Premature ovarian failure and subsequent infertility are possible long-term side effects of chemotherapy (CT) in young EBC pts. Limited data are available on the number of pts who consider FP strategies and on the reasons for refusal of these procedures. To address the significant challenges related to fertility issues, the PREFER study was developed as a national comprehensive program aiming to optimize care and improve knowledge around this topic.
This is a prospective cohort study ongoing across several Italian centers affiliated to the GIM (Gruppo Italiano Mammella) study group. Oncologists offer the available FP strategies to young EBC pts undergoing (neo)adjuvant CT: oocyte cryopreservation (OC), ovarian tissue cryopreservation (OTC) and LHRH analogue (LHRHa) during CT. Eligible pts are premenopausal, ≤ 45 years, no previously exposed to CT and/or radiotherapy. Primary objective is to obtain data about preferences and choices of young EBC pts on the FP strategies. Secondary objectives are to evaluate the success and safety of FP strategies, hormonal changes during CT and survival outcomes. The present analysis reports preliminary results of the study including pts enrolled at the coordinating center from November 2012 to May 2017.
A total of 131 EBC pts were enrolled; median age was 38.9 years (24.8-45.34). Nine pts (6.87%) refused all FP options. Reasons for refusal were no interest in fertility preservation (5 pts), previous pregnancy (3 pts), no interest in having children (1 pts). LHRHa was accepted by 120 pts (91.6%) and 27 pts (20.6%) accepted gynecologic counseling. Among these pts, 10 (7.6%) accepted OC or OTC. Main reason for refusal of cryopreservation procedures was fear of delaying cancer treatment (3 pts). No complications were observed among women who underwent OC or OTC. Median number of mature oocytes yielded and cryopreserved was 8.5 (4-13). A patient had a spontaneous pregnancy following adjuvant treatment.
Despite the great importance of fertility issues in young EBC pts, a minority of them (7.6%) require to access cryopreservation procedures. This is crucial information from a public health perspective and for resource allocation.
Clinical trial identification
Legal entity responsible for the study
IRCCS AOU San Martino IST, Genoa Italy
AIRC - Associazione Italiana per la Ricerca sul Cancro (IG 2013 No14272).
All authors have declared no conflicts of interest.