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Encouraging Results
Over a 5-year follow-up, 19.4% (95% CI, 15.2%-24.6%) of the women who had undergone fertility preservation had at least 1 live birth after breast cancer treatment. In the control group, only 8.6% (95% CI, 6.4%-11.4%) of the women had at least 1 live birth within the same time period. Over a 10-year follow-up the results were equally promising, with 40.7% (95% CI, 33.0%-49.5%) of women who had undergone fertility preservation having at least 1 live birth, whereas 15.8% (95% CI, 33.0%-49.5%) of those in the control group had at least one live birth. Twenty percent of the women in the study group and 4% of those in the control group used ART to achieve their first live birth after breast cancer treatment.
This study was limited by a lack of data on whether the women had wanted or intended to have children at the time of breast cancer diagnosis, which should have been ascertained at that time. This would influence their choosing to pursue fertility preservation prior to initiating cancer treatment. Another limitation was the researchers did not have access to data on natural conception that did not result in live births.
In addition, 27 women in the study group and 110 in the control group died; making the all-cause mortality rate lower in the group that underwent fertility preservation. The authors theorize that this could be because the group that declined fertility preservation did so because they felt sicker or because they were undergoing more medical procedures.
The Swedish group concluded that although achieving a successful pregnancy after breast cancer treatment was possible regardless of fertility preservation, pregnancy and live birth after breast cancer treatment are significantly more successful if ART is used.
Disclosures: One author disclosed affiliation with or receipt of funding from the pharmaceutical industry. Please see the original article for a full list of disclosures.
Reference
Marklund A, Lundberg FE, Eloranta S, Hedayati E, Pettersson K, Rodriguez-Wallberg KA. Reproductive outcomes after breast cancer in women with vs without fertility preservation. JAMA Oncol. Published online November 19, 2020. doi:10.1001/jamaoncol.2020.5957
