Motherhood after breast cancer: can we balance fertility preservation and cancer treatment? A narrative review of the literature

Abstract

Breast cancer may affect young women who have not yet completed childbearing. Assisted reproductive technology (ART) provides alternatives for fertility preservation such as oocyte, embryo or ovarian tissue cryopreservation. We reviewed the published literature on fertility-preserving management in breast cancer, aiming at finding evidence to answer the following questions: (1) What are the fertility sparing options available?; (2) How do these women respond to IVF? and (3) Can pregnancy influence breast cancer recurrence? There is a paucity of publications describing clinical experience and outcome data which limits accessibility to fertility preservation in this setting. Presently, oocyte or embryo cryopreservation are the main options for fertility preservation. IVF success rates are comparable to the ones of non-oncological populations according to the woman's age but current published studies lack data on definitive success rates following embryo banking for cancer patients. The perception that IVF and pregnancy may worsen cancer prognosis remains, despite the lack of scientific evidence to support this notion. Published studies show reassuring results for pregnancies occurring >2 years after breast cancer diagnosis. The best published evidence suggests pregnancy after breast cancer does not increase the risk of disease recurrence, thus pregnancy should not be forbidden once treatment is completed. Decision making for women diagnosed with cancer requires up-to-date knowledge of the efficacy and safety of available options. Providing consultation with a reproductive specialist and appropriate information on fertility preservation for these women should be an essential aspect of their supportive care.

Full-term pregnancy in breast cancer survivor with fertility preservation: A case report and review of literature

“…These cases should be managed in a multi-disciplinary manner, involving different health care specialists - oncologists, breast surgeons, gynecologists, reproductive specialists, breast nurses, psychologists - with the aim of ensuring that an educated team can keep up with the progress of fertility preservation knowledge[8]. Providing consultation with a reproductive specialist and appropriate information on fertility preservation for these women should be an essential component of their supportive care[9].…”

Reproductive concerns and fear of cancer recurrence: a qualitative study of women’s experiences of the perinatal period after cancer

“…This finding is not unique. Despite ongoing research regarding both fertility preservation throughout cancer treatment, and the safety of pregnancy after treatment, women continue to report a paucity of information [ 49 ]. Research shows that access to informational resources is integral to cancer patients’ and survivors’ well-being and psychological health.…”

Periconceptional Genetic Counseling and the First Experience of Assisted Reproductive Technologies in Patients, which Diagnosed Breast Cancer

“…Наиболее безопасными считается срок 2-3 года после завершения лечения при начальных стадиях заболевания. Этот период обусловлен наибольшим риском возврата болезни [1,4].…”