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Open Access 01-05-2020 | Fertility | Clinical trial

Preserving fertility in young women undergoing chemotherapy for early breast cancer; the Maastricht experience

Authors: Ingeborg J. H. Vriens, Elena M. ter Welle-Butalid, Maaike de Boer, Christine E. M. de Die-Smulders, Josien G. Derhaag, Sandra M. E. Geurts, Irene E. G. van Hellemond, Ernest J. T. Luiten, M. Wouter Dercksen, Bea M. D. Lemaire, Els R. M. van Haaren, Birgit E. P. J. Vriens, Agnes J. van de Wouw, Anne-marie M. G. H. van Riel, Sandra L. E. Janssen-Engelen, Marlène H. W. van de Poel, Ester E. M. Schepers-van der Sterren, Ron J. T. van Golde, Vivianne C. G. Tjan-Heijnen

Published in: Breast Cancer Research and Treatment | Issue 1/2020

Abstract

Purpose

We assessed the uptake of fertility preservation (FP), recovery of ovarian function (OFR) after chemotherapy, live birth after breast cancer, and breast cancer outcomes in women with early-stage breast cancer.

Methods

Women aged below 41 years and referred to our center for FP counseling between 2008 and 2015 were included. Data on patient and tumor characteristics, ovarian function, cryopreservation (embryo/oocyte) and transfer, live birth, and disease-free survival were collected. Kaplan–Meier analyses were performed for time-to-event analyses including competing risk analyses, and patients with versus without FP were compared using the logrank test.

Results

Of 118 counseled women with a median age of 31 years (range 19–40), 34 (29%) chose FP. Women who chose FP had less often children, more often a male partner and more often favorable tumor characteristics. The 5-year OFR rate was 92% for the total group of counseled patients. In total, 26 women gave birth. The 5-year live birth rate was 27% for the total group of counseled patients. Only three women applied for transfer of their cryopreserved embryo(s), in two combined with preimplantation genetic diagnosis (PGD) because of BRCA1-mutation carrier ship. The 5-year disease-free survival rate was 91% versus 88%, for patients with versus without FP (P = 0.42).

Conclusions

Remarkably, most women achieved OFR, probably related to the young age at diagnosis. Most pregnancies occurred spontaneously, two of three women applied for embryo transfer because of the opportunity to apply for PGD.

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Title: Preserving fertility in young women undergoing chemotherapy for early breast cancer; the Maastricht experience
Authors: Ingeborg J. H. Vriens
Elena M. ter Welle-Butalid
Maaike de Boer
Christine E. M. de Die-Smulders
Josien G. Derhaag
Sandra M. E. Geurts
Irene E. G. van Hellemond
Ernest J. T. Luiten
M. Wouter Dercksen
Bea M. D. Lemaire
Els R. M. van Haaren
Birgit E. P. J. Vriens
Agnes J. van de Wouw
Anne-marie M. G. H. van Riel
Sandra L. E. Janssen-Engelen
Marlène H. W. van de Poel
Ester E. M. Schepers-van der Sterren
Ron J. T. van Golde
Vivianne C. G. Tjan-Heijnen
Publication date: 01-05-2020
Publisher: Springer US
Keywords: Fertility
Breast Cancer
Breast Cancer
Cytostatic Therapy
Published in: Breast Cancer Research and Treatment / Issue 1/2020
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-020-05598-2

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