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Study finds strong pregnancy outcomes for survivors of childhood cancer
Date:7/12/2013

n the large-scale survivor study.

"This is the first study to examine direct questions about infertility and the use of infertility services," said lead author Sara Barton, MD, a clinical fellow of reproduction and infertility at Brigham and Women's Hospital at the time of the research. "Previous studies used surrogate markers. Parenthood. Pregnancy. Births. These don't take into account people's intent. They don't take into account how long it took to achieve pregnancy."

Among survivors of childhood cancer who had been trying unsuccessfully to get pregnant for at least a year, 64 percent conceived after, on average, another six months, compared with an average of five months for clinically infertile women in the control group who eventually conceived.

Women whose cancer was treated with alkylating agent chemotherapy or high-dose radiation to the abdomen or pelvis were most at risk of infertility. Although pediatric oncologists have changed a number of treatment protocols over the last several decades to reduce late effects, alkylating agents and radiation continue to be used.

"Women getting alkylating agents or radiation to the pelvis or abdomen should be triaged for fertility preservation. In addition to being at highest risk to report infertility, female cancer survivors who received those cancer therapies were the least likely to conceive once they had infertility," said Barton, who is now a staff physician at the Heartland Center for Reproductive Medicine and clinical professor at the University of Nebraska Medical School. The new research, she added, will help clinicians offer guidance to current patients based on the treatment protocol for their cancer. "If you're newly diagnosed with Hodgkin's lymphoma, for instance, you may be slightly more likely to experience infertility, but I don't necessarily think you need to delay your therapy to freeze your eggs."

The researchers also found that only 42 percent of cancer
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Contact: Irene Sege
irene.sege@childrens.harvard.edu
617-919-7379
Dana-Farber Cancer Institute
Source:Eurekalert

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