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Embryo Cryopreservation in Breast Cancer Patients

  • Giuliano Bedoschi
  • Kutluk OktayEmail author
Chapter
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Abstract

Breast cancer is the second most common type of cancer expected to occur in women in 2014, accounting for 29 % of incident cases among women. Approximately 11 % of all breast cancer cases occur in women <45 years. Most of those patients are likely to undergo adjuvant systemic chemotherapy with a significant impact on ovarian reserve and future reproductive potential. Embryo cryopreservation is the most established technique for fertility preservation. This procedure is an attractive strategy for fertility preservation in reproductive age breast cancer patients with available partner or willing to use donor semen. Some special considerations should be given to ovarian stimulation for fertility preservation in breast cancer patients. The development of ovarian stimulation protocols using aromatase inhibitor combined with gonadotropin appears to be effective and safe for breast cancer patients. In this chapter, we will appraise and summarize the current state of embryo cryopreservation in breast cancer patients in order to provide a better understanding of the efficacy and safety of this fertility preservation technique.

Keywords

Embryo cryopreservation Breast cancer Fertility preservation Ovarian stimulation Letrozole 

References

  1. 1.
    Siegel R, Ma J, Zou Z, Jemal A (2014) Cancer statistics, 2014. CA Cancer J Clin 64(1):9–29CrossRefPubMedGoogle Scholar
  2. 2.
    DeSantis C, Siegel R, Bandi P, Jemal A (2011) Breast cancer statistics, 2011. CA Cancer J Clin 61(6):409–418CrossRefPubMedGoogle Scholar
  3. 3.
    Ganz PA, Hahn EE (2008) Implementing a survivorship care plan for patients with breast cancer. J Clin Oncol 26(5):759–767CrossRefPubMedGoogle Scholar
  4. 4.
    Trivers KF, Fink AK, Partridge AH et al (2014) Estimates of young breast cancer survivors at risk for infertility in the U.S. Oncologist 19(8):814–822CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Hayat MJ, Howlader N, Reichman ME, Edwards BK (2007) Cancer statistics, trends, and multiple primary cancer analyses from the Surveillance, Epidemiology, and End Results (SEER) Program. Oncologist 12(1):20–37CrossRefPubMedGoogle Scholar
  6. 6.
    Goldhirsch A, Wood WC, Gelber RD et al (2007) Progress and promise: highlights of the international expert consensus on the primary therapy of early breast cancer 2007. Ann Oncol 18(7):1133–1144CrossRefPubMedGoogle Scholar
  7. 7.
    Anders CK, Hsu DS, Broadwater G et al (2008) Young age at diagnosis correlates with worse prognosis and defines a subset of breast cancers with shared patterns of gene expression. J Clin Oncol 26(20):3324–3330CrossRefPubMedGoogle Scholar
  8. 8.
    Loren AW, Mangu PB, Beck LN et al (2013) Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 31(19):2500–2510CrossRefPubMedGoogle Scholar
  9. 9.
    Partridge AH, Gelber S, Peppercorn J et al (2004) Web-based survey of fertility issues in young women with breast cancer. J Clin Oncol 22(20):4174–4183CrossRefPubMedGoogle Scholar
  10. 10.
    Gosden RG, Faddy MJ (1994) Ovarian aging, follicular depletion, and steroidogenesis. Exp Gerontol 29(3–4):265–274CrossRefPubMedGoogle Scholar
  11. 11.
    Meirow D, Nugent D (2001) The effects of radiotherapy and chemotherapy on female reproduction. Hum Reprod Update 7(6):535–543CrossRefPubMedGoogle Scholar
  12. 12.
    Tilly JL, Kolesnick RN (2002) Sphingolipids, apoptosis, cancer treatments and the ovary: investigating a crime against female fertility. Biochim Biophys Acta 1585(2–3):135–138CrossRefPubMedGoogle Scholar
  13. 13.
    Soleimani R, Heytens E, Darzynkiewicz Z, Oktay K (2011) Mechanisms of chemotherapy-induced human ovarian aging: double strand DNA breaks and microvascular compromise. Aging 3(8):782–793CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Byrne J, Fears TR, Gail MH et al (1992) Early menopause in long-term survivors of cancer during adolescence. Am J Obstet Gynecol 166(3):788–793CrossRefPubMedGoogle Scholar
  15. 15.
    Davies C, Pan H, Godwin J et al (2013) 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 381(9869):805–816CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Early Breast Cancer Trialists’ Collaborative G (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 365(9472):1687–1717CrossRefGoogle Scholar
  17. 17.
    Braems G, Denys H, De Wever O, Cocquyt V, Van den Broecke R (2011) Use of tamoxifen before and during pregnancy. Oncologist 16(11):1547–1551CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Ruddy KJ, Partridge AH (2012) The unique reproductive concerns of young women with breast cancer. Adv Exp Med Biol 732:77–87CrossRefPubMedGoogle Scholar
  19. 19.
    Hulvat MC, Jeruss JS (2011) Fertility preservation options for young women with breast cancer. Curr Opin Obstet Gynecol 23(3):174–182CrossRefPubMedGoogle Scholar
  20. 20.
    Trounson A, Mohr L (1983) Human pregnancy following cryopreservation, thawing and transfer of an eight-cell embryo. Nature 305(5936):707–709CrossRefPubMedGoogle Scholar
  21. 21.
    Bedoschi G, Oktay K (2013) Current approach to fertility preservation by embryo cryopreservation. Fertil Steril 99(6):1496–1502CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Baynosa J, Westphal LM, Madrigrano A, Wapnir I (2009) Timing of breast cancer treatments with oocyte retrieval and embryo cryopreservation. J Am Coll Surg 209(5):603–607CrossRefPubMedGoogle Scholar
  23. 23.
    Madrigrano A, Westphal L, Wapnir I (2007) Egg retrieval with cryopreservation does not delay breast cancer treatment. Am J Surg 194(4):477–481CrossRefPubMedGoogle Scholar
  24. 24.
    Oktay K, Turkcuoglu I, Rodriguez-Wallberg KA (2010) GnRH agonist trigger for women with breast cancer undergoing fertility preservation by aromatase inhibitor/FSH stimulation. Reprod Biomed Online 20(6):783–788CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Reddy J, Turan V, Bedoschi G, Moy F, Oktay K (2014) Triggering final oocyte maturation with gonadotropin-releasing hormone agonist (GnRHa) versus human chorionic gonadotropin (hCG) in breast cancer patients undergoing fertility preservation: an extended experience. J Assist Reprod Genet 31(7):927–932CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    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
  27. 27.
    von Wolff M, Thaler CJ, Frambach T et al (2009) Ovarian stimulation to cryopreserve fertilized oocytes in cancer patients can be started in the luteal phase. Fertil Steril 92(4):1360–1365CrossRefGoogle Scholar
  28. 28.
    Bedoschi GM, de Albuquerque FO, Ferriani RA, Navarro PA (2010) Ovarian stimulation during the luteal phase for fertility preservation of cancer patients: case reports and review of the literature. J Assist Reprod Genet 27(8):491–494CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    von Wolff M, Montag M, Dittrich R, Denschlag D, Nawroth F, Lawrenz B (2011) Fertility preservation in women – a practical guide to preservation techniques and therapeutic strategies in breast cancer, Hodgkin’s lymphoma and borderline ovarian tumours by the fertility preservation network FertiPROTEKT. Arch Gynecol Obstet 284(2):427–435CrossRefGoogle Scholar
  30. 30.
    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, e1681CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Oktay K, Hourvitz A, Sahin G et al (2006) Letrozole reduces estrogen and gonadotropin exposure in women with breast cancer undergoing ovarian stimulation before chemotherapy. J Clin Endocrinol Metab 91(10):3885–3890CrossRefPubMedGoogle Scholar
  32. 32.
    Baerwald AR, Adams GP, Pierson RA (2003) A new model for ovarian follicular development during the human menstrual cycle. Fertil Steril 80(1):116–122CrossRefPubMedGoogle Scholar
  33. 33.
    Sonmezer M, Turkcuoglu I, Coskun U, Oktay K (2011) Random-start controlled ovarian hyperstimulation for emergency fertility preservation in letrozole cycles. Fertil Steril 95(6):2125 e2129–2111CrossRefGoogle Scholar
  34. 34.
    Cakmak H, Rosen MP (2013) Ovarian stimulation in cancer patients. Fertil Steril 99(6):1476–1484CrossRefPubMedGoogle Scholar
  35. 35.
    Memili E, Peddinti D, Shack LA et al (2007) Bovine germinal vesicle oocyte and cumulus cell proteomics. Reproduction 133(6):1107–1120CrossRefPubMedGoogle Scholar
  36. 36.
    Tatemoto H, Muto N, Sunagawa I, Shinjo A, Nakada T (2004) Protection of porcine oocytes against cell damage caused by oxidative stress during in vitro maturation: role of superoxide dismutase activity in porcine follicular fluid. Biol Reprod 71(4):1150–1157CrossRefPubMedGoogle Scholar
  37. 37.
    Watson AJ (2007) Oocyte cytoplasmic maturation: a key mediator of oocyte and embryo developmental competence. J Anim Sci 85(13 Suppl):E1–E3CrossRefPubMedGoogle Scholar
  38. 38.
    Oktay K, Buyuk E, Rodriguez-Wallberg KA, Sahin G (2010) In vitro maturation improves oocyte or embryo cryopreservation outcome in breast cancer patients undergoing ovarian stimulation for fertility preservation. Reprod Biomed Online 20(5):634–638CrossRefPubMedGoogle Scholar
  39. 39.
    Azim AA, Costantini-Ferrando M, Oktay K (2008) Safety of fertility preservation by ovarian stimulation with letrozole and gonadotropins in patients with breast cancer: a prospective controlled study. J Clin Oncol 26(16):2630–2635CrossRefPubMedGoogle Scholar
  40. 40.
    Wirleitner B, Vanderzwalmen P, Bach M et al (2013) The time aspect in storing vitrified blastocysts: its impact on survival rate, implantation potential and babies born. Hum Reprod 28(11):2950–2957CrossRefPubMedGoogle Scholar
  41. 41.
    Wong KM, Mastenbroek S, Repping S (2014) Cryopreservation of human embryos and its contribution to in vitro fertilization success rates. Fertil Steril 102(1):19–26CrossRefPubMedGoogle Scholar
  42. 42.
    Herrero L, Martinez M, Garcia-Velasco JA (2011) Current status of human oocyte and embryo cryopreservation. Curr Opin Obstet Gynecol 23(4):245–250PubMedGoogle Scholar
  43. 43.
    Edgar DH, Gook DA (2012) A critical appraisal of cryopreservation (slow cooling versus vitrification) of human oocytes and embryos. Hum Reprod Update 18(5):536–554CrossRefPubMedGoogle Scholar
  44. 44.
    Loutradi KE, Kolibianakis EM, Venetis CA et al (2008) Cryopreservation of human embryos by vitrification or slow freezing: a systematic review and meta-analysis. Fertil Steril 90(1):186–193CrossRefPubMedGoogle Scholar
  45. 45.
    Glujovsky D, Blake D, Farquhar C, Bardach A (2012) Cleavage stage versus blastocyst stage embryo transfer in assisted reproductive technology. Cochrane Database Syst Rev 7:CD002118PubMedGoogle Scholar
  46. 46.
    Paulson RJ (2011) Hormonal induction of endometrial receptivity. Fertil Steril 96(3):530–535CrossRefPubMedGoogle Scholar
  47. 47.
    Wilcox AJ, Baird DD, Weinberg CR (1999) Time of implantation of the conceptus and loss of pregnancy. N Engl J Med 340(23):1796–1799CrossRefPubMedGoogle Scholar
  48. 48.
    Cha J, Sun X, Dey SK (2012) Mechanisms of implantation: strategies for successful pregnancy. Nat Med 18(12):1754–1767CrossRefPubMedGoogle Scholar
  49. 49.
    Norwitz ER, Schust DJ, Fisher SJ (2001) Implantation and the survival of early pregnancy. N Engl J Med 345(19):1400–1408CrossRefPubMedGoogle Scholar
  50. 50.
    Quenby S, Brosens JJ (2013) Human implantation: a tale of mutual maternal and fetal attraction. Biol Reprod 88(3):81CrossRefPubMedGoogle Scholar
  51. 51.
    Ghobara T, Vandekerckhove P (2008) Cycle regimens for frozen-thawed embryo transfer. Cochrane Database Syst Rev 1:CD003414PubMedGoogle Scholar
  52. 52.
    Groenewoud ER, Cantineau AE, Kollen BJ, Macklon NS, Cohlen BJ (2013) What is the optimal means of preparing the endometrium in frozen-thawed embryo transfer cycles? A systematic review and meta-analysis. Hum Reprod Update 19(5):458–470CrossRefPubMedGoogle Scholar
  53. 53.
    Ives A, Saunders C, Bulsara M, Semmens J (2007) Pregnancy after breast cancer: population based study. BMJ 334(7586):194CrossRefPubMedGoogle Scholar
  54. 54.
    Petrek JA (1994) Pregnancy safety after breast cancer. Cancer 74(1 Suppl):528–531CrossRefPubMedGoogle Scholar
  55. 55.
    Azim HA Jr, Peccatori FA, de Azambuja E, Piccart MJ (2011) Motherhood after breast cancer: searching for la dolce vita. Expert Rev Anticancer Ther 11(2):287–298CrossRefPubMedGoogle Scholar
  56. 56.
    Oktay KTV, Bedoschi G, Pacheco F, Moy F (2015) Fertility preservation success subsequent to concurrent aromatase inhibitor treatment and ovarian stimulation in women with breast cancer. J Clin Oncol 33(22):2424–2429CrossRefPubMedGoogle Scholar
  57. 57.
    D’Angelo A, Amso N (2007) Embryo freezing for preventing ovarian hyperstimulation syndrome. Cochrane Database Syst Rev 3:CD002806PubMedGoogle Scholar
  58. 58.
    Helmerhorst FM, Perquin DA, Donker D, Keirse MJ (2004) Perinatal outcome of singletons and twins after assisted conception: a systematic review of controlled studies. BMJ 328(7434):261CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Henningsen AK, Pinborg A, Lidegaard O, Vestergaard C, Forman JL, Andersen AN (2011) Perinatal outcome of singleton siblings born after assisted reproductive technology and spontaneous conception: Danish national sibling-cohort study. Fertil Steril 95(3):959–963CrossRefPubMedGoogle Scholar
  60. 60.
    Practice Committee of the American Society for Reproductive M, Practice Committee of the Society for Assisted Reproductive T (2015) Recommendations for practices utilizing gestational carriers: a committee opinion. Fertil Steril 103(1):e1–e8CrossRefGoogle Scholar
  61. 61.
    Dar S, Lazer T, Swanson S et al (2015) Assisted reproduction involving gestational surrogacy: an analysis of the medical, psychosocial and legal issues: experience from a large surrogacy program. Hum Reprod 30(2):345–352CrossRefPubMedGoogle Scholar
  62. 62.
    Surbone A, Petrek JA (1997) Childbearing issues in breast carcinoma survivors. Cancer 79(7):1271–1278CrossRefPubMedGoogle Scholar
  63. 63.
    Gelber S, Coates AS, Goldhirsch A et al (2001) Effect of pregnancy on overall survival after the diagnosis of early-stage breast cancer. J Clin Oncology 19(6):1671–1675Google Scholar
  64. 64.
    Higgins S, Haffty BG (1994) Pregnancy and lactation after breast-conserving therapy for early stage breast cancer. Cancer 73(8):2175–2180CrossRefPubMedGoogle Scholar

Copyright information

© Springer Japan 2016

Authors and Affiliations

  1. 1.New York Medical CollegeValhallaUSA
  2. 2.Innovation Institute for Fertility Preservation and In Vitro FertilizationNew YorkUSA

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