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Breast cancer and fertility

an update

Ronn, Ruth; Holzer, Hananel

Current Opinion in Supportive and Palliative Care: September 2015 - Volume 9 - Issue 3 - p 285–293
doi: 10.1097/SPC.0000000000000164
REVIEW
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Purpose of review This review will summarize key fertility issues in young women with breast cancer. The detrimental effects of treatment modalities on ovarian and hormonal function will be reviewed. Options for fertility protection and preservation will also be outlined, as well as the unique issues facing women in pregnancy with a previous breast cancer diagnosis.

Recent findings Gonadotropin-releasing hormone analogues continue to be in debate for their protective impact on the ovaries during the time of gonadotoxic treatment. Success rates in the cryopreservation of embryos, oocytes and gonadal tissue continue to improve. Concurrently, advancing reproductive technologies are developing promising techniques for obtaining mature oocytes from ovarian tissue and from early ovarian follicles. The pursuit of a pregnancy after breast cancer treatment is an additional challenge. Increasing bodies of evidence support the safety of pregnancy after breast cancer and the possibly improved survival. Still, there is an uncertainty regarding recommended intervals from diagnosis to conception. Preimplantation genetic diagnosis for hereditary breast cancer mutations is also becoming of increasing interest.

Summary The fertility impact of breast cancer treatment in young women is of ongoing concern. The effects should be universally addressed and options should be outlined with young women prior to commencement of treatment.

aDepartment of Obstetrics and Gynecology, Shaare Zedek Medical Center

bIVF Centers, Shaare Zedek and Bikur Cholim Medical Centers, Affiliated with the Hebrew University School of Medicine, Jerusalem, Israel

Correspondence to Ruth Ronn, MD, CM, FRCSC, Shaare Zedek Medical Center, IVF Centre, 12 Bayit Street, Jerusalem 91031, Israel. Tel: +972 2 655 5045; e-mail: RuthRonn@szmc.org.il

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