Drug May Help Preserve Fertility During Chemotherapy

Source: The New York Times – May 30, 2014

A drug used to treat prostate and breast cancer may also have the ability to preserve fertility in women who are undergoing chemotherapy for breast cancer, according to a recent presentation at the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.

The researchers conducted a clinical trial with 257 premenopausal women who were under 50 years old and receiving chemotherapy for breast cancer prior to or after tumor removal. The women were placed into two groups and treated with or without goserelin, a drug used to suppress reproductive hormones by producing a postmenopausal state.

At 2-year follow-up, 8% of women who took goserelin during their chemotherapy experienced premature ovarian failure compared with 22% of women in the group that did not take goserelin. In addition, 21% of women in the group who took goserelin became pregnant, and 15% in the group had children.

While the results in this study are promising and the study is the first of its kind to use pregnancy and live birth rate as outcomes, guidelines endorsed by ASCO state goserelin should not be relied on to preserve fertility.

Young patients have a high likelihood of survival after cancer treatment, and are more likely to still be in their childbearing years once in remission. The inability to have a family is a major source of anxiety for many of these patients. It is important for them to have a conversation about fertility preservation options prior to cancer treatment and to be offered the opportunity to make an informed decision.

While some patients may be able to conceive naturally after cancer treatment, this is not a guarantee. Different cancer treatments have varying effects on fertility—some are higher risk than others. Fertility preservation offers patients the opportunity to preserve their gametes before these potentially toxic treatments.

At RADfertility, we offer fertility preservation through cryopreserving (freezing) eggs, sperm or embryos prior to any chemotherapy or radiation. These freezing techniques offer the best chance for success. One can think of cryopreserved eggs or embryos as being frozen in time: the likelihood of pregnancy with them will always be the same as the day they were retrieved. And while the likelihood of pregnancy is always higher when patients preserve their fertility at a younger age, RADfertility will always discuss the likelihood of success using egg and embryo freezing with each individual. Many patients find the likelihood of pregnancy is higher with a frozen embryo or egg preserved prior to treatment, if their ovaries were affected by chemotherapy.

The technology behind cryopreserving eggs and embryos has changed in recent years, leading to significant advancements in vitrification, or flash freezing, techniques. Egg freezing is no longer considered experimental by the American Society for Reproductive Medicine (ASRM), and many offices now have years of experience. However, patients should ask about the length of time a particular lab has been performing egg freezing before choosing a center.

At RADfertility, our laboratory has experience with freezing embryos for over 17 years, and has been freezing eggs since 2008. For patients who cannot use their own eggs, we currently use a frozen donor egg bank—our pregnancy success rates with this bank are over 70%. While these eggs are from young women without infertility, our lab has extensive experience handling these frozen eggs and we have confidence in our ability to successfully freeze, warm and fertilize eggs.

Cancer patients today have many fertility preservation resources available to them, including a consultation with RADfertility prior to chemotherapy and egg, sperm or embryo freezing. Ferring Reproductive Health has a Heart Beat program that offers free fertility medications for patients with a cancer diagnosis prior to any treatment.

For more information and Oncofertility resources, visit our Fertility Preservation page.