Kaitlyn Wald1, Ange Wang2, Mary Kathryn Abel1,3, Jerrine Morris1, Joseph M Letourneau1,4, Evelyn Mok-Lin1, Marcelle I Cedars1, Mitchell P Rosen1. 1. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, 499 Illinois Street, 6th Floor, CA, 94158, San Francisco, USA. 2. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, 499 Illinois Street, 6th Floor, CA, 94158, San Francisco, USA. ange.wang@ucsf.edu. 3. School of Medicine, University of California, San Francisco, 533 Parnassus Avenue, San Francisco, CA, 94143, USA. 4. Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, USA.
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 [Formula: see text] 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.
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 [Formula: see text] 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.
Authors: Joseph M Letourneau; Kaitlyn Wald; Nikita Sinha; Flor Juarez-Hernandez; Eve Harris; Marcelle I Cedars; Charles E McCulloch; Milana Dolezal; A Jo Chien; Mitchell P Rosen Journal: Cancer Date: 2019-10-22 Impact factor: 6.860
Authors: Joseph M Letourneau; Nikita Sinha; Kaitlyn Wald; Eve Harris; Molly Quinn; Tal Imbar; Evelyn Mok-Lin; A Jo Chien; Mitchell Rosen Journal: Hum Reprod Date: 2017-10-01 Impact factor: 6.918
Authors: Molly M Quinn; Hakan Cakmak; Joseph M Letourneau; Marcelle I Cedars; Mitchell P Rosen Journal: Hum Reprod Date: 2017-03-01 Impact factor: 6.918
Authors: Molly B Moravek; Rafael Confino; Kristin N Smith; Ralph R Kazer; Susan C Klock; Angela K Lawson; William J Gradishar; Mary Ellen Pavone Journal: Fertil Steril Date: 2018-01-17 Impact factor: 7.329