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Archive for the ‘Cancer’ Category

Effect on the chance of subsequent pregnancy quantified for first time

Date:July 3, 2017

Source:European Society of Human Reproduction and Embryology

For the first time, a large population study has quantified the chance of pregnancy after treatment for cancer diagnosed in girls and women aged 39 or under. This landmark study, which linked all cancers diagnosed in Scotland between 1981 and 2012 to subsequent pregnancy, found that the cancer survivors were 38% less likely to achieve a pregnancy than women in the general population. This detrimental effect on fertility was evident in almost all types of cancer diagnosed.

“This analysis provides the first robust, population-based evidence of the effect of cancer and its treatment on subsequent pregnancy across the full reproductive age range,” said presenter Professor Richard Anderson from the MRC Centre for Reproductive Health, Queen’s Medical Research Institute at the University of Edinburgh, UK.

“The major impact on pregnancy after some common cancers highlights the need for enhanced strategies to preserve fertility in girls and young women.”

Professor Anderson will present the results of the study today at the Annual Meeting of ESHRE in Geneva.

The need for better access to fertility preservation has become more pressing in recent years for two reasons: first, the improved rates of survival in young women and girls diagnosed with cancer; and second, improvements in the techniques of freezing eggs and ovarian tissue to restore fertility.

This latest study, which cross-linked 23,201 female cancer survivors from the Scottish Cancer Registry with hospital discharge records, revealed 6627 pregnancies among the cancer survivors when nearly 11,000 would have been expected in a comparable matched control group from the general population.

For women who had not been pregnant before their cancer diagnosis, 20.6% of the cancer survivors achieved a first pregnancy after diagnosis (2114 first pregnancies in 10,271 women), compared with 38.7% in the control group. Thus, women with cancer were about half as likely to achieve a first pregnancy after diagnosis as were controls.

The analysis also found that the chance of pregnancy was reduced in all age groups, with substantial variations between different cancer diagnoses — notably, reduced pregnancy rates in women with cervical cancer, breast cancer and leukemia. However, those cancers diagnosed later within the study period (2005-2012) were associated with higher rates of pregnancy than those diagnosed earlier (1981-1988), suggesting that for some cancer treatments the impact on fertility has reduced.

The diagnosis and treatment of female cancers are known to affect fertility for several reasons: some chemotherapy regimens can cause damage to the ovary, and this can occur at any age; radiotherapy can also compromise female fertility through effects on the ovary, uterus and potentially those brain centres which control the reproductive axis.

However, Professor Anderson stressed that the results of the study related only to subsequent pregnancy itself, and not to the incidence of infertility caused by cancer treatment. “Some women may have chosen not to have a pregnancy,” he explained. “Thus, while these results do show an expected reduction in the chance of pregnancy after chemotherapy and radiotherapy, having a pregnancy after cancer does involve a range of complex issues that we cannot address in this study.”

With rates of cancer survival increasing in both young male and females, fertility preservation ahead of treatment has an increasing role to play in fertility clinics. However, Professor Anderson described such services in all parts of the world, including the USA and Europe, as “very variable.” “Oocyte and embryo freezing are regarded as established,” he said, “but ovarian tissue cryopreservation is considered experimental, although it is the only option for prepubertal girls.”

He added that the results of this study would allow clinicians to advise girls and women more accurately about their future chance of pregnancy. “They emphasise the need to consider the possible effects on fertility in girls and women with a new cancer diagnosis. 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.”

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A few weeks ago, I was asked by the owners of this website to start providing content for the “Keep Women Healthy” blog.  That sounded simple enough.  Since then, I’ve written about the dangers of tanning machines, abortion and a few other items.  I’ve provided you with facts and figures in an effort to try to keep you up to date on that particular issue.

But I soon found myself getting bored as I just regurgitated a bunch of stuff I found from a variety of sources, stuff that you could no doubt find on your own if you wanted to take the time.  So, I started thinking about how I could make this blog a little different and more useful.  How can we use this page to really help “Keep Women Healthy?”

Then, this morning, over a bowl of Honey Oats cereal (one percent milk- can’t yet make the leap to skim), it hit me.  You see, my background is in political action.  I’ve worked on numerous political campaigns, served as a Legislative Aide on Capitol Hill and am a former lobbyist for a women’s reproductive rights organization.  My experience has taught me that people can influence their government (despite the protestations of the Tea Party and Sara Palin).  You can get things done if you are willing to put in the effort.

So, I’ve decided to use my expertise in political organizing to help “Keep Women Healthy.”

Every day in Washington, D.C., your government is doing something that concerns women’s health.  Or, if they are not doing anything, they could be.  I know it is impossible for you to sort out all of the issues and decide where to put your energy.  You’ve got a life.  That’s where I come in.

In the future, I will use this column to give you some simple ideas.  It may be a suggestion to contact your Member of Congress about a specific piece of legislation.  Or, I may recommend you email the White House to urge the President to take some executive action on some issue.  Maybe the FDA needs to hear from people on a new, woman-friendly drug.

I promise not to overwhelm you.  Personally, I hate it when I get a message (usually in big red letters with lots of exclamation points) from some national organization urging me to do ten things, ten very complicated things.  That just guarantees that I will not do any of them.

So, I will keep it simple.  If we are organized, we can accomplish things.

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