Obstetric and offspring risks of women’s morbid conditions linked to prior anticancer treatments

Abstract

BackgroundLiterature shows the effects of type of cancer and/or anticancer treatment on live birth percentages and/or pregnancy and neonatal complications in female cancer survivors. However, studies analyzing the obstetric and offspring risks of the morbid conditions associated with previous anti-cancer treatments are missing. The present review aims to uncover these risks.MethodsA literature search based on publications up to March 2016 identified by PubMed and references cited in relevant articles.ResultsThe morbid conditions associated with prior anticancer treatments including chemotherapy, radiotherapy, surgery, and/or hematopoietic stem-cell transplant may induce not only obstetric and neonatal complications but also long-term effects on offspring. Whereas some risks are predominantly evidenced in untreated women others are observed in both treated and untreated women. These risks may be superimposed on those induced by the current women’s trend in Western societies to postpone maternity.ConclusionsMedical professionals should be aware and inform female cancer survivors wishing to have a child not only of the short- and long-term risks to themselves and their prospective offspring of previous anticancer treatments, fertility-preservation technologies, and pregnancy itself, but also of those risks linked to the morbid conditions induced by prior anticancer treatments. Once female cancer survivors wishing to have a child have been properly informed about the risks of reproduction, they will be best placed to make decisions of whether or not to have a biological or donor-conceived child. In addition, when medical professionals be aware of these risks, they will be also best placed to provide appropriate treatments before/during pregnancy in order to prevent or alleviate the impact of these morbid conditions on maternal and offspring health.

SEOM Clinical Guideline of fertility preservation and reproduction in cancer patients (2016)

“…Tarín et al [36] observed that exist different morbid conditions associated with anticancer therapies, as thyroid dysfunction, hyperprolactinemia, hyperglycemia or hypertension, may be risk factors for pregnancy or offspring.…”

Cytotoxic Activity of Antineoplastic Agents on Fertility: A Systematic Review

“…4 Because of this, the frequent rush to develop methodologies that promote improvement in the survival of these patients has made great leaps. 5 Among the currently available therapeutic modalities, we can mention chemotherapy and radiotherapy, which cause several short-term effects accompanied by more serious adverse effects, such as cardiovascular activities, worsening renal function and nephrotoxicity. [6][7][8] In view of the above, therapies that aim to improve the chances of survival of the patient may end up having a significant weight, reducing their quality of life.…”

“…[6][7][8] In view of the above, therapies that aim to improve the chances of survival of the patient may end up having a significant weight, reducing their quality of life. 5 Antineoplastic chemotherapy agents (AQAs) are characterized by the use of cytotoxic drugs individually or in combination, to act in different phases of cell division, in cells that present dysfunction in the process of growth or cell division. 9 However, in the long run, due to the lack of specificity of AQAs, they can attack normal cells that renew themselves in regular periods as germ cells, having an important weight due to the high testicular and ovarian sensitivity to these cytotoxic agents.…”

“… 4 Because of this, the frequent rush to develop methodologies that promote improvement in the survival of these patients has made great leaps. 5 …”

“… 6 7 8 In view of the above, therapies that aim to improve the chances of survival of the patient may end up having a significant weight, reducing their quality of life. 5 …”