Fertility preservation in BRCA mutation carriers

被引:0
|
作者
Revelli, Alberto [1 ]
Salvagno, Francesca [1 ]
Delle Piane, Luisa [1 ]
Casano, Simona [1 ]
Evangelista, Francesca [1 ]
Pittatore, Giulia [1 ]
Razzano, Alessandra [1 ]
Marchino, Gian L. [1 ]
Gennarelli, Gianluca [1 ]
Benedetto, Chiara [1 ]
机构
[1] Univ Turin, Dept Surg Sci, Unit Gynecol & Obstet 1, Via Ventimiglia 3, I-10126 Turin, Italy
来源
MINERVA GINECOLOGICA | 2016年 / 68卷 / 05期
关键词
Fertility preservation; Genital neoplasms; Breast Neoplasms; oocytes;
D O I
暂无
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
According to enhanced long-term survival rates of these patients, interest in fertility preservation for young women facing gonadotoxic therapies is increasing. Women who carry a mutation in the BRCA1 or BRCA2 gene have a specifically increased lifetime risk of developing breast and tubo-ovarian cancer. Moreover, they are at high risk of undergoing premature infertility due to the medical interventions that are often performed in order to reduce cancer risk or treat an already existing malignancy. Fertility issues are relevant for healthy BRCA mutation carriers, whose family-planning decisions are often influenced by the need of prophylactic bilateral salpingo-oophorectomy at young age. In BRCA mutation carriers who have a breast cancer at young age, the oncostatic treatment is associated with a significant ovarian toxicity linked to chemotherapy as well as to the long lasting hormonotherapy and to the need of delaying pregnancy for several years. Prompt counselling about different fertility preservation options should be offered to all young girls and women at high risk of ovarian insufficiency and infertility. Validated techniques to preserve fertility include oocyte and embryo cryopreservation, while experimental techniques include ovarian suppression with GnRH-analogs during chemotherapy and ovarian tissue cryopreservation. The choice of the best strategy depends on age, type of chemotherapy, partner status, cancer type, time available for fertility preservation intervention and the risk of ovarian metastasis. all available options should be offered and can be performed alone or in combination. A crucial point is to avoid a significant delay to cancer treatment.
引用
收藏
页码:587 / 601
页数:15
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