Age at menopause and its influencing factors in a cohort of survivors of childhood cancer: earlier but rarely premature

Thomas‐Teinturier, Cécile; Fayech, Chiraz; Oberlin, Odile; Pacquement, Hélène; Haddy, Nadia; Labbé, Martine; Veres, Cristina; Guibout, Catherine; Diallo, Ibrahima; Vathaire, Florent de

doi:10.1093/humrep/des391

Cited by 77 publications

(64 citation statements)

References 22 publications

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“…Thus, compensatory mechanisms may occur in the remaining ovary . In a study of childhood cancer survivors with mean age of diagnosis of 5 years old, Thomas‐Teinturier and colleagues found that those with unilateral oophorectomy experienced menopause seven years earlier than those without . The more pronounced effect in younger women, seven years versus one year earlier menopause, corroborates well with our results, as women treated with unilateral oophorectomy at younger ages in our study are more likely to enter menopause earlier.…”

Section: Discussionsupporting

confidence: 90%

Fertility Sparing Surgery for Localized Ovarian Cancers Maintains an Ability to Conceive, but is Associated With Diminished Reproductive Potential

et al. 2015

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Section: Discussionsupporting

confidence: 90%

Fertility Sparing Surgery for Localized Ovarian Cancers Maintains an Ability to Conceive, but is Associated With Diminished Reproductive Potential

et al. 2015

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“…Several studies suggest that women who receive certain types of chemotherapy such as alkylating agents, those older than 40 years, and those treated with Tamoxifen are more likely to experience amenorrhea and earlier menopause (18, 19). These studies have mostly focused on breast cancer survivors with relatively short follow-up times after cancer diagnosis (median=3.1 years).…”

Section: Introductionmentioning

confidence: 99%

Menses resumption after cancer treatment–induced amenorrhea occurs early or not at all

Jacobson

Mertens

Spencer

et al. 2016

Fertility and Sterility

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Objective To identify factors associated with cancer treatment-induced amenorrhea and time to return of menses. Design Population-based cohort study Setting Georgia Patients Female cancer survivors who were diagnosed with cancer between the ages of 20–35 and were at least 2 years post-diagnosis at the time of recruitment (median=7 years, interquartile range= 5–11). Intervention(s) None Main Outcome Measure(s) Amenorrhea (≥ 6 months without menses) and resumption of menses. Results After excluding women with hysterectomies prior to cancer diagnosis, 1,043 women were eligible for analysis. Amenorrhea occurred in 31.6% of women. Among women treated with chemotherapy (n=596), older age at diagnosis (30–35 versus 20–24 years: adjusted odds ratio (aOR)=2.37, 95% confidence interval (CI): 1.30, 4.30) and nulligravidity (versus gravid: aOR=1.50, 95% CI: 1.02, 2.21) were risk factors for amenorrhea. Among amenorrheic women, menses resumed in most (70.0%), and resumption occurred within 2 years of treatment for 90.0% of women. Survivors of breast cancer were more likely resume menses at times greater than one year compared with lymphoma and pelvic-area cancers. Women diagnosed at older ages, those exposed to chemotherapy, and those exposed to any radiation experienced longer times to return of menses. Women who were older at diagnosis were more likely to have irregular cycles when menses returned. Conclusion Treatment-induced amenorrhea is common in cancer survivors although most women resume menses within 2 years. However, once resumed, older women are more likely to have irregular cycles. Age at diagnosis and pregnancy history affect the risk of amenorrhea.

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“…There was 1 study which described the effect of radiation therapy in preterm birth [19], the RR of preterm birth was 1.83 (95 % CI was 1.37-2.46). Because of the limitation of the studies, the meta-analysis for these factors could not be proceeded.…”

Section: Resultsmentioning

confidence: 99%

Exposure to radiation therapy is associated with female reproductive health among childhood cancer survivors: a meta-analysis study

Gao

Liang

Qiu

2015

J Assist Reprod Genet

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Background and aims Many epidemiological studies have revealed a positive correlation between medical radiation exposure and the reproductive health in female childhood cancer survivors. However, because of variations in the samples size, such studies showed partly inconsistent conclusions. The aim of this meta-analysis was to clarify the association between radiotherapy and the risk of reproductive health impairment for female who survived from childhood cancer. Methods Fourteen cohort studies involving childhood radiotherapy were selected as the exposure of interest and the impaired reproductive health condition during the childbearing age as the outcome. Among meta-analysis of observational studies found in Pubmed and Embase from 1900 to 2014, we evaluated those relevant observational studies which surveyed the association of medical radiation and reproductive health in female childhood cancer survivors. Review Manager 5.2 and STATA 12.0 software were used to perform the metaanalysis. Study-specific estimations for each outcome were combined into a pooled relative risk (RR) with 95 % confidence interval (CI) by a meta-analytic approach.Results Based on a random-effects meta-analysis, significant association between infertility (RR=1.28, 95 % CI=1.16-1.42), acute ovarian failure (AOF) (RR=9.51, 95 % CI=5.03-17.96), low level of anti mullerian hormone (AMH) (<1 ng/mL) (RR=14.79, 95 % CI=3.36-66.64), stillbirth (RR=1.19, 95 % CI=1.02-1.39) and low birth weight (RR=2.22, 95 % CI= 1.55-3.17) were identified. Conversely, no significant results were found in abortion and congenital malformations. Conclusions To the best of our knowledge, this is the first meta-analysis assessing the effect of medical radiation on female childhood cancer survivors' reproductive capability and pregnancy outcomes. Although there were some limitations, our meta-analysis further supported that radiotherapy was a risk factor for reproductive health problems of female who survived from childhood cancer.

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Age at menopause and its influencing factors in a cohort of survivors of childhood cancer: earlier but rarely premature

Cited by 77 publications

References 22 publications

Fertility Sparing Surgery for Localized Ovarian Cancers Maintains an Ability to Conceive, but is Associated With Diminished Reproductive Potential

Fertility Sparing Surgery for Localized Ovarian Cancers Maintains an Ability to Conceive, but is Associated With Diminished Reproductive Potential

Menses resumption after cancer treatment–induced amenorrhea occurs early or not at all

Exposure to radiation therapy is associated with female reproductive health among childhood cancer survivors: a meta-analysis study

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