Introduction

Preservation of reproductive function is a key concern for many premenopausal women with breast cancer, given the known gonadotoxic effects of treatments. The present systematic review aimed to investigate the effectiveness and safety of fertility preservation strategies in pre-menopausal women with breast cancer.

Methods

Primary research assessing fertility preservation strategies of any type was identified. Markers of preservation of fertility including return of menstrual function, clinical pregnancy rates and live birth rates were selected as main outcome measures. An additional analysis of safety data was also performed.

Results

Fertility preservation interventions were overall associated with higher fertility outcomes: with a pooled odds ratio 4.14 (95% CI 3.59–4.77) for any kind of fertility preservation intervention. This was seen both for return of menstruation and for clinical pregnancy rate, but not for live birth rates. Fertility preservation was associated with a reduced rate of disease recurrence (OR 0.63 (95% CI 0.49–0.81)), while there was no significant difference in disease free survival (OR 0.88 (95% CI 0.74–1.05)) or in overall survival (OR 0.9 (95% CI 0.74–1.10)) between the fertility preservation group and those who had not undergone fertility preservation.

Conclusion

Fertility preservation is both effective in preserving reproductive function, and safe with regard to disease recurrence, disease free survival and overall survival in premenopausal women with breast cancer.

中文翻译：

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绝经前乳腺癌女性的生育力保存、有效性及其对疾病状态的影响：系统评价和荟萃分析

介绍

鉴于治疗已知的性腺毒性作用，保留生殖功能是许多患有乳腺癌的绝经前妇女的一个关键问题。本系统评价旨在调查绝经前乳腺癌女性生育力保存策略的有效性和安全性。

方法

确定了评估任何类型的生育力保存策略的初步研究。选择保留生育能力的标志物，包括月经功能恢复、临床妊娠率和活产率作为主要结局指标。还对安全数据进行了额外的分析。

结果

生育力保存干预措施总体上与较高的生育结果相关：任何类型的生育力保存干预措施的汇总优势比为 4.14 (95% CI 3.59–4.77)。月经恢复和临床妊娠率均出现这种情况，但活产率则不然。保留生育能力与疾病复发率降低相关（OR 0.63 (95% CI 0.49–0.81)），而无病生存率（OR 0.88 (95% CI 0.74–1.05)）或总生存率没有显着差异生育力保存组与未接受生育力保存组之间的OR为0.9（95% CI 0.74-1.10））。

结论

保留生育能力不仅可以有效地保护生殖功能，而且对于绝经前乳腺癌女性的疾病复发、无病生存和总生存而言是安全的。