J Breast Cancer.  2017 Mar;20(1):91-97. 10.4048/jbc.2017.20.1.91.

Fertility Rates in Young Korean Breast Cancer Patients Treated with Gonadotropin-Releasing Hormone and Chemotherapy

• Kim I
• Ryu JM
• Paik HJ
• Park S
• Bae SY
• Lee SK
• Yu J
• Kim SW
• Nam SJ
• Lee JE

• KMID: 2379403
• DOI: http://doi.org/10.4048/jbc.2017.20.1.91

Abstract

PURPOSE
Gonadotropin-releasing hormone (GnRH) agonists have been used with adjuvant chemotherapy to protect ovarian function. However, there are no data on the actual pregnancy rates among young breast cancer patients receiving GnRH agonists and concurrent chemotherapy in Korea.
METHODS
Among patients who underwent surgery from January 2002 to April 2012, premenopausal patients aged between 20 and 40 years were included in the analysis. We retrospectively reviewed clinicopathologic features (e.g., age, obstetric and menstruation history), recurrence, and survival status. The rate of resumption of menstruation was calculated in all patients. In the married group, pregnancy and delivery rates were also recorded.
RESULTS
Among 101 patients, 19 were lost to follow-up and 82 were eligible for the analysis. Among them, 31 were married, 10 of 51 got married, and 41 remained unmarried through the follow-up period. Among the married patients, 15 became pregnant and gave birth to 19 babies, whereas 26 did not become pregnant. The pregnancy rate in the married group was 50.0% (15/30). Three of 15 pregnancies (20.0%) were multiparous. Most of the delivered babies were healthy and 80.0% of patients had no problems breastfeeding (12/15). More than half the patients in all groups recovered menstrual status within 12 months.
CONCLUSION
Fifty percent of young breast cancer patients who attempted pregnancy succeeded in pregnancy after adjuvant chemotherapy and GnRH agonists. Further studies that include control groups are required to confirm whether the use of GnRH agonists improves pregnancy.

Keyword

Breast neoplasms; Drug therapy; Gonadotropin-releasing hormone; Pregnancy rate

MeSH Terms

Birth Rate*
Breast Feeding
Breast Neoplasms*
Breast*
Chemotherapy, Adjuvant
Drug Therapy*
Female
Fertility*
Follow-Up Studies
Gonadotropin-Releasing Hormone*
Humans
Korea
Lost to Follow-Up
Menstruation
Parturition
Pregnancy
Pregnancy Rate
Recurrence
Retrospective Studies
Single Person
Gonadotropin-Releasing Hormone

Figure

• 

  Figure 1 Fertility follow-up for 101 concurrent Gonadotropin-releasing hormone agonist users.

• 

  Figure 2 Annual cases of concurrent Gonadotropin-releasing hormone agonist use (total 101 cases).

• 

  Figure 3 Annual distribution of delivery.

• 

  Figure 4 Menstruation resumption. (A) In pregnancy group, (B) in nonpregnancy group, and (C) in still unmarried group. X-axis means each patient in due order from with the shortest recovery months to the longest recovery months. Y-axis means interval months to menstruation resumption in each patient. The dotted line indicates range of menstrual recovery within 1 year.

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