Techniques for fertility preservation in patients with breast cancer

To outline the risks of infertility from breast cancer treatment, and to illustrate current techniques in preserving fertility in breast-cancer patients who wish to become pregnant after treatment is concluded.

Breast cancer often affects women of reproductive age. Although treatment is effective, cytotoxic chemotherapy causes ovarian reserve depletion, whereas hormonal therapy necessitates a delay in pregnancy, resulting in infertility. Patients of reproductive age should be referred to fertility specialists to explore methods of fertility preservation upon diagnosis. The best established method of fertility preservation is embryo cryopreservation, although investigational techniques such as, oocyte and ovarian tissue cryopreservation, may hold potential. Embryo cryopreservation involves ovarian stimulation to retrieve oocytes in-vitro fertilization prior to freezing. Techniques for the cryopreservation of unfertilized oocytes are under investigation. Successful pregnancies have resulted in breast cancer patients after treatment, without obvious compromise in their risk of recurrence or death from breast cancer.

Ovarian stimulation with retrieval of ooctyes for in-vitro fertilization remains the best known option for fertility preservation in women with early stage breast cancer whose risk of fertility may be compromised by adjuvant chemotherapy.