Reproduction Rates After Cancer Treatment: Experience From the Norwegian Radium Hospital

Cvancarova, Milada; Samuelsen, Sven Ove; Magelssen, Henriette; Fosså, Sophie D.

doi:10.1200/jco.2007.15.3130

Cited by 93 publications

(72 citation statements)

References 54 publications

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“…Furthermore, their concerns extend beyond biological fertility potential to include concerns about recurrence, living long enough to raise children, and the health of their (potential) children [8][9][10][11][19][20][21][22]. Biological parenthood is less likely among cancer survivors than in the general population [23][24][25][26][27]; the 10-year postdiagnosis pregnancy rate for females diagnosed between 15 and 44 has been observed to be half of that expected [26]. This may be indicative of lower fertility rates as well as psychological, social/cultural, medical, and economic barriers to parenthood occurring later in the course of survivorship [14,20,25,28].…”

Section: Introductionmentioning

confidence: 99%

A multidimensional scale to measure the reproductive concerns of young adult female cancer survivors

Gorman¹,

Su²,

Roberts³

et al. 2013

PsycEXTRA Dataset

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Purpose-Concerns about fertility and parenthood are important to many young adult (YA) female cancer survivors and are associated with poorer quality of life. We aimed to develop a new scale to comprehensively measure these concerns so that they can be better addressed.Methods-Scale development involved: 1) seven focus groups to identify reproductive concerns among YA female cancer survivors and develop potential scale items followed by pilot testing and cognitive interviews to refine items, 2) administering surveys to 204 YA female survivors and conducting principal components analysis (PCA) with oblique rotation to identify underlying factors in the multidimensional scale, and 3) identification of preliminary construct validity evidence.Results-We subjected 37 potential scale items to PCA, which indicated a six-factor solution. After removing low-loading and cross-loading items, we selected the three top loading items representing each factor. The 18-item Reproductive Concerns After Cancer (RCAC) scale (α = 0.82) assesses concerns about fertility potential, partner disclosure, child's health, personal health, acceptance, and becoming pregnant. As hypothesized, women who wanted to have a baby (p < 0.001) and those for whom having a biological child was very important (p < 0.05) had higher mean scores, indicating higher concerns.Conclusions-The scale demonstrated good internal consistency and evidence of construct validity and holds promise for future clinical and research applications.Implications for Cancer Survivors-An effective tool to identify concerns related to fertility and parenthood is essential for meeting the long-term reproductive health needs of young women who have survived cancer.

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Section: Introductionmentioning

confidence: 99%

A multidimensional scale to measure the reproductive concerns of young adult female cancer survivors

Gorman¹,

Su²,

Roberts³

et al. 2013

PsycEXTRA Dataset

View full text Add to dashboard Cite

show abstract

“…However, hormone stimulation requires a delay in cancer treatment, may be contraindicated in patients with hormone-sensitive malignancies, and is not an option for prepubertal girls. As the number of young cancer survivors continues to increase [6,7], there is a need for fertility preservation options that do not require hormonal stimulation. Retrieval of immature oocytes followed by in vitro maturation (IVM) is suggested as an additional strategy for fertility preservation [8,9].…”

Section: Introductionmentioning

confidence: 99%

In Vitro Oocyte Maturation and Preantral Follicle Culture from the Luteal-Phase Baboon Ovary Produce Mature Oocytes

Fazleabas

Shikanov

et al. 2010

Biology of Reproduction

106

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Female cancer patients who seek fertility preservation but cannot undergo ovarian stimulation and embryo preservation may consider 1) retrieval of immature oocytes followed by in vitro maturation (IVM) or 2) ovarian tissue cryopreservation followed by transplantation or in vitro follicle culture. Conventional IVM is carried out during the follicular phase of menstrual cycle. There is limited evidence demonstrating that immature oocyte retrieved during the luteal phase can mature in vitro and be fertilized to produce viable embryos. While in vitro follicle culture is successful in rodents, its application in nonhuman primates has made limited progress. The objective of this study was to investigate the competence of immature luteal-phase oocytes from baboon and to determine the effect of folliclestimulating hormone (FSH) on baboon preantral follicle culture and oocyte maturation in vitro. Oocytes from small antral follicle cumulus-oocyte complexes (COCs) with multiple cumulus layers (42%) were more likely to resume meiosis and progress to metaphase II (MII) than oocytes with a single layer of cumulus cells or less (23% vs. 3%, respectively). Twenty-four percent of mature oocytes were successfully fertilized by intracytoplasmic sperm injection, and 25% of these developed to morula-stage embryos. Preantral follicles were encapsulated in fibrin-alginate-matrigel matrices and cultured to small antral stage in an FSH-independent manner. FSH negatively impacted follicle health by disrupting the integrity of oocyte and cumulus cells contact. Follicles grown in the absence of FSH produced MII oocytes with normal spindle structure. In conclusion, baboon luteal-phase COCs and oocytes from cultured preantral follicles can be matured in vitro. Oocyte meiotic competence correlated positively with the number of cumulus cell layers.This study clarifies the parameters of the follicle culture system in nonhuman primates and provides foundational data for future clinical development as a fertility preservation option for women with cancer.

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“…Becoming pregnant after a diagnosis of breast cancer does not appear to result in worse outcomes in case-control studies or cohort studies (4,5,7,8). In fact, in several series, pregnancy after a diagnosis of breast cancer appeared to result in a reduced risk of relapse (7)(8)(9), particularly for women who waited for 2 years after diagnosis to conceive (9).…”

Section: Will Pregnancy After a Breast Cancer Diagnosis Increase The mentioning

confidence: 99%

“…; [3] what is the chance that adjuvant therapy will result in loss of fertility and how can this risk be minimized? ; [4] will any of the fertility preservation procedures or pregnancy result in higher risk of relapse; and [5] what are the fertility preservation options and how would they be inserted into the breast cancer treatment plan?…”

mentioning

confidence: 99%

Breast cancer and fertility preservation

Fabian¹,

Klemp²

2011

Principles and Practice of Fertility Preservation

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Objective-To review the benefits of adjuvant systemic therapy given to women with breast cancer of reproductive age, its effects on fertility, and options for fertility preservation.Design-Publications relevant to fertility preservation and breast cancer were identified through a PubMed database search. Conclusion(s)-Mostwomen who develop invasive breast cancer under age 40 will be advised to undergo adjuvant chemotherapy with or without extended antihormonal therapy to reduce the risk of recurrence and death from breast cancer. Adjuvant chemotherapy particularly with alkylating agents such as cyclophosphamide is gonadotoxic and markedly accelerates the rate of age-related ovarian follicle loss. Although loss of fertility is an important issue for young cancer survivors, there is often little discussion about fertility preservation before initiation of adjuvant therapy. Greater familiarity with prognosis and effects of different types of adjuvant therapy on the part of infertility specialists and fertility preservation options such cryopreservation of embryos, oocytes, and ovarian tissue on the part of oncologists would facilitate these discussions. Establishment of rapid fertility consultation links within cancer survivorship programs can help ensure that every young woman who is likely to undergo gonadotoxic cancer treatment is counseled about the effects of therapy and options available to her to increase the likelihood of childbearing after cancer treatment. KeywordsBreast cancer; fertility preservation; embryo cryopreservation; oocyte cryopreservation; ovarian tissue cryopreservation; ovarian transplantation; GnRH agonist; chemotherapy; cancer survivorshipIn the United States, 5%-7% of cases of invasive breast cancer (~11,000/year) occur in women who are under age 40 at diagnosis (www.seer.cancer.gov.2008), most between the ages of 30 and 40 (1). As almost one quarter of first live births in the United States occur between the ages of 30 and 40, many of these women will not have had the opportunity to bear a child (2). Less than 10% of women who develop invasive breast cancer under age 40 have children postdiagnosis (3-5), despite survey results suggesting about half desire to do so (6) and observational studies that do not indicate an increased risk of relapse or death for women who become pregnant after a breast cancer diagnosis (7-9). Receipt of cytotoxic chemotherapy is a major factor in the low rate of live births after a diagnosis of breast

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Reproduction Rates After Cancer Treatment: Experience From the Norwegian Radium Hospital

Cited by 93 publications

References 54 publications

A multidimensional scale to measure the reproductive concerns of young adult female cancer survivors

A multidimensional scale to measure the reproductive concerns of young adult female cancer survivors

In Vitro Oocyte Maturation and Preantral Follicle Culture from the Luteal-Phase Baboon Ovary Produce Mature Oocytes

Breast cancer and fertility preservation

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