Abdo Nadia, Thom Bridgette, Chang Cassandra, Feldman Maya, Benedict Catherine, Semler Rosemary, Kelvin Joanne, Gemignani Mary, Goldfarb Shari
UCSF - East Bay, Oakland, CA, USA.
UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA.
J Cancer Surviv. 2025 Apr 23. doi: 10.1007/s11764-025-01809-1.
Approximately 19% of breast cancer cases in 2020 were diagnosed in women under age 50. These premenopausal women with early-stage breast cancer face unique challenges related to family building. This study examines the decision-making and outcomes of patients who pursue fertility preservation before treatment and family building afterwards.
Breast cancer survivors seen by a fertility nurse specialist before initiating cancer treatment at Memorial Sloan Kettering Cancer Center (MSKCC) between 2009 and 2017 were contacted to participate. Participants completed a web-based cross-sectional survey examining decisions made about fertility preservation, factors influencing them, and post-treatment reflections and outcomes.
Prior to treatment, 168 women met with a reproductive endocrinologist and 116 underwent fertility preservation. After completing cancer treatment, 36 women had children and 15 of these women used eggs/embryos frozen prior to treatment. The majority of women deemed these factors "very important" when deciding whether to freeze eggs/embryos: a desire to have a biologic child, the ability to feel hopeful about their future, the chance of success, feeling overwhelmed by their diagnosis, and concerns about having regret if they didn't freeze their eggs/embryo.
Over half of patients who attempted family building after treatment were able to have children. Many of these women used eggs/embryos frozen before treatment either by getting pregnant themselves or via surrogacy.
This data stresses the importance of referring cancer patients early to a reproductive endocrinologist before initiation of systemic therapy and has high translational promise in the clinical care of all young female cancer survivors interested in fertility preservation.
2020年约19%的乳腺癌病例是在50岁以下的女性中确诊的。这些患有早期乳腺癌的绝经前女性在生育方面面临着独特的挑战。本研究探讨了在治疗前进行生育力保存并在之后生育的患者的决策过程及结果。
联系了2009年至2017年期间在纪念斯隆凯特琳癌症中心（MSKCC）开始癌症治疗前由生育护士专家诊治的乳腺癌幸存者参与研究。参与者完成了一项基于网络的横断面调查，调查内容包括关于生育力保存的决策、影响这些决策的因素以及治疗后的反思和结果。
治疗前，168名女性咨询了生殖内分泌专家，116名接受了生育力保存。完成癌症治疗后，36名女性生育了孩子，其中15名女性使用了治疗前冷冻的卵子/胚胎。在决定是否冷冻卵子/胚胎时，大多数女性认为以下因素“非常重要”：想要亲生子女的愿望、对未来充满希望的能力、成功的机会、被诊断结果压得喘不过气来，以及担心如果不冷冻卵子/胚胎会后悔。
超过一半的治疗后尝试生育的患者能够生育。这些女性中的许多人通过自己怀孕或代孕使用了治疗前冷冻的卵子/胚胎。
这些数据强调了在开始全身治疗前尽早将癌症患者转介给生殖内分泌专家的重要性，并且在对所有有生育力保存意愿的年轻女性癌症幸存者的临床护理中具有很高的转化前景。
