Consensus on fertility preservation and breast cancer at the La Trinidad Medical Teaching Center.

Abstract

Introduction: the likelihood of pregnancy after breast cancer treatment is low, making fertility preservation essential prior to initiating therapies that may impair fertility. Methods: this study, conducted at Centro Médico Docente La Trinidad (May–October 2024), used the Delphi methodology with experts to identify the best methods for fertility preservation in women with breast cancer, considering indications, efficacy, and safety. This prospective, descriptive, exploratory, and longitudinal study included three Delphi rounds conducted online with 20 experts. Results: full consensus (100%) was achieved in 12 sections: three in the first round (post-cancer pregnancy safety, embryo and oocyte cryopreservation, ovarian cortex banking), six in the second round (preservation methods, ovarian stimulation protocols, chemotherapy effects, ovarian reserve assessment, double ovarian stimulation, in vitro maturation), and three in the focus group (counseling, breast cancer risk, embryo cryopreservation). Consensus (80% or more agreement) was reached in three additional sections: patient type, controlled ovarian stimulation, and ovarian suppression. However, no consensus was achieved for patient referrals, oocyte cryopreservation, and ovarian tissue cryopreservation. Conclusions: the Delphi methodology provided a high level of agreement in most categories, offering valuable guidance for fertility preservation in women undergoing breast cancer treatment.