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Open Access 01-12-2018 | Case report

Two successful pregnancies following fertility preservation in a patient with anaplastic astrocytoma: a case report

Authors: Alexandra Peyser, Sara L. Bristow, Avner Hershlag

Published in: BMC Cancer | Issue 1/2018

Abstract

Background

Astrocytomas are the most common malignant glial tumors. With improved prognosis, it is possible for patients to pursue pregnancy post-treatment. However, with potential gonadotoxicity of oncology treatments, fertility preservation prior to chemotherapy and/or radiation therapy should be considered. This requires close collaboration between the oncologist and reproductive endocrinologist. To our knowledge this is the first report of successful pregnancies following fertility preservation for AA.

Case presentation

33-year-old nulligravid woman with newly diagnosed anaplastic astrocytoma (AA; WHO grade III, IDH1-negative) sought fertility preservation. Prior to chemotherapy and radiation for AA, the patient underwent in vitro fertilization (IVF) for fertility preservation, resulting in 8 vitrified embryos. Following chemo-radiation, the patient underwent two rounds of frozen embryo transfers (FET), each resulting in a successful singleton pregnancy.

Conclusion

This case illustrates the realistic possibility, in carefully selected patients with brain tumors, of oocyte or embryo cryo-preservation prior to chemo-radiation and subsequent pregnancies.

Burger PC, Green SB. Patient age, histologic features, and length of survival in patients with glioblastoma multiforme. Cancer [Internet]. 1987 [cited 2017 Feb 14];59:1617–25. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3030531

Smoll NR, Hamilton B. Incidence and relative survival of anaplastic astrocytomas. Neuro Oncol. [Internet]. 2014 [cited 2017 Feb 14];16:1400–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24723565

Reuss DE, Mamatjan Y, Schrimpf D, Capper D, Hovestadt V, Kratz A, et al. IDH mutant diffuse and anaplastic astrocytomas have similar age at presentation and little difference in survival: a grading problem for WHO. Acta Neuropathol. [Internet]. 2015 [cited 2017 Feb 14];129:867–73. Available from: http://link.springer.com/10.1007/s00401-015-1438-8

Pallud J, Mandonnet E, Deroulers C, Fontaine D, Badoual M, Capelle L, et al. Pregnancy increases the growth rates of World Health Organization grade II gliomas. Ann Neurol. [Internet]. 2010 [cited 2017 Feb 14];67:398–404. Available from: http://doi.wiley.com/10.1002/ana.21888

Lynch JC, Gouvêa F, Emmerich JC, Kokinovrachos G, Pereira C, Welling L, et al. Management strategy for brain tumour diagnosed during pregnancy. Br J Neurosurg. [Internet]. 2011 [cited 2017 Feb 14];25:225–30. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20825287

Pallud J, Duffau H, Razak RA, Barbarino-Monnier P, Capelle L, Fontaine D, et al. Influence of pregnancy in the behavior of diffuse gliomas: clinical cases of a French glioma study group. J Neurol. [Internet]. 2009 [cited 2017 Feb 14];256:2014–20. Available from: http://link.springer.com/10.1007/s00415-009-5232-1

Daras M, Cone C, Peters KB. Tumor progression and transformation of low-grade glial tumors associated with pregnancy. J Neurooncol. [Internet]. 2014 [cited 2017 Feb 14];116:113–7. Available from: http://link.springer.com/10.1007/s11060-013-1261-9

Hanada T, Rahayu TU, Yamahata H, Hirano H, Yoshioka T, Arita K. Rapid malignant transformation of low-grade astrocytoma in a pregnant woman. J Obstet Gynaecol Res. [Internet]. 2016 [cited 2017 Feb 14];42:1385–9. Available from: http://doi.wiley.com/10.1111/jog.13072

Yust-Katz S, de Groot JF, Liu D, Wu J, Yuan Y, Anderson MD, et al. Pregnancy and glial brain tumors. Neuro Oncol. [Internet]. 2014 [cited 2017 Feb 14];16:1289–94. Available from: https://academic.oup.com/neuro-oncology/article-lookup/doi/10.1093/neuonc/nou019

10.

Meirow D, Lewin A, Or R, Rachmilewitz E, Slavin S, Schenker J, et al. Ovarian failure post-chemotherapy in young cancer patients - risk assessment indicate the need for intervention. Am Soc Reprod Med Annu Meet Cincinatti. 1997;68:S218.

11.

Meirow D, Nugent D. The effects of radiotherapy and chemotherapy on female reproduction. Hum Reprod Update [Internet]. 2001 [cited 2017 Feb 14];7:535–43. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11727861

12.

Strowd RE, Blackwood R, Brown M, Harmon M, Lovato J, Yalcinkaya T, et al. Impact of temozolomide on gonadal function in patients with primary malignant brain tumors. J Oncol Pharm Pract. [Internet]. 2013 [cited 2017 Feb 14];19:321–7. Available from: http://journals.sagepub.com/doi/10.1177/1078155212469243

13.

Palmieri C, Brock C, Newlands ES. Maintenance of fertility following treatment with temozolomide for a high grade astrocytoma. J Neurooncol. [Internet]. 2005 [cited 2017 Feb 14];73:185. Available from: http://link.springer.com/10.1007/s11060-004-3577-y

14.

Sitbon Sitruk L, Sanson M, Prades M, Lefebvre G, Schubert B, Poirot C. [Unknown gonadotoxicity chemotherapy and preservation of fertility: example of Temozolomide]. Gynecol Obstet Fertil. [Internet]. 2010 [cited 2017 Feb 14];38:660–2. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21030284

15.

Hernandez-Diaz S, Smith CR, Shen A, Mittendorf R, Hauser WA, Yerby M, et al. Comparative safety of antiepileptic drugs during pregnancy. Neurology [Internet]. 2012 [cited 2017 Feb 14];78:1692–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22551726

16.

Stone JB, Kelvin JF, DeAngelis LM. Fertility preservation in primary brain tumor patients. Neuro-Oncology Pract [Internet]. 2017 [cited 2017 Feb 14];npw005. Available from: https://academic.oup.com/nop/article-lookup/doi/10.1093/nop/npw005

17.

Goossens J, Delbaere I, Van Lancker A, Beeckman D, Verhaeghe S, Van Hecke A. Cancer patients’ and professional caregivers’ needs, preferences and factors associated with receiving and providing fertility-related information: a mixed-methods systematic review. Int J Nurs Stud [Internet]. 2014 [cited 2017 Feb 14];51:300–19. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0020748913001971

Title: Two successful pregnancies following fertility preservation in a patient with anaplastic astrocytoma: a case report
Authors: Alexandra Peyser
Sara L. Bristow
Avner Hershlag
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-018-4472-9

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