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Year : 2018  |  Volume : 1  |  Issue : 1  |  Page : 9-16

Breast cancer and fertility: A Review - Part 1

Department of Reproductive Medicine, Mother and Child Hospital, New Delhi, India

Correspondence Address:
Nalini Mahajan
Mother and Child Hospital, D-59, Defence Colony, New Delhi - 110 024
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tofj.tofj_6_17

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Breast cancer (BC) treatment leads to a reduction in reproductive lifespan due to the use of gonadotoxic agents and prolonged hormonal treatment. With an increasing incidence of BC in the young and better survival rates, fertility issues have come into focus. Pregnancy does not appear to have a detrimental effect and may even improve survival rates. Fertility counseling and offering fertility preservation (FP), therefore, is the standard of care. Among the FP procedures, oocyte freezing is preferred as it allows reproductive autonomy. Ovarian stimulation required for oocyte recruitment does not worsen BC prognosis. Reproductive outcome using cryopreserved gametes gives live birth rates similar to nononcological patients though studies are limited in this aspect. Ovarian tissue cryopreservation can be safely offered if neoadjuvant therapy is required. Fertility issues are extremely relevant in BRCA mutation carriers and FP should be offered to them. Co-administration of gonadotropin-releasing hormone agonist with chemotherapy is recommended in patients wishing to preserve ovarian function.

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