[Fertility preservation in breast cancer patients: the state of art in 2014?].
Fertility preservation has become the second major objective in association with the remission, in young patients suffering from breast cancer. Patients should be referred for oncofertility counseling, as soon as possible after the diagnosis. A multidisciplinary approach, involving oncologists, reproductive endocrinologists and embryologists will allow an optimal strategy according to patients' age, the ovarian reserve and the cancer treatments. The field of fertility preservation is improving and offers more and more flexible techniques. Oocyte vitrification is no more considered experimental. Ovarian stimulation combining exogenous FSH and aromatase inhibitors may be the optimal strategy of fertility preservation, while maintaining physiologic serum estradiol levels. In vitro maturation of oocyte may offer an interesting option, possibly in combination with ovarian tissue cryopreservation, in case of neo-adjuvant chemotherapy. All these techniques should not be considered only as a frozen hope but should be part of the treatment of young patients.
Hôpital Jean Verdier, service de médecine de la reproduction, avenue du 14 Juillet, 93140 Bondy, France.
Marjorie
M
Comtet
Hôpital Jean Verdier, service de médecine de la reproduction, avenue du 14 Juillet, 93140 Bondy, France; Université Paris XIII, 93000 Bobigny, France.
Charlotte
C
Sonigo
Hôpital Jean Verdier, service de médecine de la reproduction, avenue du 14 Juillet, 93140 Bondy, France.
Constance
C
Valdelièvre
Hôpital Jean Verdier, service de cytognétique et biologie de la reproduction, , avenue du 14 Juillet, 93140 Bondy, France.
Nathalie
N
Sermondade
Hôpital Jean Verdier, service de cytognétique et biologie de la reproduction, , avenue du 14 Juillet, 93140 Bondy, France.
Christophe
C
Sifer
Hôpital Jean Verdier, service de médecine de la reproduction, avenue du 14 Juillet, 93140 Bondy, France; Université Paris XIII, 93000 Bobigny, France; Université Paris-Diderot, unité Inserm U1133, 75013 Paris, France. Electronic address: michael.grynberg@jvr.aphp.fr.
Michaël
M
Grynberg
D000328:Adult; D000367:Age Factors; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000235:genetics / Q000628:therapy*; D002985:Clinical Protocols; D015925:Cryopreservation / Q000379:methods; D004622:Embryo, Mammalian; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D006801:Humans; D009865:Oocytes; D065851:Ovarian Reserve / Q000187:drug effects; D010053:Ovary; D010062:Ovulation Induction / Q000379:methods; D010348:Patient Care Team; D018570:Risk Assessment
Breast cancer; Cancer du sein; Cryopréservation de tissu ovarien; Fertility preservation; IVM; MIV; Ovarian tissue cryopreservation; Préservation de la fertilité; Vitrification