Fertility preservation in young patients with breast cancer: insights from the Gemme Dormienti network

Background: Fertility preservation (FP) is a key aspect of care for young women with breast cancer (BC), as oncologic treatments can compromise future reproductive potential. Early counseling and access to FP strategies are essential to support long-term quality of life.Objectives: To evaluate the uptake of FP counseling, the choice of preservation techniques, and reproductive outcomes in women aged 18-39 years with BC.Design: A retrospective single-center cohort study was conducted at the Gemme Dormienti network between 2018 and 2023.Methods: A total of 100 BC patients underwent baseline ovarian reserve assessments, including hormonal and ultrasound evaluations. All received gonadotropin-releasing hormone agonist therapy prior to chemotherapy. Data on FP strategies-oocyte and/or ovarian tissue cryopreservation (OTC)-and pregnancy outcomes were collected.Results: Fifty-four percent of patients pursued FP procedures: 35% underwent oocyte cryopreservation, 55% OTC, and 10% both. Younger patients (18-29 years) were more likely to opt for combined techniques. Pregnancy rates were highest among women aged 35-39. Ovarian reserve indicators, including antral follicle count and endometrial thickness, showed an age-related decline.Conclusion: This study highlights the importance of early, personalized FP counseling for young BC patients. Age significantly influences both FP choices and reproductive outcomes, reinforcing the need to integrate fertility discussions into initial cancer care.