•  

Infertility, infertility treatment, and achievement of pregnancy in female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study cohort (Aug 2013)

the lancet
Title:
Infertility, infertility treatment, and achievement of pregnancy in female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study cohort
Journal:
Lancet Oncol. 2013 Aug;14(9):873-81
Author(s):
Barton SE, Najita JS, Ginsburg ES, Leisenring WM, Stovall M, Weathers RE, Sklar CA, Robison LL, Diller L
 

 

Short description:
A more comprehensive understanding of infertility after cancer is crucial for counselling and decision making about future conception attempts and fertility preservation
Link to the journal
 

 

Abstract taken from PubMed

Background:
Previous studies have shown decreased pregnancy rates and early menopause in female cancer survivors; however, infertility rates and reproductive interventions have not been studied. We investigated infertility and time to pregnancy in female childhood cancer survivors, and analysed treatment characteristics associated with infertility and subsequent pregnancy.
Methods:
The Childhood Cancer Survivor Study (CCSS) is a cohort study including 5 year cancer survivors from 26 Canadian and US institutions who were younger than 21 years at the time of diagnosis between Jan 1, 1970, and Dec 31, 1986, and a sibling control group. We included women aged 18-39 years who had ever been sexually active. We gathered demographic, medical, and reproductive data via a baseline questionnaire, and quantified exposure to alkylating agents and radiation therapy. Self-reported infertility, medical treatment for infertility, time to first pregnancy in survivors and siblings, and the risk of infertility in survivors by demographic, disease, and treatment variables were analysed.
Results:
3531 survivors and 1366 female sibling controls who enrolled between Nov 3, 1992, and April 4, 2004, were included. Compared with their siblings, survivors had an increased risk (relative risk [RR] 1•48 [95% CI 1•23-1•78]; p<0•0001) of clinical infertility (ie, >1 year of attempts at conception without success), which was most pronounced at early reproductive ages (RR 2•92 [95% CI 1•18-7•20], p=0•020, in participants ≤24 years; 1•61 [1•05-2•48], p=0•029, in those aged 25-29 years; and 1•37 [1•11-1•69], p=0•0035, in those aged 30-40 years). Despite being equally likely to seek treatment for infertility, survivors were less likely than were their siblings to be prescribed drugs for treatment of infertility (0•57 [95% CI 0•46-0•70], p<0•0001). Increasing doses of uterine radiation and alkylating agent chemotherapy were strongly associated with infertility. Although survivors had an increased time to pregnancy compared with their siblings (p=0•032), 292 (64%) of 455 participants with self-reported clinical infertility achieved a pregnancy.
Conclusions:
A more comprehensive understanding of infertility after cancer is crucial for counselling and decision making about future conception attempts and fertility preservation.
Link to the paper on PubMed
Comment in:
 




IVF-Worldwide.com endeavors to ensure that the information in this article is accurate,reliable and up to date. However, the information is provided "as is" without warranty of any kind. IVF-Worldwide does not accept any responsibility or liability for the accuracy,content, completeness, legality, or reliability of the information contained in this article.
IVF-Worldwide.com is not responsible for the content of other websites linked to or referenced from this website. The website does not endorse the information, content,presentation or accuracy of such other websites and does not make any warranty,express or implied, regarding them.