Purpose

Breast cancer is the most common cancer diagnosed during childbearing age, and fertility preservation is becoming increasingly more essential. However, recent studies indicate a possible poorer response to controlled ovarian hyperstimulation (COH) in cancer patients than in non-cancer controls and a negative impact of BRCA mutations on female fertility. This study aims to evaluate ovarian response and the number of mature oocytes (MII) vitrified in women with breast cancer, with or without BRCA mutation, comparing them to the expected response according to an age-related nomogram.

Methods

This is a retrospective observational study involving sixty-one breast cancer patients who underwent COH for oocyte cryopreservation. The age-specific nomogram was built using 3871 patients who underwent COH due to oocyte donation, fertility preservation for non-medical reasons, or FIVET for male factor exclusively.

Results

The mean number of oocytes retrieved was 13.03, whereas the mean number of MII oocytes was 10.00. After the application of the z-score, no statistically significant differences were found compared with the expected response in the general population, neither by dividing patients according to the presence or absence of BRCA mutation nor according to the phase in which they initiated stimulation.

Conclusion

The results obtained do not support the notion of a negative impact of the BRCA mutation on the ovarian response of women with breast cancer. Women with breast cancer undergoing COH for fertility preservation can expect the ovarian response predicted for their age.

中文翻译：

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乳腺癌患者保留生育能力的 COH 结果：与按年龄划分的预期反应的比较。

 目的

乳腺癌是育龄期最常见的癌症，保留生育能力变得越来越重要。然而，最近的研究表明，与非癌症对照相比，癌症患者对受控卵巢过度刺激 (COH) 的反应可能较差，并且 BRCA 突变对女性生育能力产生负面影响。本研究旨在评估患有或不患有 BRCA 突变的乳腺癌女性的卵巢反应和玻璃化成熟卵母细胞 (MII) 的数量，并将其与根据年龄相关列线图的预期反应进行比较。

 方法

这是一项回顾性观察研究，涉及 61 名接受 COH 卵母细胞冷冻保存的乳腺癌患者。该年龄特异性列线图是使用 3871 名因卵母细胞捐赠、非医疗原因保留生育力或仅针对男性因素而接受 FIVET 而接受 COH 的患者构建的。

 结果

取出的卵母细胞平均数量为 13.03，而 MII 卵母细胞的平均数量为 10.00。应用z评分后，无论是根据 BRCA 突变的存在与否还是根据患者开始刺激的阶段来划分患者，与一般人群中的预期反应相比，均未发现统计学上的显着差异。

 结论

获得的结果并不支持 BRCA 突变对乳腺癌女性卵巢反应产生负面影响的观点。患有乳腺癌的女性接受 COH 来保留生育能力，可以预期卵巢反应与其年龄相符。