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Fertility Preservation — SCE Medical Oncology MCQ

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ModerateBreast CancerFertility PreservationSCE Medical Oncology

A 40-year-old woman with ER+/HER2- breast cancer is concerned about fertility. She is planned for adjuvant chemotherapy. What fertility preservation option should be offered BEFORE starting chemotherapy?

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Correct answer: E — Oocyte or embryo cryopreservation (and GnRH agonist co-administration during chemotherapy)

NICE CG156 and NG101 recommend urgent fertility preservation referral before starting chemotherapy. Oocyte/embryo cryopreservation (IVF) is the established standard. GnRH agonist co-administration during chemotherapy (POEMS/PROMISE trials) provides additional ovarian protection and can be given alongside IVF. Ovarian tissue cryopreservation is available but less established. The referral should be rapid (2-week pathway) to avoid delaying treatment.

Reference: NICE NG101; NICE CG156 Fertility; ESMO 2024 Fertility Preservation; POEMS trial