUSA

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