Pausing hormone therapy to pursue pregnancy does not increase the short-term risk of early-stage cancer recurrence
Full article: https://www.nejm.org/doi/full/10.1056/NEJMoa2212856
Women who paused hormone therapy treatment of early-stage hormone receptor-positive (HR-positive) breast cancer to attempt to get pregnant had no increase in short-term recurrence. (Posted 11/3/23)
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Questions To Ask Your Health Care Provider
- What is the risk of my HR-positive breast cancer recurring?
- Is it safe for me to pause hormone therapy to become pregnant? Is it safe for my baby?
- What screening will I need during and after pregnancy if I pause hormone therapy?
- As a young cancer survivor, what resources are available to help me with family planning?
- How long after pregnancy should I wait before resuming hormone therapy?
Open Clinical Trials
The following research studies related to fertility preservation are enrolling patients.
Fertility preservation studies for women
Fertility preservation for men
- NCT02972801: Testicular Tissue Cryopreservation for Fertility Preservation. Testicular tissue cryopreservation is an experimental procedure involving testicular tissue that is retrieved and frozen. This technique is reserved for young male patients, with the ultimate goal that their tissue may be used in the future to restore fertility when experimental techniques emerge from the research pipeline.
The following resources focus on fertility and cancer:
- FORCE fertility resources:
- Alliance for Fertility Preservation is an organization of healthcare professionals focused on fertility preservation.
- SaveMyFertility.org is a resource for cancer patients who want to learn more about preserving their fertility before and during cancer treatment, and protecting their hormonal health after treatment. The group provides fertility preservation pocket guides for men, women and children diagnosed with cancer.
- ReproductiveFacts.org offers a broad range of information and resources for people experiencing infertility or seeking assistance with building a family.
- Resolve empowers people who are challenged in their family-building journey as advocates for coverage of fertility-related services at the state and federal levels.
The National Comprehensive Cancer Network (NCCN) provides guidelines for fertility in people diagnosed with cancer.
The NCCN recommends doctors discuss the following with adolescents and adults with cancer before treatment begins:
- fertility plans and preferences
- fertility preservation options, including:
- whether therapy can be delayed long enough for a cycle of egg stimulation
- medications like GnRH agonist therapy during adjuvant chemotherapy to preserve ovarian function in premenopausal women with breast cancer
- the importance of follow-up with a gynecologist or fertility specialist to monitor ovarian function over time
- the risks of infertility due to cancer and related treatment
- the effects of treatment on breastfeeding
- the importance of avoiding pregnancy and options for safe and effective birth control while in treatment
- safe timing for considering pregnancy after treatment
- the emotional impact of discussions about fertility preservation
- financial resources for fertility preservation
- the effects of treatment on sexual function during and after treatment
Doctors should refer patients as indicated for the following services:
- All patients who are interested in preserving their fertility should be referred to a fertility preservation clinic before starting treatment.
- Patients who need assistance with complex medical decision-making should be referred to a mental health professional.
- Patients who are experiencing sexual dysfunction should be referred to a sexual health specialist.
FORCE is a national nonprofit organization, established in 1999. Our mission is to improve the lives of individuals and families affected by adult hereditary cancers.