Contraception in cancer survivors: Breast and gynecological cancers (Part I)

Yakushevskaya O.V., Yureneva S.V., Ashrafyan L.A., Babaeva N.A.

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow, Russia
Contraception in cancer survivors has acquired its importance for various reasons. The bulk of cancers occurs in old age, but they are often diagnosed in premenopausal and reproductive-aged women. As the efficiency of antitumor therapy for many kinds of cancer has increased, so has the number of patients who have completed it favorably. Chemotherapy, radiotherapy, and ovarian surgery can negatively affect ovarian reserve. Residual ovarian function depends on age at diagnosis, type of treatment, and baseline ovarian reserve. Over the past decade, there have been significant changes in the management of patients in terms of fertility preservation and ovarian reserve assessment. In any situation, it is important to assess a patient’s need for contraception before, during, and after anticancer treatment. This paper gives the results of the work of the European Society of Contraception Expert Group that has analyzed risks for recurrence of the most common cancers in women using different contraception methods. The results are summarized and formed into recommendations for contraception for various cancer sites. Due to a large amount of information, the results are presented in two parts. Part 1 considers the contraceptives recommended for use after breast and gynecological cancers (cervical, endometrial and ovarian cancer, trophoblastic disease). Part 2 provides advice on contraception for women who have had a history of non-gynecological cancer (skin, gastrointestinal, blood, and endocrine cancers).
Conclusion: The myth that the use of hormonal contraceptives is always accompanied by an increase in cancer risks, whereas pregnancy is associated with fewer risks than that of COCs has been now dispelled. Because of the high risk of fetal toxicity and the risk of recurrent cancer, the prevention of pregnancy during the first 2 years after chemotherapy can be considered to be a reasonable strategy to preserve and maintain women’s health.


breast cancer
cervical cancer
endometrial cancer
vulvar cancer
ovarian cancer
trophoblastic disease


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Received 08.08.2022

Accepted 13.09.2022

About the Authors

Oksana V. Yakushevskaya, PhD, Researcher at the Department of Gynecological Endocrinology, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia,, 117997, Russia, Moscow, Ac. Oparina str., 4.
Svetlana V. Yureneva, Dr. Med. Sci., Deputy Director in Science, Institute of Oncology and Mammology, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia,, 117997, Russia, Moscow, Ac. Oparina str., 4.
Levon A., Ashrafyan, Academician of the RAS, Dr. Med. Sci., Professor, Director of the Institute of Oncology and Mammology, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia,,Х, 117997, Russia, Moscow,
Ac. Oparina str., 4.
Nataliya A. Babaeva, Dr. Med. Sci., Oncologist, Oncological Department of Surgical Methods of Treatment; Leading Researcher, Institute of Oncogynecology and Mammology, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia,,, 117997, Russia, Moscow, Ac. Oparina str., 4.

Authors’ contributions: Yakushevskaya O.V. – material collection and processing, writing the text; Yureneva S.V., Ashrafyan L.A., Babaeva N.A. – editing.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The investigation has not been sponsored.
For citation: Yakushevskaya O.V., Yureneva S.V., Ashrafyan L.A., Babaeva N.A. Contraception in cancer survivors: Breast and gynecological cancers (Part I).
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 11: 45-51 (in Russian)

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