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Infertility risk among women cancer survivors

Monday July 15th, 2013

Women who have survived childhood cancer are almost 50% more likely to be infertile than others - but are less likely to be offered fertility treatment when compared with their sisters, researchers have found.

Even though cancer survivors were as likely as their siblings to seek infertility treatment, they were less likely to be prescribed drugs for infertility treatment, a newly published report reveals.

The investigation looked at the experiences of 3,531 women from the US and Canadian-based Childhood Cancer Survivor Study and 1,366 female sibling controls who enrolled between November 3, 1992, and April 4, 2004.

Researchers found that in women under the age of 24, infertility was nearly three times more common in the survivors than in the siblings.

The difference shrunk as women reached their early 30s, although researcher Dr Sara Barton of Brigham and Women's Hospital, Boston, Massachusetts, USA, said this could also be attributed to the fact that infertility is more common in all women at that age, not just cancer survivors.

Writing in Lancet Oncology online, Dr Barton said although women who’d had cancer took longer to become pregnant than their siblings, 64% of 455 study participants who reported clinical infertility – which is classed as failing to become pregnant within 12 months – eventually became pregnant.

“We do not have data about why providers did not prescribe infertility drugs, but are concerned about a provider bias against treating cancer survivors for infertility,” said Dr Barton.

“Perhaps providers assessed the chance of success as poor and therefore decide not to attempt therapy, or perhaps survivors were less motivated to take drugs after previous extensive treatment. Alternatively, reproductive medicine providers might have been uncomfortable with perceived medical comorbidities.

“Clinicians caring for survivors who request information about likelihood of pregnancy or success of treatment for infertility have a paucity of data on which to base their recommendations.

“To our knowledge, ours is the first large study of female childhood cancer survivors to quantify the risk of infertility that is based on a clinical definition, and characterises the use and success of infertility treatments in this setting.”

Infertility, infertility treatment, and achievement of pregnancy in female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study cohort. Lancet Oncology. 13 July 2013; doi.org/10.1016/S1470-2045(13)70251-1 [abstract]

Tags: Cancer | North America | Women’s Health & Gynaecology

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