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O&G CasesReproductive endocrinology & infertility

O&G Cases · Reproductive endocrinology & infertility

Newly diagnosed breast cancer — urgent fertility preservation counselling station

Communication station on urgent fertility preservation in a young woman with ER-positive breast cancer before adjuvant chemotherapy. Tests evidence-based counselling on random-start stimulation with letrozole, the realistic per-cycle yield, the safety signal in ER-positive disease, the time trade-off, and shared decision-making. Includes assessor key and marking domains.

communication5 min readVerification in progress

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FRANZCOGMRCOGABOGFRCSCMRCPI
Prompt
A 28-year-old nulliparous woman with a new diagnosis of oestrogen-receptor-positive breast cancer (T2 N0 M0) attends the fertility clinic with her partner the day after her oncology consultation. The medical oncologist has recommended adjuvant chemotherapy starting in 10 days. She asks, 'Can I freeze eggs before I start chemo? Will it make my cancer worse? How long will it delay my treatment?' The examiner will run the station as a structured communication encounter with intermittent prompts.

Station brief

Format. Communication station, approximately 12 minutes. You are the fertility fellow in the onco-fertility clinic. The patient and her partner have been referred by the medical oncologist for urgent fertility preservation counselling. The breast-care nurse is on standby; the medical oncologist is reachable by phone for any clinical questions. The assessor will feed you prompts as the conversation unfolds and the partner will ask two or three challenging questions during the station.[4]

Candidate instruction. Counsel the patient and her partner on fertility preservation options, the time trade-off with chemotherapy, the realistic per-cycle yield, and the safety of stimulation in ER-positive breast cancer. Use plain English, avoid jargon, check understanding, and reach a shared decision. Document the conversation in plain notes at the end.[4][15]

Obstetrics & Gynaecology Pro

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References8ShowHide
  1. [4]Lambertini M, Peccatori FA, Demeestere I, Amant F, Wyns C, Stukenborg JB, Paluch-Shimon S, Halaska MJ, Uzan C, Meissner J, von Wolff M, Anderson RA, Jordan K. Fertility preservation and post-treatment pregnancies in post-pubertal cancer patients: ESMO Clinical Practice Guidelines. Ann Oncol, 2020.PMID 32976936
  2. [15]Sonmezer M, Sacinti KG, Oktay KH. Female fertility preservation: 25 years of progress, expanding indications and future prospects. Hum Reprod Update, 2026.PMID 41206517
  3. [16]Practice Committee of the American Society for Reproductive Medicine. Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion. Fertil Steril, 2019.PMID 31843073
  4. [5]Cobo A, García-Velasco JA, Coello A, et al. Oocyte vitrification as an efficient option for elective fertility preservation. Fertil Steril, 2016.PMID 26688429
  5. [6]Cobo A, García-Velasco JA, Remohí J. Oocyte vitrification for fertility preservation for both medical and nonmedical reasons. Fertil Steril, 2021.PMID 33933172
  6. [18]Sönmezer M, Şükür YE, Saçıntı KG. Safety of ovarian cryopreservation and transplantation in patients with acute leukemia. Am J Obstet Gynecol, 2024.PMID 37666382
  7. [17]Lundin K, Bentzen JG, Bozdag G. Good practice recommendations on add-ons in reproductive medicine. Hum Reprod, 2023.PMID 37747409
  8. [12]Pabuccu E, Kovanci E, Israfilova G, Tulek F, Demirel C, Pabuccu R. Oral, vaginal or intramuscular progesterone in programmed frozen embryo transfer cycles: a pilot randomized controlled trial. Reprod Biomed Online, 2022.PMID 36153226
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