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Peigné M, Mur P, Laup L, Hamy AS, Sifer C, Mayeur A, Eustache F, Sarandi S, Vinolas C, Rakrouki S, Benoit A, Grynberg M, Sonigo C. Fertility outcomes several years after urgent fertility preservation for patients with breast cancer. Fertil Steril 2024:S0015-0282(24)00265-6. [PMID: 38679360 DOI: 10.1016/j.fertnstert.2024.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 04/22/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE To study the fertility outcomes of women who tried to conceive after breast cancer (BC) treatment and fertility preservation. DESIGN Retrospective observational, bicentric cohort study. SETTING University hospital. PATIENTS Patients with BC. INTERVENTION All patients who had undergone fertility preservation before BC treatment between January 2013 and July 2019 were included (n = 844). The endpoint date was March 1, 2022. Patients with missing data on pregnancy attempts after a cancer diagnosis (n = 195) were excluded from the pregnancy analysis. MAIN OUTCOME MEASURES Cumulative incidences of pregnancy and live birth (LB) were calculated. For women who became pregnant, the time to conception was calculated between the first fertility preservation consultation and the estimated day of conception. For those who did not conceive, we considered the time between the first fertility preservation consultation and the endpoint date, or the date of patient death. A Cox regression model was used to study the predictive factors for pregnancy and LB. RESULTS Among the 649 patients with available data on pregnancy attempts after BC diagnosis, 255 (39.3% [35.5-43.2]) tried to conceive (median follow-up of 6.5 years). Overall, 135 (52.9% [46.6-59.2]) of these patients achieved a pregnancy, mainly through unassisted conception (79.3% [72.8-84.8]), and 99 reported an LB (representing 38.8% of patients who attempted conception). In our cohort, 48 months after the first fertility preservation consultation, the cumulative incidence of pregnancy was 33.1% ([27.6-37.9]). After adjustment for age, parity, type of chemotherapy administration, and endocrine therapy, only multiparity at diagnosis and absence of chemotherapy were positive predictive factors of pregnancy after cancer. Of the 793 patients who had vitrified oocytes and embryos, 68 used them (27% [21.3-32.5] of the patients who tried to conceive), resulting in 8 LBs (11.8% [5.2-21.9]). Women who used their cryopreserved oocytes and embryos were older at the first consultation of fertility preservation (hazard ratio 1.71 [1.42-2.21]), and chose more often to vitrify embryos (hazard ratio 1.76 [1.28-2.23]). CONCLUSION Although pregnancy rates after fertility preservation for patients with BC are low, most conceptions are achieved without medical assistance. Our findings provide useful information to advise women on the different techniques of fertility preservation, their efficacy, and safety, as well as the relatively high chances of unassisted conception.
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Affiliation(s)
- Maëliss Peigné
- Department of Reproductive Medicine and Fertility Preservation, Jean Verdier Hospital, AP-HP-Université Sorbonne Paris Nord, Bondy, France.
| | - Pauline Mur
- Department of Reproductive Medicine and Fertility Preservation, Antoine Beclère Hospital, AP-HP-Université Paris-Saclay, Clamart, France
| | - Laëtitia Laup
- Department of Reproductive Medicine and Fertility Preservation, Jean Verdier Hospital, AP-HP-Université Sorbonne Paris Nord, Bondy, France
| | - Anne-Sophie Hamy
- Department of Medical Oncology, Institut Curie, Université Paris Cité, Paris, France
| | - Christophe Sifer
- Embryology Unit, Jean Verdier Hospital, AP-HP-Université Sorbonne Paris Nord, Bondy, France
| | - Anne Mayeur
- Histology-Embryology-Cytogenetic Laboratory, Antoine Beclère Hospital, AP-HP-Université Paris- Saclay, Clamart, France
| | - Florence Eustache
- Le Centre d'Études et de Conservation des Œufs et du Sperme (CECOS), Jean Verdier Hospital, AP-HP-Université Sorbonne Paris Nord, Bondy, France
| | - Solmaz Sarandi
- Embryology Unit, Jean Verdier Hospital, AP-HP-Université Sorbonne Paris Nord, Bondy, France
| | - Claire Vinolas
- Department of Reproductive Medicine and Fertility Preservation, Jean Verdier Hospital, AP-HP-Université Sorbonne Paris Nord, Bondy, France
| | - Sophia Rakrouki
- Department of Reproductive Medicine and Fertility Preservation, Jean Verdier Hospital, AP-HP-Université Sorbonne Paris Nord, Bondy, France
| | - Alexandra Benoit
- Department of Reproductive Medicine and Fertility Preservation, Antoine Beclère Hospital, AP-HP-Université Paris-Saclay, Clamart, France
| | - Michaël Grynberg
- Department of Reproductive Medicine and Fertility Preservation, Jean Verdier Hospital, AP-HP-Université Sorbonne Paris Nord, Bondy, France; Department of Reproductive Medicine and Fertility Preservation, Antoine Beclère Hospital, AP-HP-Université Paris-Saclay, Clamart, France
| | - Charlotte Sonigo
- Department of Reproductive Medicine and Fertility Preservation, Antoine Beclère Hospital, AP-HP-Université Paris-Saclay, Clamart, France; Physiologie et Physiopathologie Endocrinienne, Inserm, Université Paris-Saclay, Le Kremlin-Bicêtre, France
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Takae S, Harada M, Nakamura K, Furuyama S, Ono M, Osuga Y, Suzuki N. Survey on the implementation status and reproductive outcomes of oocyte and ovarian tissue cryopreservation in Japan: Historical comparison with nationwide surveys. J Obstet Gynaecol Res 2024; 50:709-718. [PMID: 38263596 DOI: 10.1111/jog.15893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/08/2024] [Indexed: 01/25/2024]
Abstract
PURPOSE To clarify the reproductive outcomes of fertility preservation (FP) treatment. METHODS We conducted a mailed-in questionnaire survey at institutions certified by the Japan Society of Obstetrics and Gynecology to investigate the number of oocyte cryopreservations (OC) and ovarian tissue cryopreservations (OTC) performed from December 2016 to the end of 2020. And, we conducted a detailed investigation of cases in which frozen specimens were used during the investigation period, and made historical comparisons with previous nationwide studies. RESULTS Responses were received from 114 out of 150 facilities (response rate: 76.0%) for OC and 43 out of 51 for OTC (response rate: 84.3%). Breast cancer was the most common disease among patients whose FP specimens were used. During the study period, 1237 OCs and 198 OTCs were performed. In addition, 57 cycles of embryo transfer (ET) using cryopreserved oocytes and 12 cases of ovarian tissue transplantation (OTT) were performed. The mean age of patients who underwent ET using cryopreserved oocytes was 34.8 (±5.8) years, with a median age of 36 years. The pregnancy rate per ET using cryopreserved oocytes was 26.3% and the live birth rate (LBR) was 17.5%. Further, the LBR per patient was 43.3%, and the pregnancy rate following OTTs was 33.3%. Also, controlled ovarian stimulation using the random start method or the combination of aromatase inhibitors had no effect on pregnancy outcome. CONCLUSION Implementation of both OCs and OTCs have markedly increased over time in Japan, with comparable reproductive outcomes as other reports.
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Affiliation(s)
- Seido Takae
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki City, Kanagawa, Japan
| | - Miyuki Harada
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kentaro Nakamura
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki City, Kanagawa, Japan
| | - Sayako Furuyama
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki City, Kanagawa, Japan
| | - Masanori Ono
- Department of Obstetrics and Gynecology, Tokyo Medical University, Tokyo, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki City, Kanagawa, Japan
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He R, He X, Su Y, Wang Y, Liang T, Cui Z, Zhang L. Effect of ABC Theory Model on Negative Emotion of Young Patients with Breast Cancer During Treatment. J Multidiscip Healthc 2023; 16:1883-1888. [PMID: 37425248 PMCID: PMC10329445 DOI: 10.2147/jmdh.s405564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/19/2023] [Indexed: 07/11/2023] Open
Abstract
Objective To evaluate the effect of emotional ABC theory on anxiety and depression in young patients with breast cancer. Methods A total of 200 eligible young patients with breast cancer were randomly divided into control group (N = 100) and experimental group (N = 100). The control group received routine treatment, while the experimental group received emotional ABC theory intervention at the same time. Results The Self Rating Anxiety Scale (SAS) and Self Rating Depression Scale (SDS) scores of the two groups were observed before and after nursing. There was no significant difference between the two groups before nursing (P > 0.05), but there was significant difference between the two groups after nursing, the control group was significantly higher than the experimental group (P < 0.05). The satisfaction degree of the control group was significantly lower than that of the experimental group (P < 0.05). Conclusion Young patients with breast cancer using emotional ABC theory can effectively improve negative emotions, clinical can promote the nursing program.
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Affiliation(s)
- Ruijing He
- Department of Neurosurgery, Affiliated Hospital of Hebei Engineering University, Handan, Hebei Province, 056002, People’s Republic of China
| | - Xiaojuan He
- Department of Neurosurgery, Affiliated Hospital of Hebei Engineering University, Handan, Hebei Province, 056002, People’s Republic of China
| | - Yongchao Su
- Department of Operating Room, The First Hospital of Handan, Handan, Hebei Province, 056002, People’s Republic of China
| | - Yongfeng Wang
- Department of Neurosurgery, Affiliated Hospital of Hebei Engineering University, Handan, Hebei Province, 056002, People’s Republic of China
| | - Tao Liang
- Department of Neurosurgery, Affiliated Hospital of Hebei Engineering University, Handan, Hebei Province, 056002, People’s Republic of China
| | - Zhiqiang Cui
- Department of Neurosurgery, Affiliated Hospital of Hebei Engineering University, Handan, Hebei Province, 056002, People’s Republic of China
| | - Linlin Zhang
- Department of Neurosurgery, Affiliated Hospital of Hebei Engineering University, Handan, Hebei Province, 056002, People’s Republic of China
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Pavone ME. Fertility preservation in breast cancer: more good news! Fertil Steril 2023; 119:474. [PMID: 36669555 DOI: 10.1016/j.fertnstert.2023.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 01/19/2023]
Affiliation(s)
- Mary Ellen Pavone
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Prentice Women's Hospital Northwestern University, Feinberg School of Medicine, Chicago, Illinois
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