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Five Best Practices in Fertility Preservation for a Young Breast Cancer Patient

A blog by Kara Nguyen, MD, MPH, RMA of Central Pennsylvania at PinnacleHealth, member of Fertile Hope & The Alliance for Fertility Preservation, January 6, 2016

Breast cancer affects 1 in 8 US women and about 20% of cases are in women less than age 50, according to the American Cancer Society. Better screening programs and early detection has helped improve the prognosis. Intensive research, better surgical treatment, and effective chemotherapy have allowed these patients to have better quality of life as well as life expectancy. Unfortunately the treatment can also greatly limit the patient’s reproductive ability due to toxic effects to the ovaries. The best state-of-the-art fertility centers follow these 5 practices to preserve a woman’s future fertility:

  1. Initial consultation within 24 hours. Making patients with cancer is a priority which means the initial discussion regarding treatment options occurs within 24 hours including weekends and holidays. They understand the diagnosis can come at any time. In addition, partnering with other medical providers who make that initial diagnosis such as breast surgeons, gynecologists, and radiologists ensures the referral is prompt. The best fertility centers will be the ones major health systems trust to deliver the most collaborative care.
  2. Ready to start treatment same day. Many studies have concluded that starting ovarian stimulation to freeze eggs or fertilize to create embryos can be done effectively at any point in the menstrual cycle for cancer patients. The fertility center will be ready to get the medications at reduced costs or free through special pharmaceutical programs. Many centers will have compassionate care pricing to cover all testing and procedures involved if the insurance does not cover fertility treatment.
  3. Entire treatment cycle can be complete within 2 weeks. Treatment for cancer is paramount which is why your fertility specialist will coordinate the visits with the oncologists so that it is uninterrupted while doing fertility treatment. Port placement and full staging procedures can be done concurrently. In most situations, chemotherapy can be planned to start immediately after egg retrieval which occurs within 2 weeks of starting fertility medications.
  4. Excellent pregnancy rates. A fertility center with excellent embryo and egg freezing techniques can quote a 95% survival rate with the thaw process and the same pregnancy rates as others doing fresh embryo transfers in each age category.
  5. Fertility treatment that is safe. Several published large population studies have reported on the safety of fertility treatment in breast cancer patients with no increase in recurrence or severity of breast cancer. Avoiding overstimulation and keeping estrogen levels low during treatment should be standard practice.

Preserving fertility for a cancer patient is like preserving the future. When the cancer treatment is complete and the disease is stable, these patients can return to fulfilling their goals of parenthood and creating a legacy that will be remembered for generations.

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