ABSTRACT
The incidence of breast cancer among young women in India surpasses that of the West, with a median age of presentation at 49 years, compared to 62 in Western populations. Fertility preservation becomes pivotal due to delayed family planning caused by later marriage and postponed childbearing in premenopausal breast cancer patients. Adjuvant chemotherapy poses a risk of ovarian dysfunction, with alkylating agents increasing the likelihood of ovarian failure. The prevalence of chemotherapy-induced amenorrhea varies with age, ranging from 30% to 95%.
Surgical fertility preservation methods, including embryo banking, oocyte banking, in vitro maturation, and ovarian tissue cryopreservation, present varied advantages and disadvantages. Non-surgical approaches, such as gonadotropin-releasing hormone (GnRH) agonists, have shown promise in preserving ovarian function and fertility post-chemotherapy.
Challenges persist, with patients often overwhelmed at the time of diagnosis, highlighting the necessity for reproductive counselling. As breast cancer rates rise in younger women, integrating fertility preservation into comprehensive cancer care for every premenopausal woman is imperative. Multidisciplinary efforts are essential to address the complexities of fertility preservation in the context of breast cancer treatment.
