Fertility Preservation in BRCA1/2 Germline Mutation Carriers: An Overview.
Erica SilvestrisGennaro CormioVera LoizziGiacomo CorradoFrancesca ArezzoEaster Anna PetraccaPublished in: Life (Basel, Switzerland) (2024)
BRCA1 and BRCA2 mutations are responsible for a higher incidence of breast and ovarian cancer (from 55% up to 70% vs. 12% in the general population). If their functions have been widely investigated in the onset of these malignancies, still little is known about their role in fertility impairment. Cancer patients treated with antineoplastic drugs can be susceptible to their gonadotoxicity and, in women, some of them can induce apoptotic program in premature ovarian follicles, progressive depletion of ovarian reserve and, consequently, cancer treatment-related infertility (CTRI). BRCA variants seem to be associated with early infertility, thus accelerating treatment impairment of ovaries and making women face the concrete possibility of an early pregnancy. In this regard, fertility preservation (FP) procedures should be discussed in oncofertility counseling-from the first line of prevention with risk-reducing salpingo-oophorectomy (RRSO) to the new experimental ovarian stem cells (OSCs) model as a new way to obtain in vitro-differentiated oocytes, several techniques may represent a valid option to BRCA-mutated patients. In this review, we revisit knowledge about BRCA involvement in lower fertility, pregnancy feasibility, and the fertility preservation (FP) options available.
Keyphrases
- breast cancer risk
- stem cells
- childhood cancer
- polycystic ovary syndrome
- pregnancy outcomes
- end stage renal disease
- healthcare
- cell death
- risk factors
- ejection fraction
- squamous cell carcinoma
- gene expression
- multiple sclerosis
- pregnant women
- young adults
- papillary thyroid
- hepatitis c virus
- preterm birth
- adipose tissue
- metabolic syndrome
- copy number
- oxidative stress
- dna methylation
- dna damage
- lymph node metastasis
- patient reported outcomes
- smoking cessation
- human immunodeficiency virus
- genome wide
- bone marrow
- atomic force microscopy
- drug induced
- patient reported
- anti inflammatory