Abstract
Purpose
To investigate if breast cancer stage and grade affect fertility preservation outcomes.
Methods
We performed a retrospective cohort study that included premenopausal women with breast cancer undergoing fertility preservation diagnosed between January 2011 and January 2019. The primary outcome measure was the number of mature oocytes (MII) per antral follicle count (AFC). Secondary outcome measures included total oocytes retrieved, total mature oocytes retrieved, and greater than 10 mature oocytes preserved. Univariate and multivariate models were used to assess the association of low vs. high stage (low stage I–II and high stage III–IV) and grade I vs. grade II/III with each outcome, with adjustment for confounders.
Results
A total of 267 premenopausal breast cancer patients undergoing fertility preservation were included in our study, with the majority presenting with low stage (N = 215, 80.5%), grade II/III (N = 235, 88.1%) disease. Baseline AFC, total gonadotropin dose, days of stimulation, and follicles \(\ge\) 13 mm on the day of trigger did not differ by stage or grade. After adjusting for age, BMI, and baseline AFC, we found that the mean MII per AFC did not differ by stage (1.0 vs. 1.1, P = 0.3) or grade (1.0 vs. 1.0, P = 0.92). Similarly, total oocytes retrieved, total MII retrieved, and percentage of patients who were able to preserve greater than 10 MII did not differ by breast cancer stage or grade (all P > 0.2).
Conclusion
Breast cancer grade and stage do not impact ovarian stimulation or fertility preservation outcome.
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Data availability
We are unable to provide our data due to its identified nature.
Code Availability
Code may be made available upon request.
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Acknowledgements
We would like to make a special thanks to our nurses and care coordinators who provided patient education and fertility preservation coordination.
Funding
This study was supported by departmental research funding within the University of California, San Francisco Department of Obstetrics, Gynecology, and Reproductive Sciences.
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K.W, A.W., M.K.A., and J.R.M.’s roles included data collection, data analysis, and manuscript writing; J.M.L.’s roles included study design and data collection; E.M.L., M.I.C., and M.R.’s roles included study design and manuscript writing. All author roles meet the following criteria: (1) substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, (3) final approval of the version to be published, and (4) agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of California, San Francisco (UCSF) Committee on Human Research and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Kaitlyn Wald and Ange Wang are joint first authors.
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Wald, K., Wang, A., Abel, M.K. et al. Breast cancer grade and stage do not affect fertility preservation outcomes. J Assist Reprod Genet 39, 1155–1161 (2022). https://doi.org/10.1007/s10815-022-02473-5
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DOI: https://doi.org/10.1007/s10815-022-02473-5