A large scale population study revealed that girls and women aged 39 years and younger may be up to 38% less likely to achieve pregnancy after surviving cancer vs patients who have never had cancer. The decrease in fertility was not limited to any specific type of cancer.
The study assessed 23,201 female cancer survivors between 1981 and 2012, and found that survivors had 6627 pregnancies vs the nearly 11,000 expected in the control group. For women who had their first pregnancy after diagnosis, only 20.6% achieved pregnancy vs 38.7% in women who have never had cancer.
Fertility can be affected in several ways by a diagnosis of female cancers; chemotherapy and radiotherapy can cause damage to the ovaries, uterus, and areas of the brain that impact reproduction.
The study found that while the rates of pregnancy decreased across all age groups, the pregnancy rates were elevated in women who were evaluated towards the end of the study (2005-2012) vs women whose cancers were diagnosed earlier, implying that the impact of therapy on fertility may have decreased.
The presenter of the study, Professor Richard Anderson, expressed that the findings of the study did not necessarily reflect infertility caused by cancer therapy, only subsequent pregnancy as some women may choose not to get pregnant.
There have been significant improvements in the rates of survival in young women with cancer, as well as improvement in the techniques to restore fertility. The findings of the study would assist clinicians in informing younger patients with cancer about future pregnancy.
Professor Anderson concluded by saying, “The implications of the diagnosis and planned treatment and, where appropriate, options for fertility preservation should be discussed with the patient and her family. Even for patients considered at low risk of infertility as a result of treatment, a fertility discussion is recommended before treatment begins.”
Reference
1. Female cancer survivors are one-third less likely to achieve pregnancy than women in general population [news release]. EurekAlert website. https://www.eurekalert.org/pub_releases/2017-07/esoh-fcs062817.php. Published July 3, 2017. Accessed July 5, 2017.