About 20% are still of reproductive age and the majority of them have not yet completed their family planning. Ovarian failure caused by chemotherapy adversely affects fertility. Fortunately, today there are specialized treatments that allow young women with breast cancer to maintain their fertility in the future.
Freezing of eggs and embryos
Egg freezing by the vitrification method promises even higher survival rates of up to 90% per egg collection. Both egg quality and births are not associated with increased rates of abnormalities. In case the patient is married or in a relationship at the time of diagnosis, there is the possibility of freezing fetuses, with a chance of success that reaches or exceeds 50%, especially if the patient is less than 35 years old at the time of ovulation.
Preparing to take eggs
Taking hormones while taking aromatase inhibitors ensures low estrogen levels during arousal, especially in breast cancer with positive hormone receptors. This technique is considered the safest. Hormonal stimulation lasts 10-12 days and may even begin
and in the luteal phase, applying the so-called random start protocol. The short period of stimulation does not allow any acceleration of tumor growth, while women who became pregnant after breast cancer do not have an increased risk of recurrence, which is described as a healthy mother effect.
When is pregnancy planned?
The passage of two years after the completion of chemotherapy and radiation is considered an acceptable period of time in the case of breast tumors with negative hormone receptors, if agreed by the treating physicians. If the tumor is hormone dependent and hormone therapy lasts at least
five to ten years, discontinue hormone therapy after two years if there is no recurrence, achieve pregnancy within the next two years and continue hormone therapy after childbirth for as long as necessary.
Egg donation
The solution of egg donation is chosen in case the production of eggs after the completion of the treatment is not possible. The selection of the donor is made with very strict criteria based on the legal framework. The donor’s eggs are fertilized by the recipient’s sperm and the resulting embryos are placed in the recipient’s uterus, which has already received medication to support the implant. The course of pregnancy is the same as that which results from normal conception or after conventional in vitro fertilization.
Surrogacy
If pregnancy in a woman with breast cancer is contraindicated, another woman (surrogate mother) is used, in whose womb the embryo resulting from the in vitro fertilization of the biological mother’s eggs or even borrowed eggs with sperm is transferred. of her partner. After the approval of the procedure by the court, the gynecologist has the right to proceed with the embryo transfer. By law, the surrogate mother is between 25 and 45 years old, and she must have had at least one child and have no more than two caesareans in her history.
Epilogue
The continuous development in the field of Oncology, the increase of the life expectancy of women with cancer and the postponement of family planning to older age necessitate the taking of fertility maintenance measures for this category of patients. Pregnancy in women with a history of breast cancer is possible as long as the patient’s health and prognosis allow. In vitro fertilization by freezing eggs or embryos before chemotherapy is safe, while egg donation and surrogacy are a solution when egg production or pregnancy is not possible or contraindicated. These methods should be applied only in centers that cooperate with oncology clinics and have the appropriate know-how such as the new Assisted Reproduction Unit HYGEIA IVF EMBRYOGENESIS.
Writes:
Ioannis Zervomanolakis Obstetrician – Gynecologist
Assisted Reproduction Specialist
HEALTH Unit IVF EMBRYOGENESIS
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