Further Evidence on the Safety and Success of Ovarian Stimulation With Letrozole and Tamoxifen in Breast Cancer Patients Undergoing In Vitro Fertilization to Cryopreserve Their Embryos for Fertility Preservation

Journal of Clinical Oncology (Impact Factor: 18.43). 07/2005; 23(16):3858-9. DOI: 10.1200/JCO.2005.04.011
Source: PubMed
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    • "In the initial nonrandomized studies, stimulation protocols that include the selective estrogen receptor modulator tamoxifen or aromatase inhibitors such as letrozole administered during gonadotropin treatment have been shown to decrease estradiol level production while not decreasing overall oocyte numbers. Initial reassuring data indicates that this approach has not been shown to increase short-term cancer recurrences for breast cancer patients [39, 40]. "
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    ABSTRACT: Given the increases in 5-year cancer survival and recent advances in fertility preserving technologies, an increasing number of women with cancer are presenting for discussion of fertility preserving options. This review will summarize the risk of infertility secondary to cancer treatment, available treatment options for fertility preservation, and techniques to reduce future risks for patients. Concerns that will be addressed include the risk of the medications and procedures, the potential delay in cancer treatment, likelihood of pregnancy complications, as well as the impact of future pregnancy on the recurrence risk of cancer. Recent advances in oocyte cryopreservation and ovarian stimulation protocols will be discussed. Healthcare providers need to be informed of available treatment options including the risks, advantages, and disadvantages of fertility preserving options to properly counsel patients.
    Full-text · Article · Mar 2012 · Obstetrics and Gynecology International
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    • "Evidently, in that case IVM has to be performed prior to fertilisation of the oocytes. Employing tamoxifen or letrozole based stimulation regimes may be used in the case of hormone sensitive tumors (see previous paragraph) (Oktay et al., 2005a, 2005b; Sonmezer & Oktay, 2006). Oktay et al. (2005b) has shown that in cancer patients who had been stimulated with this compound, recurrence rates were not elevated compared to cancer patients who had not been receiving any ovarian stimulation. "

    Full-text · Chapter · Jan 2012
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    • "One of the concerns of this treatment is the high serum estrogen concentration during ovarian stimulation in patients with hormone-sensitive tumors such as breast cancer [6, 18]. The use of tamoxifen or letrozole—SERM (selective estrogen receptor modulator) or aromatase inhibitor—for ovarian stimulation to reduce the risk of estrogen exposure revealed no increase of cancer recurrence rates in some studies [19, 20], but larger and long-term follow-up results are needed. "
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    ABSTRACT: With improved survival rates among cancer patients, fertility preservation is now being recognized as an issue of great importance. There are currently several methods of fertility preservation available in female cancer patients and the options and techniques via assisted reproduction and cryopreservation are increasing, but some are still experimental and continues to be evaluated. The established means of preserving fertility include embryo cryopreservation, gonadal shielding during radiation therapy, ovarian transposition, conservative gynecologic surgery such as radical trachelectomy, donor embryos/oocytes, gestational surrogacy, and adoption. The experimental methods include oocyte cryopreservation, ovarian cryopreservation and transplantation, in vitro maturation, and ovarian suppression. With advances in methods for the preservation of fertility, providing information about risk of infertility and possible options of fertility preservation to all young patients with cancer, and discussing future fertility with them should be also considered as one of the important parts of consultation at the time of cancer diagnosis.
    Full-text · Article · Jan 2012 · ISRN obstetrics and gynecology
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