Hope for Cancer Survivors to Conceive

Childhood cancer survivors can still get pregnant

(RxWiki News) Women who are cancer survivors may worry about their ability to get pregnant. While new research suggests that getting pregnant may not be an issue for many of these women, it is still important that they discuss family planning with their doctor, who can help make the process easier.

A recent study found that women who beat cancer in their childhood can still get pregnant, but it might take them longer.

This study showed that the chances of a cancer survivor getting pregnant depended on the type of cancer, as well as the cancer treatment she received.

According to the researchers, cancer survivors should discuss pregnancy with a doctor who specializes in fertility.

"Talk to your OB/GYN when planning to start a family."

For this study, Sara Barton, MD, led a team of researchers from Dana-Farber/Boston Children's Cancer and Blood Disorders Center and Brigham and Women's Hospital to find out whether childhood cancer and cancer treatments caused infertility (inability to get pregnant) in women.

These researchers used data from the Childhood Cancer Survivor Study (CCSS), which was conducted at 26 institutions in the US and Canada. The women in this study had been diagnosed with cancer between January 1, 1970 and December 31, 1986, before they turned 21.

These cancer survivors were compared with their sisters who had not had cancer. Both groups of women were sexually active and between 18 and 39 years old. The study had a total of 3,531 female survivors who were compared to 1,366 sisters with no cancer history.

The study looked at two types of infertility: clinical infertility and total infertility.

Clinical infertility was defined as trying unsuccessfully to become pregnant for one year or longer. Total infertility was defined as missing menstrual periods for the previous five years or longer.

Both groups of women answered questions between 1992 and 2004 about their ability to get pregnant. They were also asked if they had had medical treatments to get pregnant, and how long it took to get pregnant the first time.

The researchers used this information to determine the risk of infertility in women who had survived cancer. The researchers also compared specific types of cancer and cancer treatments to see if they impacted the women's ability to get pregnant.

The results were sorted by age, race, education, marital status, smoking status and body mass index (BMI), which estimates percentage of body fat.

This study found that women who were childhood cancer survivors were about 50 percent more likely to suffer both clinical infertility and total infertility.

Cancer survivors were no more likely to have seen a fertility doctor than the other group of women. Futhermore, the study found that cancer survivors were less likely to receive medical treatment to increase fertility.

Infertility was more common in women who had cancer at an older age than those who had cancer very young.

Lymphoma and radiotherapy also appeared to increase the risk that women would have trouble getting pregnant.

Cancer survivors, and especially survivors that received radiotherapy, took longer to get pregnant than the women who had never had cancer. However, two-thirds of the cancer survivors who had reported infertility eventually became pregnant.

The researchers found that survivors who had been treated with alkylating agent chemotherapy or high-dose radiation to the abdomen or pelvis had the highest rates of infertility.

Dr. Barton stated that knowing how cancer treatments affect a patient’s ability to get pregnant will help doctors know whether it's necessary to spend the time and money to preserve eggs.

The researchers noted that none of the women studied were ovarian cancer survivors. If women who had survived ovarian cancer were included, the infertility rates would have most likely been higher. Additionally, the women in the study were young and the cancer survivors had lower marriage rates than the non-cancer group. It is possible that because these women had not tried to get pregnant, the study underestimated infertility.

It is also worth noting that many of the women in this study were asked about their attempts to get pregnant prior to 1992, before improvements to in vitro fertilization had been made. They may be more successful trying to get pregnant after that time.

Lisa Diller, MD, the senior author on this study, stated that childhood cancer survivors have a good chance of getting pregnant, but also noted, "...It might be important to see an expert sooner rather than later if a desired pregnancy doesn’t happen within the first six months."

This study was published July 13 in The Lancet.

The study was funded by the National Cancer Institute, American Lebanese Syrian Associated Charities and Swim Across America, Inc. The authors disclosed no conflicts of interest.

Review Date: 
July 16, 2013