In the US, breast cancer is the most common invasive cancer in women, with more than 200,000 diagnosed with the disease each year. Approximately 25% of these women will be diagnosed before they experience menopause. Because childbearing often is delayed until later in life, many premenopausal young women with breast cancer may not have started to have children or completed their families.
Improved public awareness, routine diagnostic testing with mammography, and medical advances in treatment have greatly increased the chances of long-term survival following a diagnosis of breast cancer. The life-saving treatment of breast cancer often profoundly affects fertility, leaving many women unable to fulfill childbearing goals.[3,4] For all women, breast cancer is a crisis; for young women desiring children, the combined threat to life and fertility is likely catastrophic.
Infertility following treatment is related to gonadotoxic chemotherapeutic agents and/or the length of time required to complete treatment. Age at diagnosis is a major factor, as fertility naturally declines with age; women in their later childbearing years are at an increased risk for ovarian failure and permanent infertility. Ovarian function following treatment is also related to ovarian function at the time treatment began and the specific chemotherapeutic agents prescribed (eg, see Table 1).[6,7]