Study on Fertility Parameters in Women With Germline Variants in BRCA1 and BRCA2 (BFert)

B.Fert: Retrospective and Prospective Observational Study on Fertility Parameters in Women With Germline Variants in BRCA1 and BRCA2

Pathogenic variants (PVs) in the BRCA1 and BRCA2 genes are associated with an increased risk of developing breast and ovarian cancers. According to current guidelines from the National Comprehensive Cancer Network, the risk of developing breast cancer exceeds 60% for both genes, while the risk for ovarian cancer ranges from 39% to 58% for the BRCA1 and from 13% to 29% for the BRCA2. The detection of a pathogenic variant in the BRCA1 or BRCA2 genes necessitates both the establishment of appropriate primary and secondary surveillance measures for carriers and the discussion of the familial implications of such findings.

The molecular basis initially suggesting a possible association between germline variants in BRCA1 and BRCA2 genes and diminished ovarian reserve lies in the cellular impact of impaired or defective repair of DNA double-strand breaks (DSBs) on oocytes. Notably, BRCA1 and BRCA2 genes play a key role in the ATM-related mechanism for DSB repair through the homologous recombination (HR) pathway.

Although preclinical evidence supports a potential correlation between defective DSB repair and normal follicle maturation processes, clinical studies on large cohorts of patients with pathogenic BRCA1 and BRCA2 variants yield inconsistent results. This discrepancy is likely attributable to the inherent challenges in recruiting a sufficiently homogeneous and statistically significant sample size.

The aim of the study is to evaluate reproductive capacity in women carrying pathogenic variants in the BRCA1/2 genes by assessing the number of pregnancies during the period from January 1, 2018, to December 31, 2023. Secondary objectives include evaluating menopausal characteristics and pregnancy outcomes.

Study Overview

• Status: Not yet recruiting
• Conditions: Menopause; Fertility; BRCA1 and/or BRCA2 Variant Carriers; Pregnancy Outcomes; Reproductive Age

• Study Type: Observational
• Enrollment (Estimated): 128

Contacts and Locations

• Study Contact: Name: Emanuela Lucci Cordisco, MD; Phone Number: +39 0630156780; Email: emanuela.luccicordisco@policlinicogemelli.it

Study Locations

• Italy
  • RM
    • Roma, RM, Italy, 00136
      • UOC Genetica Medica Fondazione Policlinico Universitario A.Gemelli IRCCS

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

Carriers and non carriers of BRCA pathogenic variants

Description

BRCA1 and BRCA2 carriers

Inclusion Criteria:

• age > 18 years
• presence of a pathogenic variant in the BRCA genes
• signed informed consent Exclusion Criteria
• presence of a pathogenic variant in another gene (not BRCA)
• significant psychiatric or clinical impairment affecting the ability to consent to the study

Control cohort

Inclusion Criteria:

- Relatives up to the third degree of the first cohort who tested negative on predictive testing for the familial pathogenic variant in the BRCA genes, matched for age where possible.

Exclusion Criteria:

• absence of a pathogenic variant in another gene (non-BRCA) found in a family member
• significant psychiatric or clinical impairment affecting the ability to consent to the study

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
BRCA1 and BRCA2 carriers; Inclusion criteria: age > 18 years; presence of a pathogenic variant in the BRCA genes; signed informed consent for study participation
Control cohort; >18 y.o; Relatives up to the third degree of kinship from cohort 1 who tested negative on predictive testing for the familial pathogenic variant in the BRCA genes, matched for age where possible.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Evaluate the reproductive capacity in women carrying PVs in BRCA1/2 genes	Evaluate number of pregnancies	1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The evaluation of menopausal characteristics and pregnancy outcomes	Evaluate: age at menopause, type of menopause, number of miscarriages, age at pregnancies, cancer diagnosis	1 year

Collaborators and Investigators

• Sponsor: Fondazione Policlinico Universitario Agostino Gemelli IRCCS
• Investigators: Principal Investigator: Emanuela Lucci Cordisco, Fondazione Policlinico Universitario A. Gemelli, IRCCS

Study record dates

Study Major Dates

• Study Start (Estimated): December 1, 2024
• Primary Completion (Estimated): December 1, 2025
• Study Completion (Estimated): June 1, 2026

Study Registration Dates

• First Submitted: November 26, 2024
• First Submitted That Met QC Criteria: November 26, 2024
• First Posted (Actual): November 29, 2024

Study Record Updates

• Last Update Posted (Actual): November 29, 2024
• Last Update Submitted That Met QC Criteria: November 26, 2024
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Other Study ID Numbers: 6591 (CTEP)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO