Exploring new frontiers in oncofertility preservation: a case of ovarian stimulation during pregnancy

Abstract Background The standard treatment for Pregnancy-Associated Breast Cancer (PABC) includes surgery and neoadjuvant chemotherapy, which can impair fertility, emphasizing the critical need for fertility preservation in these patients. This case report discusses a breast cancer patient who was f...

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Main Authors: Parisa Pirooznia, Esmat Mashhadi Meighani, Firouzeh Ghaffari
Format: Article
Language:English
Published: BMC 2025-02-01
Series:Journal of Ovarian Research
Subjects:
Online Access:https://doi.org/10.1186/s13048-025-01615-4
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author Parisa Pirooznia
Esmat Mashhadi Meighani
Firouzeh Ghaffari
author_facet Parisa Pirooznia
Esmat Mashhadi Meighani
Firouzeh Ghaffari
author_sort Parisa Pirooznia
collection DOAJ
description Abstract Background The standard treatment for Pregnancy-Associated Breast Cancer (PABC) includes surgery and neoadjuvant chemotherapy, which can impair fertility, emphasizing the critical need for fertility preservation in these patients. This case report discusses a breast cancer patient who was found to be pregnant shortly after starting treatment. Despite the pregnancy and increased levels of βHCG and progesterone, the ovarian stimulation cycle yielded a satisfactory number of mature oocytes and high-quality embryos. Case presentation A 40-year-old woman, G1Ab1 (Gravida1Abortion1), who was diagnosed with Invasive Ductal Carcinoma with negative receptors (Estrogen Receptor, Progesterone Receptor, and Human Epidermal Growth Factor Receptor 2) was referred to the oncofertility unit of the Royan Infertility Center for fertility preservation prior to the commencement of chemotherapy. Following necessary consultations and procedures, and confirming a negative pregnancy test, a random start letrozole-based protocol was initiated for ovarian stimulation. During the cycle, a positive pregnancy test was encountered. Despite the positive test, the cycle continued, and on day 13 of the cycle, triggering was performed with a GnRH agonist. A puncture was performed 36 h later, yielding 12 oocytes and 8 embryos. Conclusion This case highlights the feasibility of adapting random-start ovarian stimulation protocols during pregnancy, warranting further investigation in similar clinical scenarios.
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spelling doaj-art-547ebd1e520446448237085d0f2e01762025-08-20T03:03:22ZengBMCJournal of Ovarian Research1757-22152025-02-011811610.1186/s13048-025-01615-4Exploring new frontiers in oncofertility preservation: a case of ovarian stimulation during pregnancyParisa Pirooznia0Esmat Mashhadi Meighani1Firouzeh Ghaffari2Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECRDepartment of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECRDepartment of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECRAbstract Background The standard treatment for Pregnancy-Associated Breast Cancer (PABC) includes surgery and neoadjuvant chemotherapy, which can impair fertility, emphasizing the critical need for fertility preservation in these patients. This case report discusses a breast cancer patient who was found to be pregnant shortly after starting treatment. Despite the pregnancy and increased levels of βHCG and progesterone, the ovarian stimulation cycle yielded a satisfactory number of mature oocytes and high-quality embryos. Case presentation A 40-year-old woman, G1Ab1 (Gravida1Abortion1), who was diagnosed with Invasive Ductal Carcinoma with negative receptors (Estrogen Receptor, Progesterone Receptor, and Human Epidermal Growth Factor Receptor 2) was referred to the oncofertility unit of the Royan Infertility Center for fertility preservation prior to the commencement of chemotherapy. Following necessary consultations and procedures, and confirming a negative pregnancy test, a random start letrozole-based protocol was initiated for ovarian stimulation. During the cycle, a positive pregnancy test was encountered. Despite the positive test, the cycle continued, and on day 13 of the cycle, triggering was performed with a GnRH agonist. A puncture was performed 36 h later, yielding 12 oocytes and 8 embryos. Conclusion This case highlights the feasibility of adapting random-start ovarian stimulation protocols during pregnancy, warranting further investigation in similar clinical scenarios.https://doi.org/10.1186/s13048-025-01615-4Pregnancy-associated breast cancerPABCFertility preservationRandom start ovarian stimulation
spellingShingle Parisa Pirooznia
Esmat Mashhadi Meighani
Firouzeh Ghaffari
Exploring new frontiers in oncofertility preservation: a case of ovarian stimulation during pregnancy
Journal of Ovarian Research
Pregnancy-associated breast cancer
PABC
Fertility preservation
Random start ovarian stimulation
title Exploring new frontiers in oncofertility preservation: a case of ovarian stimulation during pregnancy
title_full Exploring new frontiers in oncofertility preservation: a case of ovarian stimulation during pregnancy
title_fullStr Exploring new frontiers in oncofertility preservation: a case of ovarian stimulation during pregnancy
title_full_unstemmed Exploring new frontiers in oncofertility preservation: a case of ovarian stimulation during pregnancy
title_short Exploring new frontiers in oncofertility preservation: a case of ovarian stimulation during pregnancy
title_sort exploring new frontiers in oncofertility preservation a case of ovarian stimulation during pregnancy
topic Pregnancy-associated breast cancer
PABC
Fertility preservation
Random start ovarian stimulation
url https://doi.org/10.1186/s13048-025-01615-4
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AT esmatmashhadimeighani exploringnewfrontiersinoncofertilitypreservationacaseofovarianstimulationduringpregnancy
AT firouzehghaffari exploringnewfrontiersinoncofertilitypreservationacaseofovarianstimulationduringpregnancy