The role of patient age in fertility preservation among women with breast cancer: biological mechanisms and clinical implications
4 affiliations
- 1Department of Life Science, Health, and Health Professions, Link Campus University, Rome, Italy
- 2Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
- 3Breast Unit, San Salvatore Hospital, L’Aquila, Italy
- 4Medical Oncology, San Salvatore Hospital, L’Aquila, Italy
Abstract
Background: Breast cancer (BC) is the most common malignancy among women of reproductive age. Improved survival has shifted clinical focus toward survivorship and fertility preservation. While the gonadotoxic effects of anticancer therapy are well recognized, the influence of patient age on fertility outcomes remains insufficiently integrated into clinical decision-making.
Methods: This review synthesizes current evidence from clinical, molecular, and translational studies addressing the relationship between age, ovarian reserve, and reproductive outcomes in women with BC undergoing gonadotoxic treatments. It also examines how age interacts with BRCA mutations, endocrine therapy, and fertility preservation strategies.
Main findings: Age critically modulates the ovarian response to chemotherapy, the extent of oocyte depletion, and recovery of ovarian function. Younger patients show higher resilience and better success with fertility preservation methods such as oocyte, embryo, or ovarian tissue cryopreservation. Conversely, older women face accelerated follicular depletion, reduced AMH levels, and delayed conception due to prolonged adjuvant therapy. BRCA-related DNA repair defects further exacerbate age-related decline.
Conclusion: Patient age represents the most decisive factor guiding fertility preservation in BC care. Incorporating age-specific counseling and early referral into multidisciplinary oncofertility practice is essential to optimize reproductive outcomes and align survivorship with future family planning goals.
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BibTeX
@article{placidi2026role,
title = {{The role of patient age in fertility preservation among women with breast cancer: biological mechanisms and clinical implications}},
author = {Martina Placidi and Manuela Ludovisi and Laura Pizzorno and Tina Sidoni and Giovanna Di Emidio and Carla Tatone},
journal = {Journal of Assisted Reproduction and Genetics},
year = {2026},
month = jun,
doi = {10.1007/s10815-026-03923-0},
url = {https://doi.org/10.1007/s10815-026-03923-0},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - The role of patient age in fertility preservation among women with breast cancer: biological mechanisms and clinical implications
AU - Martina Placidi
AU - Manuela Ludovisi
AU - Laura Pizzorno
AU - Tina Sidoni
AU - Giovanna Di Emidio
AU - Carla Tatone
PY - 2026
DA - 2026/06/11
JO - Journal of Assisted Reproduction and Genetics
DO - 10.1007/s10815-026-03923-0
UR - https://doi.org/10.1007/s10815-026-03923-0
AB - Background: Breast cancer (BC) is the most common malignancy among women of reproductive age. Improved survival has shifted clinical focus toward survivorship and fertility preservation. While the gonadotoxic effects of anticancer therapy are well recognized, the influence of patient age on fertility outcomes remains insufficiently integrated into clinical decision-making. Methods: This review synthesizes current evidence from clinical, molecular, and translational studies addressing the relationship between age, ovarian reserve, and reproductive outcomes in women with BC undergoing gonadotoxic treatments. It also examines how age interacts with BRCA mutations, endocrine therapy, and fertility preservation strategies. Main findings: Age critically modulates the ovarian response to chemotherapy, the extent of oocyte depletion, and recovery of ovarian function. Younger patients show higher resilience and better success with fertility preservation methods such as oocyte, embryo, or ovarian tissue cryopreservation. Conversely, older women face accelerated follicular depletion, reduced AMH levels, and delayed conception due to prolonged adjuvant therapy. BRCA-related DNA repair defects further exacerbate age-related decline. Conclusion: Patient age represents the most decisive factor guiding fertility preservation in BC care. Incorporating age-specific counseling and early referral into multidisciplinary oncofertility practice is essential to optimize reproductive outcomes and align survivorship with future family planning goals.
SN - 1058-0468
SN - 1573-7330
ER -