Women who receive a breast cancer diagnosis can take time to freeze their eggs and embryos without fear of delaying their cancer treatment, according to researchers at University of California, San Francisco, or UCSF.
The researchers, who reported their findings in a paper published Saturday in Human Reproduction, have helped develop a faster fertility preservation technique that can achieve in two weeks what used to take a month or longer.
They examined how long it took for 89 breast cancer patients at the UCSF fertility clinic to start neoadjuvant chemotherapy, in which patients are given chemotherapy prior to surgery to shrink aggressive tumors, and found that it was the same whether or not women decided to freeze their eggs.
They looked at the medical records of breast cancer patients between the ages of 18 and 45 who had been referred to the UCSF Center for Reproductive Health between 2011 and 2017, before starting neoadjuvant chemotherapy, which will put them into menopause. Two-thirds of the women decided to harvest eggs, using the new, faster ovarian stimulation technique, before cancer treatment. The remainder decided against it, after receiving counseling from the fertility clinic.
Yet, both groups took nearly the same time to start chemotherapy: an average of 38 days for the women who froze their eggs and embryos, and 39 for those who did not.
Mitchell Rosen, an associate professor at UCSF and the senior author of the study, said he undertook the research because cancer doctors have become reticent in recent years to refer their patients for fertility preservation out of fear that it would delay the more aggressive timeline of neoadjuvant chemotherapy.
However, fertility experts can now harvest eggs in as little as two weeks, using random-start ovarian stimulation, which does not wait for a woman's natural menstrual cycle to stimulate ovaries to release eggs. Before this technique was developed, doctors timed the procedure with a woman's natural cycle, which meant that it took them four to six weeks to harvest eggs.
"Women with breast cancer should feel confident about undergoing fertility preservation before starting chemotherapy," Rosen was quoted as saying in a news release. "The data clearly show that it will not delay their treatment, even in the neoadjuvant setting."
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