Impact des caractéristiques tumorales mammaires sur la réserve ovarienne et la réponse à la stimulation ovarienne en préservation de fertilité

Abstract : INTRODUCTION: The presence and degree of expression of various tumor markers such as expression of HER2, SBR or Ki67 are increasingly taking place in the management of patients with breast cancer. Indeed, they influence the prognosis of the disease and guide the choice of treatment. OBJECTIVE: The purpose of this study was to determine the impact of breast cancer tumor characteristics on ovarian function and response to ovarian stimulation in the context of fertility preservation. MATERIALS AND METHODS: One hundred and fifty-one patients with breast cancer who used fertility preservation by stimulation of ovulation and collection of mature oocytes were prospectively included in the study. Stimulation was initiated regardless of the phase of the cycle with an antagonist protocol, sometimes associated with an anti-estrogen. The punctured oocytes and / or the embryos obtained were vitrified. The factors of poor prognosis of the cancer studied were: Ki 67> 20%, "triple negative" tumor, grade SBR III, over expression of HER2. Univariate and multivariate analyzes were performed to determine their impact on ovarian reserve and response to exogenous FSH stimulation. RESULTS: One hundred and fifty-four cycles of ovarian stimulation were performed, resulting in 9.2 ± 7.4 mature oocytes per cycle. A Ki67> 20%, such as SBR III grade, triple negative status and HER2 overexpression did not appear to have a significant influence on ovarian reserve the number of mature oocytes collected, maturation rate, index of FORT (Follicle Output RaTe). CONCLUSION: In this study, we did not demonstrate the impact of the factors of poor prognosis of breast cancer on the ovarian reserve or on the response to stimulation. More powerful studies will be needed to confirm these results.
Complete list of metadatas

Cited literature [116 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-01962829
Contributor : Pointe À Pitre Bhu <>
Submitted on : Thursday, December 20, 2018 - 7:19:14 PM
Last modification on : Wednesday, May 15, 2019 - 9:58:04 AM

File

ThEse__Zeghari_Faycal.pdf
Files produced by the author(s)

Identifiers

  • HAL Id : dumas-01962829, version 1

Collections

Citation

Fayçal Zeghari. Impact des caractéristiques tumorales mammaires sur la réserve ovarienne et la réponse à la stimulation ovarienne en préservation de fertilité. Gynécologie et obstétrique. 2017. ⟨dumas-01962829⟩

Share

Metrics

Record views

8

Files downloads

61