Pregnancy, fertility concerns, and fertility preservation procedures in French breast cancer survivors in the FEERIC national study (on behalf of the Seintinelles research network)

Objective To study fertility concerns and oncofertility practices at time of breast cancer (BC) diagnosis. Design The FEERIC study (Fertility, Pregnancy, Contraception after BC in France) is a prospective, multicenter study. Setting Web-based collaborative research platform Seintinelles . Patients 517 patients with prior BC diagnosis free from relapse and aged 18 to 43 years at inclusion (from 12 th March 2018 to 27 th June 2019). Intervention Baseline online self-administered questionnaires. Main Outcome Measure Fertility preservation procedures at BC diagnosis. Results Median age at BC diagnosis was 33.6 years and 424 patients (82.0%) received chemotherapy. Overall, 236 (45.6%) patients were offered specialized oncofertility counseling, 124 (24.0%) underwent one or more FP procedures with material preservation (oocytes n=108, 20.9%; embryos n=31, 6.0%; both oocytes and embryos n=13, 2.5%; ovarian cryopreservation n=6, 1.2%) and 78 patients received gonadotropin-releasing hormone agonists (15.1%). With a median follow-up of 26.7 months after the end of treatments,133 pregnancies (25.7%) had occurred in 85 patients (16.4%), including 20 unplanned pregnancies (15.0%). Most of the pregnancies were spontaneous (n=113, 87.6%), while 16 (12.4%) required medical interventions. Patients who had an unplanned pregnancy were less likely to have received fertility counseling (p=0.02) and contraceptive counseling (p=0.08) at BC diagnosis. Conclusion Most of the patients were not offered proper specialized oncofertility counseling at the time of BC diagnosis. Spontaneous pregnancies after BC were very much more frequent than pregnancies resulting from the use of cryopreserved gametes. Adequate contraceptive counseling seems as important as information about fertility and might prevent unplanned pregnancies.