Dr. Stephanie L. Graff, MD, FACP, FASCO, Director of Breast Oncology at Lifespan Cancer Institute, has outlined current strategies for fertility preservation in women diagnosed with breast cancer. In an in-depth discussion, Dr. Graff highlighted key approaches, including the use of gonadotropin-releasing hormone (GnRH) agonists for ovarian suppression, embryo and egg cryopreservation, and the potential benefits of combinatorial methods.
Dr. Graff emphasized the importance of an early referral to a fertility specialist for patients with breast cancer, advocating for a multi-faceted strategy that prioritizes timely fertility preservation. The gold standard remains embryo cryopreservation, followed closely by egg preservation. These procedures are typically performed before the initiation of chemotherapy, underscoring the necessity of fertility discussions being integrated into the early stages of diagnosis.
In cases where patients are unable to pursue traditional methods of fertility preservation—due to personal preferences or practical barriers—Dr. Graff recommends ovarian preservation through GnRH agonists during chemotherapy. These agents can help protect ovarian function during treatment, enhancing the likelihood of future fertility. Even when patients have opted for embryo or egg preservation, the use of GnRH agonists can further support ovarian function, making it possible for patients to carry their preserved embryos or eggs in the future.
While fertility preservation is often discussed in the context of female breast cancer patients, Dr. Graff noted that male patients should also be considered. Though less commonly affected, younger men diagnosed with breast cancer are at risk of infertility as a result of treatment. Dr. Graff stressed the importance of sperm banking for male patients prior to chemotherapy to safeguard future reproductive options.
Overall, Dr. Graff underscored the need for comprehensive fertility preservation counseling for both female and male breast cancer patients, highlighting early intervention as a critical factor in preserving reproductive health.
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