Archives for March 2024

Assisted Reproduction for Breast Cancer Patients

Obtaining Assisted Reproduction as a Breast Cancer Patient

For breast cancer patients who are looking to become pregnant but are currently undergoing endocrine therapy, assisted reproduction may be an option. In 2021 alone, nearly 92,000 live births took place because of assisted reproduction. Recent studies have been performed to assess the possibility of using assisted reproduction for HR-positive breast cancer patients.

What Is Assisted Reproduction?

Assisted reproductive technology (ART) involves various techniques that can be used to treat cases of infertility. These fertility treatments are capable of handling sperm and eggs. The process typically occurs by removing the eggs from the ovaries that are then mixed with the sperm to create embryos. Once the embryos are formed, they are placed into the parent’s body. The numerous types of assisted reproduction available to prospective parents include the following:

  • In vitro fertilization (IVF)
  • Embryo transfers
  • Surrogacy arrangements
  • Artificial insemination

ART treatments can use donor sperm, donor eggs, or frozen embryos. The person who carries the embryos can be a gestational or surrogate carrier. A gestational carrier is someone who becomes pregnant with sperm from one partner and an egg from the other. In comparison, a surrogate is an individual who provides the egg, is inseminated with the sperm from one member of the couple, and then carries the resulting child.

If you have questions about the differences between a surrogate and a gestational carrier and which one may meet your needs, a New Jersey assisted reproduction lawyer may be able to provide clarification.

What Is HR-positive Breast Cancer?

HR-positive breast cancer is a common type that develops because of the hormone receptors found on breast cells. These receptors pick up the progesterone or estrogen signals that cause cell growth to occur. If the cells have receptors for one or both hormones, breast cancer is considered HR-positive. By identifying whether the tumor requires one or both hormones to grow, it becomes easier to target and treat the cancer.

The primary treatment that is administered to patients who suffer from this form of breast cancer is endocrine therapy. The purpose of this treatment is to reduce the possibility of the cancer returning. Some patients begin receiving the treatment before the surgery takes place. In most cases, the treatment must be taken for five or more years, which may impact a woman’s ability to give birth.

Initial Assisted Reproduction Study

In early December 2023, the San Antonio Breast Cancer Symposium was held among scientists and clinicians to focus on improving the diagnosis and treatment of all types of breast cancer. During the symposium, researchers presented results from the recent POSITIVE trial, which was performed to determine if assisted reproductive technologies impacted breast cancer recurrence rates for patients with HR-positive breast cancer.

Since the average age of childbearing has been increasing over the past decade, more women are being diagnosed with cancer before they have even started a family. Because of the issues that can be caused by endocrine therapy, many patients are choosing to use fertility preservation techniques before starting treatment. ART techniques are also used to increase the chances of a pregnancy. The most common fertility preservation methods involve ovarian stimulation, gonadotropin-releasing hormone analogs, and cryopreservation of ovarian tissue.

The results of the POSITIVE clinical trial indicate that patients who suffer from HR-positive breast cancer can pause their treatment for up to 24 months. During this time, the chances of breast cancer returning shouldn’t increase. The timeline after the initial 24 months remains unclear.

Details from Secondary Study

A secondary analysis was performed to study the outcomes of the POSITIVE trial. Nearly 500 people participated in this trial by pausing endocrine therapy. Just under 75% of these participants became pregnant.

The people who took part in this study used different types of assisted reproduction and fertility preservation. For example, 179 participants used oocyte or embryo preservation before taking part in the trial. Another 215 participants used ART to try to become pregnant.

During this study, researchers discovered that more than 82% of patients who took part in cryopreserved embryo transfer became pregnant. Close to 10% of patients used ovarian stimulation before cryopreservation, which didn’t result in worse disease outcomes. Around 9.7% of breast cancer patients who took part in this procedure went through breast cancer recurrence within two to three years. The rate was just under 9% among patients who didn’t undergo the procedure.

If you are considering starting a family with assisted reproduction technology, there are many moving parts to this process. From sperm donor contracts to pre-birth orders of parentage, numerous types of arrangements can be made before and during assisted reproduction. If you require legal representation, call our New Jersey adoption lawyer today at (856) 429-5005 to schedule a meeting.

Telling Your Children That They Were Born Through Assisted Reproduction

Having the Talk About Assisted Reproduction

According to some New Jersey adoption attorneys, more than 2% of infants born in the state are conceived through assisted reproductive technology. Those in the ART field expect that number to continue rising as the technologies improve and society becomes more comfortable with the approach overall. Furthermore, we are now gaining research that shows how ART affects the children later in life.

What Is Assisted Reproduction?

Assisted reproduction is a broad term, and the definition varies based on who is using it and where. Generally, it refers to any conception achieved through medical assistance involving the ovary. That includes combining ovaries and sperm in a laboratory and then returning them to a woman’s body. In some cases, the ovary is returned to the woman who provided it. In others, it is donated to another woman who will serve as the mother or surrogate mother.

In the U.S., gestational surrogacy is most common. This is where the surrogate mother has no genetic connection to the child she is carrying. Partial surrogacy is an option as well and much more common in the United Kingdom, for instance. It is also more prevalent overseas for surrogates to become part of the family. Commercial surrogates are more pervasive in the U.S. However, some families want the relationship and seek it out, and it is becoming more common here according to some experts.

Parents Worry Over Telling Children

When it comes to adoption, our society has many decades of experience and a wealth of data to fall back on. We generally know what to expect from child outcomes and the paths necessary to achieve positive ones. This is not yet the case with ART. It is only recently that we have access to studies involving many children who were achieved through ART and have now progressed into adulthood.

One of the chief concerns that parents and others have had is when should you tell a child that they were conceived through ART? Not only when should you tell them, but how much should you disclose?

Telling Children Early Helps

A 2023 study published in the journal Developmental Psychology followed 65 children. Of that group, 22 were born via surrogacy, 26 by sperm donation and 17 through egg donation. Researchers met with the children at age 1, 2, 3, 7, 10 and 14. What they found at age 3 did not come as a surprise. This is the point when children become curious about babies. They want to understand why they are here.

The data also showed that children who were told before age 7 reported better relationships with their mothers throughout their lives. When asked when they learned about the assisted reproduction, the children in this group responded that they always knew. This means that they grew up with the information and never had to experience the shock or surprise that could undermine trust.

Children who were born through surrogacy and made aware of it did tend to experience relationship issues around age 7. At this point, their mental advancement was allowing them to grapple with the concept of surrogacy. But when the researchers returned at age 10, those issues had disappeared in all cases.

Children Want to Be Wanted

One of the things the researchers found was that the assisted reproduction became even more of a positive as the children aged. The children knew they were wanted. This was important to them above all else, and they talked to the researchers about it a great deal.

Legal Representation for Assisted Reproduction

The Law Office of Cofsky & Zeidman has more than 25 years of experience helping families. That includes navigating the many wonderful varieties of assisted reproduction that help people realize their dreams of starting a family. We provide initial consultations without charge or obligation. If you’re ready to begin this journey or already underway, have your case reviewed by a seasoned New Jersey adoption attorney. To set up that appointment, call our Haddonfield office at (856) 429-5005 or our Woodbury location at (856) 845-2555, or contact us online.

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