Abstract P2-14-01: A Prospective Controlled Analysis of Fertility Preservation by Oocyte and Embryo Cryopreservation Using an Aromatase Inhibitor-Gonadotropin Protocol: Treatment Outcomes and Safety in Young Women with Breast Cancer

2010 ◽  
Author(s):  
K Oktay ◽  
SH Lee ◽  
F Moy
Keyword(s):  
Breast Cancer ◽  
Aromatase Inhibitor ◽  
Treatment Outcomes ◽  
Fertility Preservation ◽  
Young Women ◽  
Embryo Cryopreservation

scholarly journals Prospective Study of Fertility Preservation in Young Women With Breast Cancer in Mexico

2021 ◽  
pp. 1-8
Author(s):  
Cynthia Villarreal-Garza ◽  
Fernanda Mesa-Chavez ◽  
Alejandra Plata de la Mora ◽  
Melina Miaja-Avila ◽  
Marisol Garcia-Garcia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Supportive Care ◽  
Fertility Preservation ◽  
Young Women ◽  
Young Patients ◽  
Young Group ◽  
Embryo Cryopreservation ◽  
Resource Constrained ◽  
Chi Square ◽  
Patient Reported

Background: Despite the risk of treatment-related infertility, implementation of fertility-preservation (FP) strategies among young patients with breast cancer is often suboptimal in resource-constrained settings such as Mexico. The “Joven & Fuerte: Program for Young Women With Breast Cancer” strives to enhance patient access to supportive care services, including FP measures through alliances with assisted-reproduction units and procurement of coverage of some of these strategies. This study describes patients from Joven & Fuerte who have preserved fertility, and assesses which characteristics were associated with the likelihood of undergoing FP. Methods: Women aged ≤40 years with recently diagnosed breast cancer were prospectively accrued. Sociodemographic and clinicopathologic data were collected from patient-reported and provider-recorded information at diagnosis and 1-year follow-up. Descriptive statistics, chi-square test, and simple logistic regression were used to compare patients who preserved fertility with those who did not. Results: In total, 447 patients were included, among which 53 (12%) preserved fertility, representing 38% of the 140 women who desired future biologic children. Oocyte/embryo cryopreservation was the most frequently used method for FP (59%), followed by temporary ovarian suppression with gonadotropin-releasing hormone agonists (GnRHa) during chemotherapy (26%), and use of both GnRHa and oocyte/embryo cryopreservation (15%). Younger age, higher educational level, being employed, having private healthcare insurance, and having one or no children were associated with a significantly higher likelihood of preserving fertility. Conclusions: By facilitating referral and seeking funds and special discounts for underserved patients, supportive care programs for young women with breast cancer can play a crucial role on enhancing access to oncofertility services that would otherwise be prohibitive because of their high costs, particularly in resource-constrained settings. For these efforts to be successful and widely applied in the long term, sustained and extended governmental coverage of FP options for this young group is warranted.

P–457 Emergency fertility preservation (FP) in female patients- utilisation rate of the stored eggs/embryos and pregnancy outcomes

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
V Balakumar ◽  
S C Khaw ◽  
P Milne ◽  
S Kini
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Survival Rate ◽  
Fertility Preservation ◽  
Young Women ◽  
Pregnancy Outcomes ◽  
Cancer Survival ◽  
Embryo Cryopreservation ◽  
Utilisation Rate ◽  
The Mean

Abstract Study question The aim of the study was to determine the percentage of patients returning to use their stored eggs/embryos following FP and their pregnancy outcomes. Summary answer The patient utilisation rate for eggs/embryos was 17% with a live birth rate of 59%. What is known already Fertility preservation is considered as a vital issue for individuals in the reproductive stage of life when their future fertility may be compromised. Increased cancer survival rate and advances in assisted reproductive techniques make this an essential service to offer to patients facing life limiting disease or long-term medical conditions.FP is important to improve the quality of life in cancer survivors. Study design, size, duration A retrospective analysis was performed over a period of ten years between January 2010 to December 2020 in our tertiary unit. A total of 75 patients who underwent FP were identified. Participants/materials, setting, methods Infertility database for embryology and andrology (IDEAS) was used for the data collection and analysis. Patient’s age, reasons for fertility preservation, type of benign/cancer condition, protocol used for controlled ovarian stimulation (COS), dose of the gonadotropins, number of eggs collected, number of eggs/embryos cryopreserved, duration between storage and fertility treatment, pregnancy outcomes were included in the analysis. Main results and the role of chance Seventy-five patients underwent FP during the 10-year study period. The mean age was 30 years (range 17–43). Seventy-two patients (96%) underwent treatment for oncological reasons and the rest (4%) were for gender transition and Crohn’s disease. The most common types of malignancies include breast cancer (36%), Hodgkin’s lymphoma (18%) and cervical cancer (15%). Ninety-two percentage of patients underwent COS with an antagonist cycle, with an average of 10.8 eggs collected. Recombinant follicle stimulating hormone (FSH) was used in 92% of the cycles and human menopausal gonadotropin (HMG) was used in 8%. Fifty-eight percentage were given a maximum dose of 300IU of gonadotropin. The mean yield of eggs was higher in patients with breast cancer (12.62) followed by Hodgkin’s (10.5) and cervical cancer (9.6). Majority (60%) had embryo cryopreservation (82% at blastocyst stage and 18% at day 3 cleavage stage) and the rest (40%) had egg cryopreservation. A total of 17% (12) of patients returned for treatment with a livebirth rate of 59% and miscarriage rate of 8%. One third of livebirths were achieved through surrogacy. The average duration between fertility preservation and return for treatment was 2.4 years. Limitations, reasons for caution During the last 5 years, there has been an increase in the number of young women requiring FP in our unit. These women may require a considerable amount of time to complete their oncological treatment before embarking on pregnancy using their stored eggs/embryos. Wider implications of the findings: As cancer survival rate improves, there will be a likely increase in the utilisation rate for follow up treatment among young women who had FP. The overall awareness of the gonadotoxic effect of cancer therapy and available fertility preservation options among both patients and clinicians needs to be increased. Trial registration number NA

scholarly journals Value of Early Referral to Fertility Preservation in Young Women With Breast Cancer

2010 ◽  
Vol 28 (31) ◽  
pp. 4683-4686 ◽  
Author(s):  
Sanghoon Lee ◽  
Sinan Ozkavukcu ◽  
Elke Heytens ◽  
Fred Moy ◽  
Kutluk Oktay
Keyword(s):  
Breast Cancer ◽  
Fertility Preservation ◽  
Young Women ◽  
Breast Surgery ◽  
Secondary Analysis ◽  
Group Versus ◽  
Oocyte Retrieval ◽  
Embryo Cryopreservation ◽  
Early Referral ◽  
Patients With Cancer

Purpose To determine whether early referral to reproductive specialists improves fertility preservation (FP) outcomes and reduces delay in adjuvant treatment in young women with breast cancer. Patients and Methods A secondary analysis of a prospective database of patients with breast cancer undergoing ovarian stimulation (OS) for FP by oocyte or embryo cryopreservation was performed. Results Of the 154 patients, 93 met the inclusion criteria (mean age, 35.2 ± 4.4 years). Thirty-five of the 93 patients were referred before breast surgery (PreS), and 58 patients were referred after surgery (PostS). The time periods from initial diagnosis (ID) to initiation of OS (42.6 ± 27.7 days for PreS v 71.9 ± 30.7 days for PostS; P < .001) and from ID to initiation of chemotherapy (83.9 ± 24.3 days for PreS v 107.8 ± 42.9 days for PostS; P = .045) were significantly shorter for the PreS group versus the PostS group. Nine (25.7%) of 35 patients in the PreS group versus one (1.7%) of 58 patients in the PostS group were able to undergo two FP cycles (P < .001), resulting in an increased yield of oocytes in the PreS group (18.2% [93 of 511 oocytes] v 0.6% [five of 800 oocytes], respectively; P < .001) and embryos (17.2% [40 of 233 embryos] v 0.6% [two of 357 embryos], respectively; P < .001). Patients who had an oocyte retrieval within 5 weeks of the surgery were able to complete a second cycle within 9 weeks of the surgery. Conclusion FP referral before breast surgery enables earlier initiation of cryopreservation cycles and chemotherapy and, when appropriate, multiple FP cycles. Women who can undergo multiple cycles may be at advantage for FP because of a larger number of oocytes or embryos cryopreserved. This is the first study demonstrating the benefit of early FP referral in patients with cancer.

scholarly journals Amenorrhea, fertility preservation, and counseling among young women treated with anthracyclines and taxanes for early-stage breast cancer, a retrospective study

Medicine ◽  
2020 ◽  
Vol 99 (11) ◽  
pp. e19566 ◽  
Author(s):  
Hikmat N. Abdel-Razeq ◽  
Razan A. Mansour ◽  
Khawla S. Ammar ◽  
Rashid H. Abdel-Razeq ◽  
Hadil Y. Zureigat ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Retrospective Study ◽  
Fertility Preservation ◽  
Young Women ◽  
Early Stage ◽  
Early Stage Breast Cancer

scholarly journals Fertility Preservation Success Subsequent to Concurrent Aromatase Inhibitor Treatment and Ovarian Stimulation in Women With Breast Cancer

2015 ◽  
Vol 33 (22) ◽  
pp. 2424-2429 ◽  
Author(s):  
Kutluk Oktay ◽  
Volkan Turan ◽  
Giuliano Bedoschi ◽  
Fernanda S. Pacheco ◽  
Fred Moy
Keyword(s):  
Breast Cancer ◽  
In Vitro Fertilization ◽  
Fertility Preservation ◽  
Embryo Transfer ◽  
Ovarian Stimulation ◽  
Live Birth Rate ◽  
Embryo Cryopreservation ◽  
Vitro Fertilization ◽  
Embryo Freezing

Purpose We have previously reported an approach to ovarian stimulation for the purpose of fertility preservation (FP) in women with breast cancer via embryo freezing with the concurrent use of letrozole. The aim of this study was to provide the pregnancy and FP outcomes when embryos generated with the same protocol are used. Patients and Methods In all, 131 women with stage ≤ 3 breast cancer underwent ovarian stimulation and received concurrent letrozole 5 mg per day before receiving adjuvant chemotherapy and cryopreserving embryos. Results Thirty-three of the 131 women underwent 40 attempts to transfer embryos to their own uterus (n = 18) or via the use of a gestational carrier (n = 22) at a mean age of 41.5 ± 4.3 years with a median 5.25 years after embryo cryopreservation. The overall live birth rate per embryo transfer was similar to the US national mean among infertile women of a similar age undergoing in vitro fertilization–embryo transfer (45.0 v 38.2; P = .2). Seven (38.8%) of the 18 pregnancies were twins with no higher-order pregnancies being encountered. No fetal anomalies or malformations were reported in 25 children after a mean follow-up of 40.4 ± 26.4 months. Seventeen of the 33 women attempting pregnancy had at least one child, translating into an FP rate of 51.5% per attempting woman. Conclusion Embryo cryopreservation after ovarian stimulation with the letrozole and follicle-stimulating hormone protocol preserves fertility in women with breast cancer and results in pregnancy rates comparable to those expected in a noncancer population undergoing in vitro fertilization.

Abstract P2-12-12: Breast cancer in young women: Fertility preservation as a component of treatment planning and discussion

2015 ◽  
Author(s):  
Hugo Nunes ◽  
Fátima Vaz ◽  
Margarida Brito ◽  
Cláudia Melo ◽  
Ana Teresa Almeida Santos ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Fertility Preservation ◽  
Treatment Planning ◽  
Young Women
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