title: Fertility preservation options in breast cancer patients.
abstract: The purpose of this review is to analyse current options for fertility preservation in young women with breast cancer (BC). Considering an increasing number of BC survivors, owing to improvements in cancer treatment and delaying of childbearing, fertility preservation appears to be an important issue. Current fertility preservation options in BC survivors range from well-established standard techniques to experimental or investigational interventions. Among the standard options, random-start ovarian stimulation protocol represents a new technique, which significantly decreases the total time of the in vitro fertilisation cycle. However, in patients with oestrogen-sensitive tumours, stimulation protocols using aromatase inhibitors are currently preferred over tamoxifen regimens. Cryopreservation of embryos and oocytes are nowadays deemed the most successful techniques for fertility preservation in BC patients. GnRH agonists during chemotherapy represent an experimental method for fertility preservation due to conflicting long-term outcome results regarding its safety and efficacy. Cryopreservation of ovarian tissue, in vitro maturation of immature oocytes and other strategies are considered experimental and should only be offered within the context of a clinical trial. An early pretreatment referral to reproductive endocrinologists and oncologists should be suggested to young BC women at risk of infertility, concerning the risks and benefits of fertility preservation options.
authors.affiliation: a Department of Obstetrics and Gynaecology , University Hospital Centre Zagreb, School of Medicine, University of Zagreb , Zagreb , Croatia .
authors.forename: Miro
authors.initials: M
authors.lastname: Kasum
authors.affiliation: b Division of Gynaecological Endocrinology and Reproductive Medicine , Women's Hospital, University of Berne , Berne , Switzerland .
authors.forename: Michael
authors.initials: M
authors.lastname: von Wolff
authors.affiliation: a Department of Obstetrics and Gynaecology , University Hospital Centre Zagreb, School of Medicine, University of Zagreb , Zagreb , Croatia .
authors.forename: Daniela
authors.initials: D
authors.lastname: Franulić
authors.affiliation: c Cantonal Hospital Zenica , Zenica , Bosnia and Herzegovina , and.
authors.forename: Ermin
authors.initials: E
authors.lastname: Čehić
authors.affiliation: d Department of Gynecology , Comunity Health Center Zagreb East , Zagreb , Croatia.
authors.forename: Tajana
authors.initials: T
authors.lastname: Klepac-Pulanić
authors.affiliation: a Department of Obstetrics and Gynaecology , University Hospital Centre Zagreb, School of Medicine, University of Zagreb , Zagreb , Croatia .
authors.forename: Slavko
authors.initials: S
authors.lastname: Orešković
authors.affiliation: a Department of Obstetrics and Gynaecology , University Hospital Centre Zagreb, School of Medicine, University of Zagreb , Zagreb , Croatia .
authors.forename: Josip
authors.initials: J
authors.lastname: Juras
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D015925:Cryopreservation / Q000379:methods*; D004622:Embryo, Mammalian; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D005307:Fertilization in Vitro / Q000379:methods; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D059471:In Vitro Oocyte Maturation Techniques / Q000379:methods; D007247:Infertility, Female / Q000139:chemically induced / Q000517:prevention & control*; D054315:Oocyte Retrieval / Q000379:methods; D009865:Oocytes; D010062:Ovulation Induction / Q000379:methods*; D013629:Tamoxifen / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D013629:Tamoxifen; D007987:Gonadotropin-Releasing Hormone
keywords: Breast cancer; chemotherapy; fertility preservation options; young age