Fertility in Female Childhood Cancer Survivors

Bruin, Marie L. De; Broeder, Eline van Dulmen‐den; Berg, Marleen H van den; Lambalk, Cornelis B.

doi:10.1159/000207613

Cited by 16 publications

(8 citation statements)

References 72 publications

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“…In addition, a significantly higher risk of a preterm delivery was found in CCSs treated with lower abdominal/pelvic radiotherapy before the age of 10 years. This is in line with previous studies indicating that radiotherapy to the uterus administered pre-pubertally is associated with a smaller uterus in adulthood, as uterine development is not completed before the onset of puberty (Bath et al 1999;Bruin et al 2009), thereby increasing the risk of delivering preterm. Finally, we found soft tissue sarcoma survivors to be at increased risk of preterm delivery.…”

Section: Discussionsupporting

confidence: 91%

Pregnancy, time to pregnancy and obstetric outcomes among female childhood cancer survivors: results of the DCOG LATER-VEVO study

Dijk

Leeuwen

Overbeek

et al. 2020

J Cancer Res Clin Oncol

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Purpose To evaluate pregnancy rates, time to pregnancy (TTP) and obstetric outcomes in female childhood cancer survivors (CCSs) and to identify specific diagnosis- and treatment-related factors associated with these outcomes. Methods The study is part of the DCOG LATER-VEVO study, a nationwide multicenter cohort study evaluating fertility among long-term Dutch female CCSs. Data were collected by questionnaire. The current study included 1095 CCSs and 812 controls, consisting of sisters of CCSs and a random sample of women from the general population. Results Among the subgroup of women who ever had the desire to become pregnant, the chance of becoming pregnant was significantly lower for CCSs than controls (OR 0.5, 95%CI 0.4–0.8). Moreover, TTP was 1.1 times longer for CCSs compared to controls (p = 0.09) and was significantly longer in survivors of CNS and renal tumours. Overall, no differences were found between CCSs and controls regarding the probability of ever having had a miscarriage, still birth, or induced abortion. However, CCSs had a significantly increased risk of delivering preterm (OR 2.2, 95%CI 1.3–3.7) and delivering via caesarean section (OR 1.8, 95%CI 1.2–2.6). Treatment with lower abdominal/pelvic radiotherapy was strongly associated with several adverse obstetric outcomes. Conclusion CCSs are less likely to have ever been pregnant. Among those who do become pregnant, certain subgroups of CCSs are at increased risk of longer TTP. Moreover, as pregnant CCSs, especially those treated with lower abdominal/pelvic radiotherapy, are more likely to develop various adverse obstetric outcomes, appropriate obstetric care is highly advocated.

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Section: Discussionsupporting

confidence: 91%

Pregnancy, time to pregnancy and obstetric outcomes among female childhood cancer survivors: results of the DCOG LATER-VEVO study

Dijk

Leeuwen

Overbeek

et al. 2020

J Cancer Res Clin Oncol

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“…Therefore, it is crucial that at the time of diagnostic workup, paediatric oncologists approach their young patients as potential long-term survivors and develop a plan that takes into account the impact of treatment on fertility without jeopardizing survival. Results of this study encourage counselling of current survivors and their families about fertility after successful treatment (Zebrack et al, 2007;De Bruin et al, 2009;Mitchell et al, 2009). …”

Section: Discussionmentioning

confidence: 77%

Life after childhood cancer: marriage and offspring in adult long-term survivors – a population-based study in the Piedmont region, Italy

Dama

Maule

Mosso

et al. 2009

European Journal of Cancer Prevention

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The majority of childhood cancer cases survive to adulthood. We describe the experience of marriage and reproduction as indicators of quality of life, in a population-based cohort of adult long-term survivors after early cancer reported to the Childhood Cancer Registry of Piedmont. The study included 1237 survivors with a malignant neoplasm diagnosed during 1967-2000 when aged 0-14 years, who attained age 18 years. Vital and marital status and number of offspring were assessed through the Vital Statistics Offices. Marriage and fertility deficits were estimated by comparison with the Piedmont population. Among the individuals included in this study, 919 (74.3%) never married and never lived as married. The marriage deficit was 32% [observed/expected 0.68; 95% confidence interval (CI): 0.55-0.83] in men and 18% (observed/expected 0.82; 95% CI: 0.68-0.98) in women. A total of 179 children were born to 120 women, with a fertility deficit of 41% (observed/expected 0.59; 95% CI: 0.51-0.69). In conclusion, the observed decrements in marriage in men and women and fertility in women suggest that efforts should be made to improve the recovery from physical and psychological traumas related to diagnosis and treatment of cancer.

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“…37 Environmental Exposure and Ovarian Aging Exogenous influences affect the rate of ovarian follicular depletion and ovarian reserve. Cigarette smoking, 38 radiation exposure, 39 low socioeconomic status, 40 extensive pelvic scarring from pelvic surgery, and chronic psychological stress 41 have all been identified as ovotoxic and associated with ovarian senescence.…”

Section: Apoptosis and Other Mechanisms That Affect Ovarian Agingmentioning

confidence: 99%

Determinants of Female Reproductive Senescence: Differential Roles for the Ovary and the Neuroendocrine Axis

Büyük¹,

Nejat²,

Neal‐Perry³

2010

Semin Reprod Med

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Aging in women is a complex process that begins with the transition into reproductive senescence and evolves to impact not just women's procreative potential but also multiple health-related parameters including longevity. Although somatic aging is an equal opportunity nemesis, certain disease states correlate highly with ovarian failure and the menopause, such as osteoporosis, diabetes, cardiovascular disease, and compromised cognitive function. Epidemiological studies suggest that a delayed natural menopause confers longevity and decelerates the appearance of many of the debilitating morbidities associated with the menopause. However, recent randomized clinical trials assessing the benefits of menopausal hormone therapy during the postmenopause clearly suggest that attenuation of the negative consequences of reproductive aging involves much more than a simple add back of ovarian steroids in the postmenopause. Conflicts between observations in epidemiological studies and in randomized clinical trials give good reason for continued innovative research focused on identifying the mechanisms that bring about the transition from peak reproductive potential to female reproductive quiescence. This article provides a brief update on our current understanding of the physiological and cellular mechanisms that precipitate and/or commit women to transit into reproductive senescence.

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Fertility in Female Childhood Cancer Survivors

Cited by 16 publications

References 72 publications

Pregnancy, time to pregnancy and obstetric outcomes among female childhood cancer survivors: results of the DCOG LATER-VEVO study

Pregnancy, time to pregnancy and obstetric outcomes among female childhood cancer survivors: results of the DCOG LATER-VEVO study

Life after childhood cancer: marriage and offspring in adult long-term survivors – a population-based study in the Piedmont region, Italy

Determinants of Female Reproductive Senescence: Differential Roles for the Ovary and the Neuroendocrine Axis

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