Changing the Perspective on Fertility Preservation for Women with Metastatic or Advanced Stage Cancer

Mary Kathryn Abel; Ange Wang; Joseph M Letourneau; Michelle E Melisko; Marcelle I Cedars; Mitchell P Rosen

doi:10.1007/s11912-024-01530-9

Changing the Perspective on Fertility Preservation for Women with Metastatic or Advanced Stage Cancer

Curr Oncol Rep. 2024 Apr 19. doi: 10.1007/s11912-024-01530-9. Online ahead of print.

Authors

Mary Kathryn Abel^{1

2

3}, Ange Wang⁴, Joseph M Letourneau^{4

5}, Michelle E Melisko⁶, Marcelle I Cedars⁴, Mitchell P Rosen⁴

Affiliations

¹ San Francisco School of Medicine, University of California San Francisco, San Francisco, CA, USA. mabel@bwh.harvard.edu.
² Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA. mabel@bwh.harvard.edu.
³ Deparment of Obstetrics and Gynecology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, 75 Francis Street, 3rd Floor, Boston, MA, 02115, USA. mabel@bwh.harvard.edu.
⁴ Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
⁵ Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, USA.
⁶ Division of Hematology and Oncology, University of California San Francisco, San Francisco, CA, USA.

PMID: 38639793
DOI: 10.1007/s11912-024-01530-9

Abstract

Purpose of review: In this Perspective we share the personal story of a 33-year-old patient diagnosed with metastatic breast cancer and her journey through fertility preservation, surrogacy, and eventually motherhood, highlighting misconceptions about fertility preservation in this population.

Recent findings: There are nearly 1 million women under the age of 50 diagnosed and living with cancer in the USA. These patients are met with life-altering decisions, including those that may limit their reproductive ability. While there have been tremendous advances and advocacy in the field of oncofertility, there has been limited focus on patients with advanced stage or metastatic cancer. We describe five key misconceptions surrounding fertility preservation in patients with advanced stage cancer, offering a review of the literature and our approach to challenging topics like desiring fertility preservation in the face of Stage 4 disease, the safety and timing of ovarian stimulation during cancer treatment, and passing away following fertility preservation. We review the importance of assessing perceptions of fertility preservation in patients with metastatic cancer and highlight the lack of research in this area as a call to action.

Keywords: Cancer; Fertility preservation; Metastasis.

Publication types

Review