Infertility, infertility treatment, and achievement of pregnancy in female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study cohort
Sara E. Barton,Julie Najita,Elizabeth S. Ginsburg,Wendy M. Leisenring,Marilyn Stovall,Rita E. Weathers,Charles A. Sklar,Leslie L. Robison,Lisa Diller,Lisa Diller +9 more
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TLDR
Although survivors had an increased time to pregnancy compared with their siblings, 292 of 455 participants with self-reported clinical infertility achieved a pregnancy, and increasing doses of uterine radiation and alkylating agent chemotherapy were strongly associated with infertility.Abstract:
Summary 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. Findings 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 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 Interpretation A more comprehensive understanding of infertility after cancer is crucial for counselling and decision making about future conception attempts and fertility preservation. Funding National Cancer Institute, American Lebanese Syrian Associated Charities, Swim Across America.read more
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Fertility preservation in the age of assisted reproductive technologies.
Paul R. Brezina,Paul R. Brezina,William H. Kutteh,A.P. Bailey,Jianchi Ding,Raymond W. Ke,James L. Klosky +6 more
TL;DR: An overview of the state of the art within fertility preservation including surgical and medical interventions and therapies that necessitate the need for cryopreservation of eggs, sperm, and embryos is offered.
Journal ArticleDOI
Reproductive intentions and use of reproductive health care among female survivors of childhood cancer.
M. van Dijk,M. van den Berg,A. Overbeek,C.B. Lambalk,M.M. van den Heuvel-Eibrink,Wim J. E. Tissing,Leontien C. M. Kremer,H. J. H. van der Pal,Jacqueline J. Loonen,Birgitta Versluys,Dorine Bresters,Gertjan J.L. Kaspers,F.E. van Leeuwen,E. van Dulmen-den Broeder +13 more
TL;DR: No difference was found in the desire to have children between female childhood cancer survivors (CCSs) and controls, whereas CCSs consult a fertility specialist more often, at a younger age, and sooner after their first attempt at conceiving.
Journal ArticleDOI
Adoption and cancer survivors: Findings from a learning activity for oncology nurses.
TL;DR: The results of a learning activity are described in which nurses contacted an adoption agency to learn more about the process for survivors with the goal of helping nurses provide patients with accurate information for making a well‐informed decision regarding adoption.
Journal ArticleDOI
Gonadal Function and Fertility Among Survivors of Childhood Cancer.
Zoltan Antal,Charles A. Sklar +1 more
TL;DR: Identifying risk factors that decrease fertility is essential in proper counseling and timely referral for interventions that may allow for future fertility in high-risk populations.
Journal ArticleDOI
A pilot study about female adolescent/young childhood cancer survivors' knowledge about reproductive health and their views about consultation with a fertility specialist
J. Kim,J.E. Mersereau +1 more
TL;DR: A limited number of CCSs took advantage of RC in spite of their high interest in and limited knowledge about reproductive issues, and targeted referrals for RC may allow for improved decision making about reproductive options.
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TL;DR: The findings suggest that cryopreservation of ovarian tissue should be offered to all young women diagnosed with cancer and a livebirth after orthotopic autotransplantation of Cryopreserved ovarian tissue is described.
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