Chemotherapy for early-stage breast cancer will not destroy our young patients’ dream of motherhood (fertility)

Through research in America, accomplished Turkish physician Kutluk Oktay demonstrated that fertility can be preserved to a substantial extent in young breast cancer patients and that they can safely become mothers after completing cancer treatment.

Early-stage breast cancer diagnosis is followed, depending on cancer characteristics and stage, by a course of chemotherapy either before surgery to shrink the tumor and improve surgical success or afterward for prevention. Following these chemotherapy treatments, depending on age, patients may experience fertility loss at a rate of %10-50 . In other words, without precautions before chemotherapy, some patients may lose their chance of future children.

Young patients naturally experience considerable fear and anxiety about their lives upon diagnosis. They react strongly to the cancer in their breast and are ready to sacrifice almost anything to survive. They may request complete removal of one or both breasts and the most intensive treatments to avoid facing the disease again. Oncologists must manage this sensitive period well and minimize future recurrence risk using scientific knowledge. We must also minimize harm from surgery and medical treatments, skillfully using every available opportunity for the patient’s benefit.

Continuing his work as a professor of gynecology and obstetrics at New York Medical College, Kutluk Oktayhas spent nearly 15 years researching fertility preservation and prevention of fertility loss, offering hope not only to cancer patients but to thousands of women facing these difficulties.

More than a hundred studies and scientific papers by him and his colleagues made him a world leader in this field. He demonstrated that unmarried young women with breast cancer could preserve fertility before chemotherapy using a method he developed and scientifically established as safe. The methods are collecting and freezing eggs; laparoscopically removing and freezing an ovary; and, for married women, collecting eggs, fertilizing them with their spouse’s sperm and freezing the embryos. Once the disease threat has passed, these frozen materials are transferred back to the prospective mother to enable pregnancy.

As you can imagine, following these years-long investigations, Prof. Dr. Kutluk Oktay reported in perhaps his most gratifying study, offering the strongest scientific evidence, that transfer of embryos obtained from eggs collected after ovarian stimulation before chemotherapy to the recovered patient or a surrogate resulted in live, healthy births in nearly half of cases. He compared these data with outcomes from the same approach in women without cancer who could not conceive naturally, emphasizing similar success rates.

All women diagnosed with early-stage breast cancer who have not yet had children, are unmarried or wish to retain the possibility of future children should discuss these opportunities thoroughly with their physicians before chemotherapy and choose the best method with their family and physician.

Prof. Dr. Kutluk Oktay’s dedication to his chosen specialty and resulting success should inspire young physicians. On behalf of all patients benefiting from this method, we thank Kutluk Oktay.

• Advances in breast cancer treatment – 2017 and 2018