Fertility preservation options for young women with breast cancer

With improved treatments for breast cancer forming a large community of young survivors, quality-of-life issues including fertility are becoming more important. Oncologists, whose treatments may put their young patient's fertility at risk, must be aware of the existing options for fertility preservation.

Many commonly used chemotherapeutic agents diminish a woman's ovarian function. The mechanisms for this damage include follicular apoptosis and cortical fibrosis. While highly variable, depending on factors such as age at exposure, agent and dose, the incidence of permanent amenorrhea following adjuvant systemic therapy for breast cancer patients older than age 30 years spans 13-68%. There are many fertility preservation options available, and a growing number of systems in place to link patients with resources. Advances in the sciences of oocyte, embryo and ovarian tissue preservation are important, and an increase in the awareness of fertility preservation options by both physicians and patients is also critical.

Fertility preservation is an important part of a young breast cancer patient's quality of life as she contemplates a cancer-free future. The authors will define the scope of the problem and its causes, and explore currently available strategies for fertility preservation in this patient population.