Fertility preservation in young females with non-gynaecologic malignancy: an emerging speciality

Obstetric and offspring risks of women's morbid conditions linked to prior anticancer treatments

BACKGROUND

Literature shows the effects of type of cancer and/or anticancer treatment on live birth percentages and/or pregnancy and neonatal complications in female cancer survivors. However, studies analyzing the obstetric and offspring risks of the morbid conditions associated with previous anti-cancer treatments are missing. The present review aims to uncover these risks.

METHODS

A literature search based on publications up to March 2016 identified by PubMed and references cited in relevant articles.

RESULTS

The morbid conditions associated with prior anticancer treatments including chemotherapy, radiotherapy, surgery, and/or hematopoietic stem-cell transplant may induce not only obstetric and neonatal complications but also long-term effects on offspring. Whereas some risks are predominantly evidenced in untreated women others are observed in both treated and untreated women. These risks may be superimposed on those induced by the current women's trend in Western societies to postpone maternity.

CONCLUSIONS

Medical professionals should be aware and inform female cancer survivors wishing to have a child not only of the short- and long-term risks to themselves and their prospective offspring of previous anticancer treatments, fertility-preservation technologies, and pregnancy itself, but also of those risks linked to the morbid conditions induced by prior anticancer treatments. Once female cancer survivors wishing to have a child have been properly informed about the risks of reproduction, they will be best placed to make decisions of whether or not to have a biological or donor-conceived child. In addition, when medical professionals be aware of these risks, they will be also best placed to provide appropriate treatments before/during pregnancy in order to prevent or alleviate the impact of these morbid conditions on maternal and offspring health.

Ovarian hyperstimulation and breast cancer on PET imaging with sonographic correlation

We present interesting PET/CT and ultrasound findings in a 36-year-old lactating woman with stage T2 N0 M0 right breast cancer undergoing oocyte retrieval for fertility preservation. Her cancer treatment plan included neoadjuvant chemotherapy; therefore, the patient wanted to undergo an oocyte retrieval procedure for fertility preservation. She underwent a transvaginal ultrasound-guided oocyte retrieval procedure in the morning and a staging F-FDG PET/CT later the same day. At the time of PET imaging, she had been breast-feeding her 9-month-old infant with only her left breast.