dc.contributor
Institut Català de la Salut
dc.contributor
[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
dc.contributor
Vall d'Hebron Barcelona Hospital Campus
dc.contributor.author
Demeestere, Isabelle
dc.contributor.author
Niman, Samuel
dc.contributor.author
Partridge, Ann
dc.contributor.author
Diego, Daniela S.
dc.contributor.author
Kammler, Roswitha
dc.contributor.author
Ruggeri, Monica
dc.contributor.author
Saura Manich, Cristina
dc.date.accessioned
2025-10-04T05:19:05Z
dc.date.available
2025-10-04T05:19:05Z
dc.date.issued
2025-10-03T08:32:27Z
dc.date.issued
2025-10-03T08:32:27Z
dc.identifier
Demeestere I, Niman SM, Partridge AH, Diego DS, Kammler R, Ruggeri M, et al. Hormonal factors predictive of fertility in patients with breast cancer interrupting adjuvant endocrine therapy to attempt pregnancy in POSITIVE trial. The Breast. 2025 Oct;83:104547.
dc.identifier
http://hdl.handle.net/11351/13764
dc.identifier
10.1016/j.breast.2025.104547
dc.identifier
001546347700001
dc.identifier.uri
https://hdl.handle.net/11351/13764
dc.description.abstract
Assisted reproductive technology; Breast cancer; Pregnancy
dc.description.abstract
Tecnologia de reproducció assistida; Càncer de mama; Embaràs
dc.description.abstract
Tecnología de reproducción asistida; Cáncer de mama; Embarazo
dc.description.abstract
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.
dc.format
application/pdf
dc.relation
The Breast;83
dc.relation
https://doi.org/10.1016/j.breast.2025.104547
dc.rights
Attribution-NonCommercial-NoDerivatives 4.0 International
dc.rights
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights
info:eu-repo/semantics/openAccess
dc.subject
Mama - Càncer - Tractament
dc.subject
Reproducció humana assistida
dc.subject
DISEASES::Neoplasms::Neoplasms by Site::Breast Neoplasms
dc.subject
Other subheadings::Other subheadings::Other subheadings::/drug therapy
dc.subject
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Reproductive Techniques::Reproductive Techniques, Assisted::Fertility Preservation
dc.subject
PHENOMENA AND PROCESSES::Reproductive and Urinary Physiological Phenomena::Reproductive Physiological Phenomena::Reproduction::Pregnancy
dc.subject
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Reproductive Techniques::Reproductive Techniques, Assisted
dc.subject
ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias de la mama
dc.subject
Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia
dc.subject
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::técnicas reproductivas::técnicas reproductivas asistidas::conservación de la fertilidad
dc.subject
FENÓMENOS Y PROCESOS::fenómenos fisiológicos reproductivos y urinarios::fenómenos fisiológicos de la reproducción::reproducción::embarazo
dc.subject
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::técnicas reproductivas::técnicas reproductivas asistidas
dc.title
Hormonal factors predictive of fertility in patients with breast cancer interrupting adjuvant endocrine therapy to attempt pregnancy in POSITIVE trial
dc.type
info:eu-repo/semantics/article
dc.type
info:eu-repo/semantics/publishedVersion
