Pregnancy, fertility concerns and fertility preservation procedures in a national study of French breast cancer survivors

Manon Mangiardi-Veltin; Clara Sebbag; Christine Rousset-Jablonski; Isabelle Ray-Coquard; Clémentine Berkach; Lucie Laot; Yuting Wang; Inès Abdennebi; Julie Labrosse; Camille Sautter; Aullène Toussaint; Laura Sablone; Enora Laas; Sarah Khallouch; Florence Coussy; Pietro Santulli; Charles Chapron; Angelique Bobrie; William Jacot; Nadir Sella; Elise Dumas; Claire Sénéchal-Davin; Marc Espie; Sylvie Giacchetti; Lorraine Maitrot; Geneviève Plu-Bureau; Charles Coutant; Julien Guerin; Bernard Asselain; Pierre Fumoleau; Manuel Rodrigues; Christine Decanter; Audrey Mailliez; Lidia Delrieu; Amélie Lemoine; Christelle Jouannaud; Doriane Houdre; Fabien Reyal; Anne-Sophie Hamy; Seintinelles Research Network

doi:10.1016/j.rbmo.2021.12.019

Pregnancy, fertility concerns and fertility preservation procedures in a national study of French breast cancer survivors

Reprod Biomed Online. 2022 Jun;44(6):1031-1044. doi: 10.1016/j.rbmo.2021.12.019. Epub 2022 Jan 19.

Authors

Manon Mangiardi-Veltin¹, Clara Sebbag², Christine Rousset-Jablonski³, Isabelle Ray-Coquard³, Clémentine Berkach², Lucie Laot², Yuting Wang¹, Inès Abdennebi², Julie Labrosse², Camille Sautter², Aullène Toussaint², Laura Sablone², Enora Laas², Sarah Khallouch², Florence Coussy¹, Pietro Santulli⁴, Charles Chapron⁴, Angelique Bobrie⁵, William Jacot⁵, Nadir Sella⁶, Elise Dumas⁶, Claire Sénéchal-Davin⁷, Marc Espie⁸, Sylvie Giacchetti⁸, Lorraine Maitrot⁴, Geneviève Plu-Bureau⁴, Charles Coutant⁹, Julien Guerin¹⁰, Bernard Asselain¹¹, Pierre Fumoleau¹, Manuel Rodrigues¹, Christine Decanter¹², Audrey Mailliez¹³, Lidia Delrieu⁶, Amélie Lemoine¹⁴, Christelle Jouannaud¹⁴, Doriane Houdre⁶, Fabien Reyal¹⁵, Anne-Sophie Hamy¹⁶; Seintinelles Research Network¹⁷

Affiliations

¹ Department of Medical Oncology, Institut Curie, Paris, France, University Paris, Paris, France.
² Department of Surgical Oncology, Institut Curie, Paris, France, University Paris, Paris, France.
³ Centre Léon Bérard, Lyon, France, RESearch on HealthcAre PErformance (RESHAPE), University Claude Bernard Lyon 1, Lyon, France.
⁴ Department of Obstetrics and Gynecology, Hôpital Cochin, Paris, France, University Paris, Paris, France.
⁵ Department of Medical Oncology, Institut du Cancer de Montpellier, Montpellier, France.
⁶ Residual Tumor and Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, University Paris, Paris, France.
⁷ Department of Oncogenetics, Institut Bergonié, Bordeaux, France.
⁸ Sénopole, Hôpital Saint-Louis, AP-HP, Paris, France, University Paris, Paris, France.
⁹ Department of Surgical Oncology, Centre Georges-François Leclerc (Unicancer), Dijon, France.
¹⁰ Data Factory, Data Office, Institut Curie, 25 Rue d'Ulm, Paris 75005, France.
¹¹ Department of Biostatistics, Institut Curie, Paris, France.
¹² ART Department, Centre Hospitalier Régional Lille, Lille, France.
¹³ Department of Medical Oncology, Centre Oscar Lambert, Lille, France.
¹⁴ Department of Medical Oncology, Institut Jean Godinot, Reims, France.
¹⁵ Department of Surgical Oncology, Institut Curie, Paris, France, University Paris, Paris, France; Residual Tumor and Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, University Paris, Paris, France; Clinical Research Department, Centre Georges-François Leclerc (Unicancer), Dijon, France. Electronic address: fabien.reyal@curie.fr.
¹⁶ Department of Medical Oncology, Institut Curie, Paris, France, University Paris, Paris, France; Department of Surgical Oncology, Institut Curie, Paris, France, University Paris, Paris, France; Residual Tumor and Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, University Paris, Paris, France.
¹⁷ Seintinelles Research Network, 40 Rue Rémy Dumoncel, Paris 75014, France.

PMID: 35525718
DOI: 10.1016/j.rbmo.2021.12.019

Abstract

Research question: What are the real-life oncofertility practices in young women diagnosed with breast cancer?

Design: The FEERIC (FErtility, prEgnancy, contRaceptIon after breast Cancer in France) study is a web-based cohort study launched with the French collaborative research platform Seintinelles. The current work is based on the enrolment self-administered questionnaire of 517 patients with prior breast cancer diagnosis, free from relapse and aged 18 to 43 years at inclusion (from 12 March 2018 to 27 June 2019).

Results: Median age at breast cancer diagnosis was 33.6 years and 424 patients (82.0%) received chemotherapy. Overall, 236 (45.6%) patients were offered specialized oncofertility counselling, 181 patients underwent at least one fertility preservation procedure (FPP); 125 (24.2%) underwent one or more FPP with material preservation (oocytes n = 108, 20.9%; embryos n = 31, 6.0%; ovarian cryopreservation n = 6, 1.2%) and 78 patients received gonadotrophin-releasing hormone agonists (15.1%). With a median follow-up of 26.9 months after the end of treatments, 133 pregnancies had occurred in 85 patients (16.4%), including 20 unplanned pregnancies (15.0%). Most of the pregnancies were natural conceptions (n = 113, 87.6%), while 16 (12.4%) required medical interventions. For the planned pregnancies, median time to the occurrence of an ongoing pregnancy was 3 months. Patients who had an unplanned pregnancy reported lower rates of information on the consequences of the treatments on fertility (P = 0.036) at diagnosis.

Conclusions: Most of the patients were not offered proper specialized oncofertility counselling at the time of breast cancer diagnosis. Naturally conceived pregnancies after breast cancer were much more frequent than pregnancies resulting from the use of cryopreserved gametes. Adequate contraceptive counselling seems as important as information about fertility and might prevent unplanned pregnancies.

Keywords: Breast cancer; Contraception; Fertility preservation; Pregnancy.

MeSH terms

Breast Neoplasms* / drug therapy
Cancer Survivors*
Cohort Studies
Cryopreservation
Female
Fertility Preservation* / methods
Humans
Neoplasm Recurrence, Local
Pregnancy