Malacarne Elisa, Devesa Marta, Martinez Francisca, Rodriguez Ignacio, Coroleu Buenaventura
Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, University of Pisa, Via Roma, 67, 56126, Pisa, Italy.
Human Reproduction Service, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Dexeus, Barcelona, Spain.
J Assist Reprod Genet. 2020 Dec;37(12):3069-3076. doi: 10.1007/s10815-020-01944-x. Epub 2020 Sep 18.
Breast cancer is the most common cancer diagnosed during childbearing age, and fertility preservation is becoming increasingly more essential. However, recent studies indicate a possible poorer response to controlled ovarian hyperstimulation (COH) in cancer patients than in non-cancer controls and a negative impact of BRCA mutations on female fertility. This study aims to evaluate ovarian response and the number of mature oocytes (MII) vitrified in women with breast cancer, with or without BRCA mutation, comparing them to the expected response according to an age-related nomogram.
This is a retrospective observational study involving sixty-one breast cancer patients who underwent COH for oocyte cryopreservation. The age-specific nomogram was built using 3871 patients who underwent COH due to oocyte donation, fertility preservation for non-medical reasons, or FIVET for male factor exclusively.
The mean number of oocytes retrieved was 13.03, whereas the mean number of MII oocytes was 10.00. After the application of the z-score, no statistically significant differences were found compared with the expected response in the general population, neither by dividing patients according to the presence or absence of BRCA mutation nor according to the phase in which they initiated stimulation.
The results obtained do not support the notion of a negative impact of the BRCA mutation on the ovarian response of women with breast cancer. Women with breast cancer undergoing COH for fertility preservation can expect the ovarian response predicted for their age.
乳腺癌是育龄期诊断出的最常见癌症，生育力保存变得越来越重要。然而，最近的研究表明，癌症患者对比非癌症对照，对控制性卵巢刺激（COH）的反应可能更差，并且BRCA突变对女性生育力有负面影响。本研究旨在评估有或无BRCA突变的乳腺癌女性的卵巢反应以及玻璃化冷冻的成熟卵母细胞（MII）数量，并将其与根据年龄相关列线图预测的预期反应进行比较。
这是一项回顾性观察研究，纳入了61例因卵母细胞冷冻而接受COH的乳腺癌患者。使用3871例因卵母细胞捐赠、非医学原因的生育力保存或仅因男性因素接受卵泡浆内单精子注射（FIVET）而接受COH的患者构建特定年龄列线图。
回收的卵母细胞平均数量为13.03，而MII期卵母细胞平均数量为10.00。应用z分数后，无论是根据是否存在BRCA突变还是根据开始刺激的阶段对患者进行划分，与一般人群的预期反应相比均未发现统计学上的显著差异。
获得的结果不支持BRCA突变对乳腺癌女性卵巢反应有负面影响这一观点。因生育力保存而接受COH的乳腺癌女性可以预期其年龄所预测的卵巢反应。
