Hamy Anne-Sophie, Chabassier Agathe, Sebbag Clara, Rousset-Jablonski Christine, Berkach Clémentine, Ray-Coquard Isabelle, Sablone Laura, Darrigues Lauren, Dumas Elise, Bobrie Angélique, Jacot William, Espié Marc, Giacchetti Sylvie, Jochum Floriane, Toussaint Aullène, Plu-Bureau Geneviève, Maitrot-Mantelet Lorraine, Gompel Anne, Gougis Paul, Bas Raphaëlle, Decanter Christine, Asselain Bernard, Coutant Charles, Sohn Lili, Jacob Guillemette, Saule Claire, Frank Sophie, Abécassis Judith, Coussy Florence, Reyal Fabien
Department of Medical Oncology, Institut Curie, Paris, France.
Université Paris Cité, Paris, France.
EClinicalMedicine. 2025 Jul 30;86:103392. doi: 10.1016/j.eclinm.2025.103392. eCollection 2025 Aug.
Data on fertility after breast cancer (BC) relative to the general population are lacking. This study aimed to compare the time-to-pregnancy between women with and without prior BC seeking to become pregnant.
We conducted a prospective exposed-unexposed cohort study between March 13, 2018 and June 27, 2019, recruiting participants via the collaborative network Seintinelles. Women aged 18-43 years with a history of localized BC without relapse (exposed) were compared to women without BC (unexposed). Follow-up data were collected every six months over three years. The primary endpoint, time-to-pregnancy, was analyzed using Kaplan-Meier survival analysis with inverse probability weighting. Censoring was performed if women stopped trying to conceive for personal reasons, were lost to follow-up before conception, or completed the study without achieving pregnancy or using assisted reproductive technologies (ART).
Among 4351 women enrolled, 642 sought pregnancy during the study period (76 exposed, 566 unexposed). Among them, 50 exposed (65.8%) and 402 weighted unexposed women (weighted percentage 71.0%) became pregnant at least once. Median time-to-pregnancy was 5.0 months, 95% CI [3.0-7.0] for exposed and 3.0 months, 95% CI [2.0-5.0] for unexposed women (difference in median time-to-pregnancy: 2.0 months, 95% CI [-2.5; 5]). Two years after starting to seek pregnancy, 74.9% of weighted unexposed women and 74.1% of exposed women obtained a pregnancy. Overall, 15 exposed women (19.8%) used either ART methods ( = 7, 9.2%) or cryopreserved material ( = 8, 10.5%) and 25 unexposed women (4.4%) used ART.The median time-to-pregnancy was 3.0 months for both exposed and unexposed women (95% CI [2.0; 5.0] and [2.0; 4.0] respectively) (difference in median time-to-pregnancy: -0.0 months [-2.0; 3.0]) in women who sought pregnancy spontaneously, and 14.0 months for exposed (95% CI [6.0-27.0]) and 17.6 months for unexposed women (95% CI [17.6-30.0]) in women seeking pregnancy with ART.
In this study from a French collaborative research network, we found no strong evidence of a largely reduced time-to-pregnancy in exposed women seeking to become pregnant compared with unexposed women. Further research on fertility outcomes in the broader population of BC survivors is warranted.
The FEERIC study was funded by (InCA), InCA-SHS, grant no. 2016-124, and is part of the Young Breast Cancer Project, funded by Monoprix.
缺乏乳腺癌（BC）患者相对于普通人群的生育数据。本研究旨在比较有和没有既往乳腺癌病史且试图怀孕的女性的受孕时间。
我们在2018年3月13日至2019年6月27日期间进行了一项前瞻性暴露-未暴露队列研究，通过协作网络Seintinelles招募参与者。将年龄在18-43岁且有局限性乳腺癌病史且无复发的女性（暴露组）与无乳腺癌的女性（未暴露组）进行比较。在三年时间里每六个月收集一次随访数据。主要终点即受孕时间，采用逆概率加权的Kaplan-Meier生存分析进行分析。如果女性因个人原因停止尝试受孕、在受孕前失访或在未怀孕或未使用辅助生殖技术（ART）的情况下完成研究，则进行删失处理。
在纳入的4351名女性中，642名在研究期间寻求怀孕（76名暴露组，566名未暴露组）。其中，50名暴露组女性（65.8%）和402名加权未暴露组女性（加权百分比71.0%）至少怀孕一次。暴露组女性的受孕中位时间为5.0个月，95%置信区间[3.0-7.0]；未暴露组女性为3.0个月，95%置信区间[2.0-5.0]（受孕中位时间差异：2.0个月，95%置信区间[-2.5；5]）。开始寻求怀孕两年后，74.9%的加权未暴露组女性和74.1%的暴露组女性成功受孕。总体而言，15名暴露组女性（19.8%）使用了ART方法（n=7，9.2%）或冷冻保存材料（n=8，10.5%），25名未暴露组女性（4.4%）使用了ART。自发寻求怀孕的女性中，暴露组和未暴露组女性的受孕中位时间均为3.0个月（分别为95%置信区间[2.0；5.0]和[2.0；4.0]）（受孕中位时间差异：-0.0个月[-2.0；3.0]）；使用ART寻求怀孕的女性中，暴露组女性的受孕中位时间为14.0个月（95%置信区间[6.0-27.0]），未暴露组女性为17.6个月（95%置信区间[17.6-30.0]）。
在这项来自法国协作研究网络的研究中，我们没有发现有力证据表明，与未暴露组女性相比，寻求怀孕的暴露组女性的受孕时间大幅缩短。有必要对更广泛的乳腺癌幸存者人群的生育结局进行进一步研究。
FEERIC研究由法国国家癌症研究所（InCA）、InCA-SHS资助，资助编号2016-124，是由Monoprix资助的青年乳腺癌项目的一部分。
