title: IVF for fertility preservation in breast cancer patients--efficacy and safety issues.
abstract: BACKGROUND
  Potential risks on future fertility have become a dominant issue in consultation and management of newly diagnosed young cancer patients. Several fertility preservation strategies are currently available. Of those, ovarian stimulation followed by IVF and embryo cryopreservation is the most established one and is especially applicable in reproductive aged breast cancer patients.
  
  
  OBJECTIVE
  The aim of this study is to provide a comprehensive review on ovarian stimulation and IVF for fertility preservation in newly diagnosed breast cancer patients.
  
  
  METHODS
  Review of relevant literature is available through PubMed and Google scholar.
  
  
  RESULTS
  The use of IVF for fertility preservation in breast cancer patients raises dilemmas regarding efficacy and safety of controlled ovarian stimulation. Among these are the suggested role of malignancy and BRCA mutation in reducing ovarian response to stimulation, strategies designated to protect against hyper-estrogenic state associated with stimulation (co-treatment with tamoxifen or letrozole), and possible adjustments to accommodate oncologic-related time constraints.
  
  
  CONCLUSIONS
  Ovarian stimulation followed by IVF forms an important fertility preservation strategy for newly diagnosed young breast cancer patients, though live born rates following thawed embryo transfer in these patients are still lacking. Recent advances in controlled ovarian stimulation protocols provide practical options for some of the challenges that breast cancer patients present.
authors.affiliation: IVF Unit, Division of Obstetrics and Gynecology, Fertility Preservation Center, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Shapira
authors.forename: H
authors.initials: H
authors.lastname: Raanani
authors.forename: D
authors.initials: D
authors.lastname: Meirow
mesh_terms: D019313:BRCA1 Protein / Q000235:genetics; D024682:BRCA2 Protein / Q000235:genetics; D001943:Breast Neoplasms / Q000150:complications / Q000628:therapy; D004967:Estrogens / Q000009:adverse effects / Q000494:pharmacology; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy; D009865:Oocytes / Q000502:physiology; D016471:Ovarian Hyperstimulation Syndrome / Q000209:etiology; D010053:Ovary / Q000502:physiology / Q000503:physiopathology; D010062:Ovulation Induction / Q000009:adverse effects / Q000379:methods; D011247:Pregnancy; D013997:Time Factors
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human; D004967:Estrogens