Sistema de Salut de Catalunya
Institut Català de la Salut
[Demeestere I] Research Laboratory on Human Reproduction, Université Libre de Bruxelles (ULB), Brussels, Belgium. Gynecology and Obstetrics Department, Fertility Clinic, H.U.B Erasme Hospital, Brussels, Belgium. [Niman SM] International Breast Cancer Study Group Statistical Center, Boston, MA, USA. Department of Data Science, Division of Biostatistics, Dana-Farber Cancer Institute, Boston, MA, USA. [Partridge AH] Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. Harvard Medical School, Boston, MA, USA. [Diego DS] Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA. [Kammler R] Translational Research Coordination, International Breast Cancer Study Group, a Division of ETOP IBCSG Partners Foundation, Bern, Switzerland. [Ruggeri M] Program for Young Patients, International Breast Cancer Study Group, a Division of ETOP IBCSG Partners Foundation, Bern, Switzerland. [Saura C] Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. SOLTI Breast Cancer Research Group, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2025-10-03T08:32:27Z
2025-10-03T08:32:27Z
2025-10
Assisted reproductive technology; Breast cancer; Pregnancy
Tecnologia de reproducció assistida; Càncer de mama; Embaràs
Tecnología de reproducción asistida; Cáncer de mama; Embarazo
Purpose The POSITIVE trial showed that premenopausal women with breast cancer (BC) can safely pause adjuvant endocrine treatment (ET) to attempt conception. 74 % of patients conceived spontaneously or through assisted reproductive technology (ART); Investigating hormonal factors that predict fertility was a key secondary endpoint. Methods Hormonal factors were assessed in non-pregnant women at months 3, 6, and 12 after ET interruption. The frequency of low ovarian reserve, defined as anti-Mullerian hormone (AMH) < 0.5 ng/mL at month 3, and of premature ovarian insufficiency (POI), defined as follicle stimulating hormone (FSH) > 25 IU/L at month 12, were primary measures. Secondary analyses to predict pregnancy included AMH, FSH, thyroid stimulating hormone (TSH), prolactin and ovulatory status (defined as progesterone >3 ng/mL at month 6), considering covariates such as age, treatment, and ART use. Results Of 518 women enrolled in POSITIVE, 438 were eligible for low ovarian reserve analysis. Low ovarian reserve was observed in 209 women (47.7 %), more frequently among older women and those with prior chemotherapy, but not in relation to ET type or duration. Overall, low ovarian reserve was associated with reduced odds of pregnancy (OR:0.52; 95 % CI:0.31–0.87). Of 142 patients evaluated for POI, 16.7 % of those who received prior chemotherapy experienced POI. FSH at month 3 was associated with POI, but only modestly with spontaneous pregnancy (OR:0.96; 95 %CI: 0.93–1.00); other factors were not predictive of pregnancy. Conclusion Hormonal factors are associated with pregnancy in BC patients pausing adjuvant ET to conceive, and their assessment may help to optimize fertility counseling. Trial registration ClinicalTrials.gov number NCT02308085.
Article
Published version
English
Mama - Càncer - Tractament; Embaràs; Reproducció humana assistida; DISEASES::Neoplasms::Neoplasms by Site::Breast Neoplasms; Other subheadings::Other subheadings::Other subheadings::/drug therapy; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Reproductive Techniques::Reproductive Techniques, Assisted::Fertility Preservation; PHENOMENA AND PROCESSES::Reproductive and Urinary Physiological Phenomena::Reproductive Physiological Phenomena::Reproduction::Pregnancy; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Reproductive Techniques::Reproductive Techniques, Assisted; ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias de la mama; Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::técnicas reproductivas::técnicas reproductivas asistidas::conservación de la fertilidad; FENÓMENOS Y PROCESOS::fenómenos fisiológicos reproductivos y urinarios::fenómenos fisiológicos de la reproducción::reproducción::embarazo; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::técnicas reproductivas::técnicas reproductivas asistidas
Elsevier
The Breast;83
https://doi.org/10.1016/j.breast.2025.104547
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
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