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Successful Preservation of Fertility After Aromatase Inhibitor Treatment and Ovarian Stimulation in Women With Breast Cancer

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Key Points

  • The live birth rate per embryo transfer was similar to the U.S. national mean among infertile women of similar age undergoing in vitro fertilization.
  • Of 33 women attempting pregnancy, 17 had one or more children.

In a study reported in the Journal of Clinical Oncology, Oktay et al found that fertility could be preserved in women with breast cancer via embryo freezing after concurrent aromatase inhibitor treatment and ovarian stimulation.

In the study, 131 women with stage ≤ III breast cancer underwent ovarian stimulation with follicle-stimulating hormone and received concurrent letrozole at 5 mg per day prior to adjuvant chemotherapy and cryopreservation of embryos.

Fertility Preservation

Embryo transfer to the uterus was attempted 40 times in 33 women, using their own uterus (n = 18) or via the use of a gestational carrier (n = 22) at a mean age of 41.5 years and at a median of 5.25 years after embryo cryopreservation. The overall live birth rate per embryo transfer (45.0%) was similar to the U.S. national mean among infertile women of similar age undergoing in vitro fertilization (38.2%, P = .2).

Of the 18 pregnancies, 7 (38.8%) were twins, with no higher-order pregnancies occurring. No fetal anomalies or malformations were reported in 25 children born after mean follow-up of 40.4 months. Overall, 17 of the 33 women attempting pregnancy had one or more children, yielding a fertility preservation rate of 51.5% per attempting woman.

The investigators concluded: “Embryo cryopreservation after ovarian stimulation with the letrozole and follicle-stimulating hormone protocol preserves fertility in women with breast cancer and results in pregnancy rates comparable to those expected in a noncancer population undergoing in vitro fertilization.”

Kutluk Oktay, MD, of the Innovation Institute for Fertility Preservation and In Vitro Fertilization, New York, is the corresponding author for the Journal of Clinical Oncology article.

The study was supported by grants from the National Institute of Child Health and Human Development.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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