Pregnancy, fertility concerns, and fertility preservation procedures in French breast cancer survivors in the FEERIC national study (on behalf of the Seintinelles research network)

Abstract

Research Question

: What are the oncofertility practices in real life in young women diagnosed with breast cancer (BC)?

Design

: The FEERIC study (Fertility, Pregnancy, Contraception after BC in France) is a web-based cohort study launched with the French collaborative research platform Seintinelles. The current work is based on the enrollment self-administered questionnaire of 517 patients with prior BC diagnosis, free from relapse and aged 18 to 43 years at inclusion (from 12^th March 2018 to 27^th June 2019).

Results

: Median age at BC diagnosis was 33.6 years and 424 patients (82.0%) received chemotherapy. Overall, 236 (45.6%) patients were offered specialized oncofertility counseling, 124 (24.0%) underwent one or more FP procedures with material preservation (oocytes n=108, 20.9%; embryos n=31, 6.0%; both oocytes and embryos n=13, 2.5%; ovarian cryopreservation n=6, 1.2%) and 78 patients received gonadotropin-releasing hormone agonists (15.1%). With a median follow-up of 26.7 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 spontaneous (n=113, 87.6%), while 16 (12.4%) required medical interventions. For the planned pregnancies, median time to evolutive pregnancy was three months. Patients who had an unplanned pregnancy reported lower rates of fertility counseling (p=0.02) at diagnosis.

Conclusions

: Most of the patients were not offered proper specialized oncofertility counseling at the time of BC diagnosis. Spontaneous pregnancies after BC were very much more frequent than pregnancies resulting from the use of cryopreserved gametes. Adequate contraceptive counseling seems as important as information about fertility and might prevent unplanned pregnancies.