Value of Early Referral to Fertility Preservation in Young Women with Breast Cancer

Sanghoon Lee, Sinan Ozkavukcu, Elke Heytens, Fred Moy, Kutluk Oktay

Research output: Contribution to journalArticle

88 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)4683-4686
Number of pages4
JournalJournal of Clinical Oncology
Volume28
Issue number31
DOIs
Publication statusPublished - 2010 Nov 1
Externally publishedYes

Fingerprint

Fertility Preservation
Referral and Consultation
Breast Neoplasms
Oocytes
Embryonic Structures
Ovulation Induction
Cryopreservation
Breast
Oocyte Retrieval
Drug Therapy
Databases

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Value of Early Referral to Fertility Preservation in Young Women with Breast Cancer. / Lee, Sanghoon; Ozkavukcu, Sinan; Heytens, Elke; Moy, Fred; Oktay, Kutluk.

In: Journal of Clinical Oncology, Vol. 28, No. 31, 01.11.2010, p. 4683-4686.

Research output: Contribution to journalArticle

Lee, Sanghoon ; Ozkavukcu, Sinan ; Heytens, Elke ; Moy, Fred ; Oktay, Kutluk. / Value of Early Referral to Fertility Preservation in Young Women with Breast Cancer. In: Journal of Clinical Oncology. 2010 ; Vol. 28, No. 31. pp. 4683-4686.
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abstract = "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.",
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