乳腺癌和胚系BRCA致病变异对年轻女性生育力保存的影响。

Impact of Breast Cancer and Germline BRCA Pathogenic Variants on Fertility Preservation in Young Women.

作者信息

Prokurotaite Elze, Condorelli Margherita, Dechene Julie, Bouziotis Jason, Lambertini Matteo, Demeestere Isabelle

机构信息

Fertility Clinic, Department of Obstetrics and Gynecology, H.U.B-Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium.

Research Laboratory on Human Reproduction, Université Libre de Bruxelles, 1070 Brussels, Belgium.

出版信息

Life (Basel). 2023 Apr 1;13(4):930. doi: 10.3390/life13040930.

DOI:10.3390/life13040930

PMID:37109459

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10146760/

Abstract

BACKGROUND

Several studies have suggested that breast cancer (BC) and germline BRCA pathogenic variants (gBRCA PVs) could have a deleterious impact on ovarian reserve. Nevertheless, data are limited and mixed. Our objective was to evaluate the performance of fertility preservation (FP) in terms of the number of collected mature oocytes after ovarian stimulation (OS) in young women carrying a gBRCA PV, associated or not with BC.

METHODS

We conducted a retrospective monocentric study at HUB-Hôpital Erasme in Brussels. All women aged between 18 and 41 years diagnosed with invasive non-metastatic BC and/or gBRCA PV carriers who underwent OS for FP or preimplantation genetic testing for monogenic disorder (PGT-M) between November 2012 and October 2021 were included. Three groups were compared: BC patients without a gBRCA PV, BC patients with a gBRCA PV, and healthy gBRCA PV carriers. Ovarian reserve was evaluated based on the efficacy of OS and AMH levels.

RESULTS

A total of 85 patients underwent 100 cycles. The mean age (32.2 ± 3.9 years; = 0.61) and median AMH level (1.9 [0.2-13] μg/L; = 0.22) were similar between groups. Correlations between the number of mature oocytes and AMH level ( < 0.001) and between AMH and age ( < 0.001) were observed. No differences in the number of retrieved mature oocytes were observed between groups ( = 0.41), or for other OS parameters.

CONCLUSION

Neither BC nor a gBRCA PV significantly affects ovarian reserve and FP efficacy in terms of the number of mature oocytes retrieved.

摘要

背景

多项研究表明，乳腺癌（BC）和种系BRCA致病变异（gBRCA PVs）可能对卵巢储备产生有害影响。然而，数据有限且存在矛盾。我们的目的是评估携带gBRCA PV且伴有或不伴有BC的年轻女性在卵巢刺激（OS）后收集到的成熟卵母细胞数量方面的生育力保存（FP）效果。

方法

我们在布鲁塞尔的HUB-伊拉斯谟医院进行了一项回顾性单中心研究。纳入了2012年11月至2021年10月期间所有年龄在18至41岁之间、被诊断为浸润性非转移性BC和/或gBRCA PV携带者且因FP或单基因疾病植入前基因检测（PGT-M）而接受OS的女性。比较了三组：无gBRCA PV的BC患者、有gBRCA PV的BC患者和健康的gBRCA PV携带者。基于OS的效果和抗穆勒氏管激素（AMH）水平评估卵巢储备。

结果

共有85例患者进行了100个周期。各组之间的平均年龄（32.2±3.9岁；P = 0.61）和AMH水平中位数（1.9[0.2 - 13]μg/L；P = 0.22）相似。观察到成熟卵母细胞数量与AMH水平之间（P < 0.001）以及AMH与年龄之间（P < 0.001）存在相关性。各组之间在回收的成熟卵母细胞数量方面（P = 0.41）或其他OS参数方面均未观察到差异。