University of California, San Francisco School of Medicine, San Francisco, CA, USA.
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, 499 Illinois Street, 6th Floor, San Francisco, CA, 94158, USA.
J Assist Reprod Genet. 2021 Jul;38(7):1755-1765. doi: 10.1007/s10815-021-02133-0. Epub 2021 Mar 19.
As the paradigm shifts towards improving cancer survivorship, an important concern for reproductive-aged women diagnosed with cancer is how their disease and its treatment will affect their future fertility. We sought to characterize pregnancy attempts and outcomes in breast cancer patients following chemotherapy.
We conducted a prospective cohort study of women diagnosed with breast cancer seen between 2010 and 2019. A questionnaire was administered following cancer treatment with questions regarding oncologic and reproductive history and attempts and method of conception.
Of 181 participants, 46 (25.4%) attempted to conceive following chemotherapy. Thirty-five patients (76.1%) had return of ovarian function. Of those, 34 patients (mean age 32.8 years) first attempted to conceive by intercourse, and 22 (64.7%) became pregnant, resulting in 17 live births. Of the remaining 12 who did not successfully conceive through intercourse, eight went on to try other methods, resulting in five additional pregnancies and one live birth. Twelve patients (mean age 34.6 years) proceeded directly to ART; of those, eight (66.7%) became pregnant, resulting in six live births.
In breast cancer patients with return of ovarian function after chemotherapy, half were able to conceive by intercourse alone. In order to maximize reproductive potential in patients who have return of ovarian function, providers should offer natural conception as a reasonable option prior to the use of cryopreserved tissue. For those who did not attempt to conceive on their own, the use of pre-treatment cryopreserved eggs or embryos had a high likelihood of success.
随着癌症生存模式的转变，提高癌症患者的生存质量成为一个重要问题，对于诊断患有癌症的育龄期女性而言，她们尤为关注疾病及其治疗对未来生育能力的影响。本研究旨在探讨化疗后乳腺癌患者的妊娠尝试和结局。
我们进行了一项前瞻性队列研究，纳入了 2010 年至 2019 年间诊断为乳腺癌的女性患者。在癌症治疗后，我们通过问卷调查的方式了解患者的肿瘤学和生殖史，以及妊娠尝试和受孕方法。
在 181 名参与者中，46 名（25.4%）在化疗后尝试妊娠。35 名患者（76.1%）卵巢功能恢复。其中，34 名患者（平均年龄 32.8 岁）首先通过性交尝试妊娠，22 名（64.7%）成功妊娠，最终有 17 名活产儿。其余 12 名未通过性交成功妊娠的患者中，8 名尝试了其他方法，其中 5 名成功妊娠，1 名活产。12 名患者（平均年龄 34.6 岁）直接进行了辅助生殖技术（ART）；其中 8 名（66.7%）成功妊娠，最终有 6 名活产儿。
在化疗后卵巢功能恢复的乳腺癌患者中，有一半可以通过性交自然妊娠。为了最大限度地提高有卵巢功能恢复的患者的生育潜能，医生应在使用冷冻组织之前，为患者提供自然妊娠这一合理的选择。对于那些未能自行尝试妊娠的患者，使用预处理的冷冻卵子或胚胎受孕的成功率较高。
