Controlled ovarian hyperstimulation in breast cancer patients: Does oestrogen receptor status make a difference?
breast cancer
controlled ovarian stimulation
fertility preservation
oestrogen receptor
Journal
The Australian & New Zealand journal of obstetrics & gynaecology
ISSN: 1479-828X
Titre abrégé: Aust N Z J Obstet Gynaecol
Pays: Australia
ID NLM: 0001027
Informations de publication
Date de publication:
14 Jun 2023
14 Jun 2023
Historique:
received:
20
12
2022
accepted:
01
06
2023
medline:
15
6
2023
pubmed:
15
6
2023
entrez:
15
6
2023
Statut:
aheadofprint
Résumé
The presence of different breast cancer receptor status may impact ovarian stimulation outcomes. To study the association between oestrogen receptor (ER) status in breast cancer patients and fertility preservation outcomes in a major tertiary referral centre. Women who underwent fertility preservation following the diagnosis of breast cancer from 2008 to 2018 were included in the study. Patient age, ovarian stimulation parameters and laboratory outcomes were recorded and compared between the ER positive and negative groups. The primary outcome was total number of oocytes frozen. Secondary outcomes included total number of oocytes collected, mature oocytes, and embryos frozen. The women included in the study (n = 214) were analysed in the following groups based on their fertility preservation method: oocyte freezing (n = 131), embryo freezing (n = 70), and both embryo and oocyte freezing (n = 13). There was an increase in the mean (but not mature) number of oocytes frozen (12.4 and 9.2, P-value = 0.03) favouring the ER positive group, even though the women in this group were older (35.0 and 33.4, P-value of 0.03). There is no difference in the starting follicle-stimulating hormone dose, duration of stimulation, mature oocytes collected, and embryos frozen in both groups. Patients with ER positive breast cancer may have more positive ovarian stimulation outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
The presence of different breast cancer receptor status may impact ovarian stimulation outcomes.
AIM
OBJECTIVE
To study the association between oestrogen receptor (ER) status in breast cancer patients and fertility preservation outcomes in a major tertiary referral centre.
MATERIALS AND METHODS
METHODS
Women who underwent fertility preservation following the diagnosis of breast cancer from 2008 to 2018 were included in the study. Patient age, ovarian stimulation parameters and laboratory outcomes were recorded and compared between the ER positive and negative groups. The primary outcome was total number of oocytes frozen. Secondary outcomes included total number of oocytes collected, mature oocytes, and embryos frozen.
RESULTS
RESULTS
The women included in the study (n = 214) were analysed in the following groups based on their fertility preservation method: oocyte freezing (n = 131), embryo freezing (n = 70), and both embryo and oocyte freezing (n = 13). There was an increase in the mean (but not mature) number of oocytes frozen (12.4 and 9.2, P-value = 0.03) favouring the ER positive group, even though the women in this group were older (35.0 and 33.4, P-value of 0.03). There is no difference in the starting follicle-stimulating hormone dose, duration of stimulation, mature oocytes collected, and embryos frozen in both groups.
CONCLUSION
CONCLUSIONS
Patients with ER positive breast cancer may have more positive ovarian stimulation outcomes.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023 Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Références
Siegel R, Miller K, Fuchs H, Jemal A. Cancer statistics. CA Cancer J Clin 2022; 72(1): 7-33.
Pregnancy and Breast Cancer. RCOG. Greentop Guideline 12, March 2011.
Ghafoor A, Jemal A, Ward E. Trends in breast cancer by race and ethnicity. CA Cancer J Clin 2003; 53: 342-355.
Marklund A, Lekberg T, Hedayati E et al. Rlapse rates and disease- specific mortality following procedures for fertility preservation at time of breast cancer diagnosis. JAMA Oncol 2022; 8: 1438-1446.
Arreco L, Blondeaux E, Bruzzone M et al. Safety of fertility preservation techniques before and after anticancer treatments in young women with breast cancer: a systematic review and meta-analysis. Hum Reprod 2022; 37: 954-968.
Lambertini M, Del Mastro L, Viglietti G et al. Ovarian function suppression in premenopausal women with early-stage breast cancer. Curr Treat Options Oncol 2017; 18(1): 4.
Elkin M, Domingo J, De Castro G et al. Ovarian stimulation for oocyte vitrification does not modify disease-free survival and overall survival rates in patients with early breast cancer. Reprod Biomed Online 2019; 39: 860-867.
Ruddy K, Gelber S, Tamimi R et al. Prospective study of fertility concerns and preservation strategies in young women with breast cancer. J Clin Oncol 2014; 32: 1151-1156.
Lambertini M, Del Mastro L, Pescio M et al. Cancer and fertility preservation: international recommendations from an expert meeting. BMC Med 2016; 14: 1.
Ethics Committee of the American Society for Reproductive Medicine. Fertility preservation and reproduction in patients facing gonadotoxic therapies: an ethics committee opinion. Fertil Steril 2018; 110: 380-386.
Phillips KA, Collins IM, Milne RL et al. Anti-Müllerian hormone serum concentrations of women with germline BRCA1 or BRCA2 mutations. Hum Reprod 2016; 31: 1126-1132.
Lambertini M, Goldrat O, Ferrerira A et al. Reproductive potential and performance of fertility preservation strategies in BRCA-mutated breast cancer patients. Ann Oncol 2018; 29(1): 237-243.
Oktay K, Kim J, Barad D, Babayev SN. Association of BRCA1 mutations with occult primary ovarian insufficiency: a possible explanation for the link between infertility and breast/ovarian cancer risks. J Clin Oncol 2010; 28: 240-244.
Blows FM, Driver KE, Schmidt MK et al. Subtyping of breast cancer by immunohistochemistry to investigate a relationship between subtype and short and long term survival: a collaborative analysis of data for 10,159 cases from 12 studies. PLoS Med 2010; 7: e1000279.
Allemani C, Sant M, Berrino F et al. Prognostic value of morphology and hormone receptor status in breast cancer - a population-based study. Br J Cancer 2004; 91: 1263-1268.
Marklund A, Eloranta S, Wikander I et al. Efficacy and safety of controlled ovarian stimulation using GnRH antagonist protocols for emergency fertility preservation in young women with breast cancer- a prospective Nationwide Swedish multicentre study. Hum Reprod 2020; 35(4): 929-938.
Balayla J, Tulandi T, Buckett W et al. Outcomes of ovarian stimulation and fertility preservation in breast cancer patients with different hormonal profiles. J Assist Reprod Genet 2020; 37: 913-921.
Badowska-Kozakiewicz AM, Patera J, Sobol M, Przybylski J. The role of oestrogen and progesterone receptors in breast cancer -immunohistochemical evaluation of Oestrogen and progesterone receptor expression in invasive breast cancer in women. Contemp Oncol 2015; 19: 220-225.
Rodgers R, Reid G, Koch J et al. The safety and efficacy of controlled ovarian hyperstimulation for fertility preservation in women with early breast cancer: a systematic review. Human Reprod 2017; 32(5): 1033-1045.
Oktay K, Buyuk E, Libertella N et al. Fertility preservation in breast cancer patients: a prospective controlled comparison of ovarian stimulation with tamoxifen and letrozole for embryo cryopreservation. J Clin Oncol 2005; 23(19): 4347-4353.
Meirow D, Raanan H, Maman E et al. Tamoxifen Co-administration during controlled ovarian hyperstimulation for In vitro- fertilisation in breast cancer patients increases the safety of fertility-preservation treatment strategies. Fertil Steril 2014; 102(2): 488-495.
Balkenende E, Dahhan T, Beerendonk C et al. Fertility preservation for women with breast cancer: a multicentre randomised controlled trail on various ovarian stimulation protocols. Hum Reprod 2022; 37(8): 1786-1794.
Wang A, Letourneau J, Juarez-Henandez F et al. Hormone concentrations of dominant follicles in the TLAES randomised controlled trial comparing letrozole with tamoxifen. J Assist Reprod Genet 2022; 39: 2617-2624.
Cobo A, Garcia-Velasco J, Remohi J, Pellicer A. Oocyte vitrification for fertility preservation for both medical and non medical reasons. Fertil Steril 2021; 115(5): 1091-1101.
Danis R, Pereira N, Elias R. Random start ovarian stimulation for oocyte or embryo cryopreservation in women desiring fertility preservation prior to gonadotoxic cancer therapy. Curr Pharm Biotechnol 2017; 18: 609-613.
KHalili M, Shahedi A, Ashourzadeh S et al. Vitrfication of human immature oocytes before and after In vitro maturation: a review. J Assit Reprod Genet 2017; 34: 1413-1426.
Shu Y, Gebhardt J, Watt J et al. Fertilization, embryo development, and clinical outcome of immature oocytes from stimulated intracytoplasmic sperm injection cycle. Fertil Steril 2007; 87: 1022-1027.
Titus S, Li F, Stobezki R et al. Impairment of BRCA1-related DNA double-Dtrand break repair leads to ovarian aging in mice and Humans. Sci Transl Med 2013; 5: 172ra121.
Foulkes Q, Metcalfe K, Hanna W et al. Estrogen receptor status in BRCA1 and BRCA2 related breast cancer. Clin Cancer Res 2004; 10: 2029-2034.
Wang L, Di L. BRCA1 and estrogen/estrogen receptor in breast cancer: where they interact? Int J Biol Sci 2014; 10(5): 566-575.
Raad J, Sonigo C, Benoit A et al. Influence of breast cancer prognostic factors on oocyte in vitro maturation outcomes performed for urgent fertility preservation. Hum Reprod 2022; 37(7): 1480-1488.
Kim S, Kim T, Han J et al. Impact of BRCA mutations and hormone receptor status on reproductive potential in breast cancer patients undergoing fertility preservation. Gynaecol Endocrinol 2022; 38(3): 227-230.